Literature Review

Homebound seniors living alone often slip through health system’s cracks KFF Health News; by Judith Graham; 12/2/24 Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern. “What’s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’s Visiting Doctors Program. “I don’t know,” she answered, so softly it was hard to hear. “Going from here to the bathroom or the door, I get really winded. I don’t know when it’s going to be my last breath.” Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’s fallen several times and dropped to 85 pounds, a dangerously low weight. And she lives alone, without any help — a highly perilous situation. Across the country, about 2 million adults 65 and older are completely or mostly homebound, while an additional 5.5 million seniors can get out only with significant difficulty or assistance. ... It’s a population whose numbers far exceed those living in nursing homes — about 1.2 million — and yet it receives much less attention from policymakers, legislators, and academics who study aging.

Big Bend Hospice’s promise to North Florida [New parent company, Seven Oaks Health] Tallahassee Democrat; by Bill Wertman, "Your Turn"; 11/29/24 As CEO of Big Bend Hospice, I see every day how vital our mission focused hospice care is to families across North Florida. Yet, in today’s healthcare landscape, nonprofit hospices like ours are increasingly rare. Only about 30% of hospices nationwide operate as nonprofits (CDC, 2020), and for-profit hospices have made up nearly all new providers in recent years (Hospice News, 2022). These changes mean that the type of personalized, community-centered care that Big Bend Hospice provides is at risk of disappearing. In 2024 alone, 12 hospice acquisitions took place, with about half involving nonprofit organizations (Hospice News, 2024). This trend is forcing many nonprofits to either consolidate or scale back services. For Big Bend Hospice, the choice was clear: expand our offerings to meet more in-home healthcare needs, while keeping compassion and family-centered care at the forefront. To accomplish this, we established Seven Oaks Health, our new parent company. With Seven Oaks Health, we’re creating a sustainable model that enables us to support families from diagnosis through end-of-life, especially in the rural areas we’ve served for over 40 years. By broadening our services, we’re ensuring that more families have access to high-quality care wherever they call home.

Aged care nursing in the digital future Atlassian Jira, Australia; by Flinders University; 11/27/24 The results call for nurses to be included when digital innovations are in development, so they can actively shape their implementation and ensure high-quality, compassionate care for residents in their final stages of life. "In Australia and around the world, we have seen a significant increase in digital technologies in the health care sector," says study lead author Dr. Priyanka Vandersman, a Senior Research Fellow at Flinders University's Research Center for Palliative Care, Death and Dying (RePaDD).  "In aged care, these digital approaches can include helping with care planning and assisting with managing medication, but we need to ensure that nurses are equipped with the digital skills needed to use these tools effectively, while continuing to provide high quality, person-centered care."

Addus taking a cautious approach to hospice deals Hospice News; by Jim Parker; 11/22/24 Valuations in the hospice space have led Addus Homecare (Nasdaq: ADUS) to take a more conservative approach to hospice transactions as it actively seeks home health and personal care deals. Hospice multiples reach record highs in 2020 and 2021, as much as 26x. Since then the price tags have reportedly come down, but they haven’t gone far enough, according to Addus President and COO Brad Bickham. The company also seeks to bulk up its home health business relative to the scale of its hospice operations. “First and foremost is the pricing aspect of it. But secondly, it’s probably sequencing to a certain extent,” Bickham said during the Stephens Annual Investment Conference. “Our hospice platform is certainly significantly larger than our home health platform. We have found that home health does a good job of feeding hospice in the markets where we do have that overlap. It’d be good to essentially catch up our home and health platform at the hospice side, and certainly it’s a cheaper valuation.”

National Alliance for Care at Home lays out 2024, 2025 priorities HomeCare, Washington, DC; 11/21/24 As 2024 starts to wind down and a new administration and Congress begins to take over in Washington, home health advocates are focused on two primary priorities: reversing planned reimbursement cuts for home health and reforming plans that target underperforming hospices. As Americans gather for Thanksgiving, “these are major family issues and also major national public policy issues of the highest level of strategic importance for our country,” said Dr. Steve Landers, CEO of the National Alliance for Care at Home, the organization formed by the recent merger of the National Association for Homecare and Hopsice and the National Hospice and Palliative Care Organization. “We’re not done with 2024 yet,” Landers said Thursday, Nov. 21. “We’ve got a lot that we want to accomplish right now, this year—and we’re looking to the future.” The number one priority, he said, is for Congress to intervene and stop home health payment cuts as outlined in a final rule from the Centers for Medicare and Medicaid Services (CMS). He said that the cuts would impact patient outcomes, reduce visits and hurt providers—and that they were implemented based on a Congressional mandate saying CMS should support home health.

The Alliance applauds Gerald’s Law passing through Congress National Alliance for Care at Home (the Alliance; formerly NAHC and NHPCO); Press Release; 11/19/24 The National Alliance for Care at Home (the Alliance) celebrates the historic passage of H.R. 8371, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act in the U.S. House of Representatives last night with a bipartisan vote of 389-9. This landmark legislation includes Section 301, Gerald’s Law, which addresses a critical gap in benefits impacting seriously-ill veterans and their families receiving hospice care. The story of Gerald “Jerry” Elliott, a U.S. Army veteran, underscores the importance of this legislative achievement. Diagnosed with cancer, Jerry was admitted to his local Veterans Affairs (VA) hospital in 2019 before transitioning to VA hospice care at home to be surrounded by his family. After his passing, his family discovered they were ineligible for full burial and funeral financial support because Jerry died outside of a VA facility.

Owatonna MN Hospice Care Program by Freedom Home Care updated and relaunched Freedom Home Care, Owatonna, MN; 11/15/24 Freedom Home Care announced the relaunch of its enhanced Hospice Care Supplement Program, designed to provide support for families and their loved ones receiving hospice care. The program addresses critical gaps by offering additional assistance with daily household tasks, personal care, family respite, overnight caregiving and 24 hour care.  ... The Hospice Care Supplement program is designed to complement the essential medical and emotional care provided by hospice teams, creating a holistic approach that prioritizes both the patient’s and the family’s well-being.

Grant helps launch paramedicine program for patients in need Westfair Business Journal, Sleepy Hollow, NY; by Westfair Online; 11/15/24 Northwell Phelps Hospital received a $125,000 grant from the Phelps Community Foundation to help launch the Westchester Community Paramedicine Program. ... They will utilize remote physiological monitoring to track blood pressure, oxygen saturation and cardiac rhythms, providing convenient and cost-effective care compared to emergency room visits. “This program is designed to address the gap in access to primary and nonemergency medical care for vulnerable populations,” said Barry Geller, M.D., chair of the emergency department and associate medical director at Phelps Hospital. ...  The initiative will first focus on patients served by Phelps’ palliative care, geriatric and emergency medicine programs with plans to expand service to cancer patients. It is expected to reach approximately 200 individuals during the first year, ...

Beacon Hill resident contributes to success of VNA Care’s annual Gala Patch, Beacon Hill, MA; by Deborah Corkum; 11/14/24 Sold-out Heroes in Health Care raised essential funds for home health and hospice care. VNA Care, the first organized visiting nurse association in the United States, raised $220,000 for patient care services during the sold-out annual Heroes in Health Care Gala at the Mandarin Oriental, Boston. Heroes in Health Care is VNA Care’s signature fundraising event and has raised nearly $4.5 million in essential funding for home health and hospice care in Massachusetts. 

Meals on Wheels substantially reduces risk of senior hospitalizations: report McKnights Home Care; by Adam Healy; 11/8/24 Home-delivered nutritious foods programs can help keep seniors out of the hospital and reduce their feelings of social isolation, according to a new report by Meals on Wheels and home care technology firm WellSky. The report examined how Meals on Wheels programs helped seniors recover after being discharged from a hospital stay. Each meal delivery also involved a social determinants of health assessment, which allowed Meals on Wheels staff to engage with participants and gauge their wellness and safety. After 30 days of the program, the researchers observed an 85% decrease in hospitalizations among participants. Approximately 98% of meal recipients said that Meals on Wheels helped their recovery, and 61% said it lowered their feelings of social isolation.Editor's note: While we know hospice patients experience a significant decline in appetite, the person's changing needs for nutrition continue. Pair this data with several recent articles we've posted regarding seniors' struggles compounded by living alone, isolation, and depression. We invite you to explore this educational/support video for caregivers/families of persons experiencing serious illness, palliative, or hospice care: Small Words - Big Meanings: EAT. Disclosure: Composing Life Out of Loss is a sponsor of our newsletter.

‘Everything is lining up’: Home-based care M&A expected to soar in near-term future Home Health News; by Audrie Martin; 11/11/24 Home health, home care and hospice M&A was historically high in 2021, with high valuations serving sellers and solid return on investment serving buyers. Transactions plummeted after that, but recent signs suggest M&A is beginning to pick back up across sectors. ... Sellers should expect questions about employee retention, the company’s track record of growth after M&A and whether their leadership has done due diligence before entering the race. ... Experts predict that large, founder-led home health and hospice businesses will be in high demand in the coming year. Larger home care companies, especially those that are Medicaid-funded, will also be in demand. 

Homecare owner allegedly withholds $86k in wages HomeCare, Indianapolis, IN; 11/11/24 The U.S. Department of Labor (DOL) has alleged that home health care company owner Hahn March violated federal wage laws and withheld $86,000 in wages by using improper pay practices at her two Indianapolis, Indiana, companies: Signal Health Group Inc. and SHG Employee Leasing Company. In 2018, federal investigators cited March for not paying overtime wages to employees at her then-owned company, Aging and Disabled Home Healthcare. ... The complaint was filed following an investigation by the DOL Wage and Hour Division, which discovered March and Nancy Stanley, the chief financial officer of both companies, used an artificial regular rate pay scheme to lower hourly pay rates and, in turn, shortchanged employees $86,427 in overtime wages. ... The DOL is seeking $172,854—including $86,427 in back wages and an equal amount in liquated damages—for 43 current and former employees. ... “Employees who work in home health care—one of our nation’s lowest-paying professions—provide necessary daily and hospice care that allow individuals to remain in their homes and aid them in navigating their basic needs, providing dignity and comfort to clients and their families,” said Aaron Loomis, Wage and Hour Division district director.

Sioux City’s first Caregiver Olympics celebrates home care KCAU Sioux City; by Alyssa Tatsch; 11/7/24 November is National Care at Home Month, and to celebrate, several local healthcare organizations came together to participate in Sioux City’s first Caregiver Olympics. “I was watching the Olympics this summer and I was thinking of something fun to do with our caregiving team,” Visiting Angels owner and director Kristen Hammerstrom said. “Then I was at a meeting with some of the other [home care organizations] and I floated the idea to them and they said ‘that would be awesome.’” In honor of National Hospice and Palliative Care month, nine Sioux City caregiving teams went head-to-head competing in a relay race with specialized in-home care tasks. ... “As much as it is difficult to be a caregiver, it is also difficult for these employees too to help and take care of families, so this is just our light heartfelt fun moment to help people,” Hospice of Siouxland marketing & fund director Kim Wilson said. Despite the friendly competitive atmosphere, all nine teams shared one common goal. “While we might be competitors, at the end of the day our main goal is to care for patients and make sure that our patients and their loved ones are taken care of. That is our main goal,” Wilson said.