Literature Review

Retiring NAHC President Bill Dombi exhorts advocates to keep fighting HomeCare; 10/22/24 The departing leader shares his vision for the future of home health & hospice at his final conference. Bill Dombi met his first bully in kindergarten. It only took a day for him to fight back, leaving the bully with a bloody nose and Dombi punished in a corner, the retiring president emeritus of the National Association for Homecare and Hospice (NAHC) said as he bid farewell on the last day of the organization’s annual conference in Tampa, Florida. "I was smiling the entire time—and learning that’s not the way to do it," Dombi told the crowd during his last moments on the convention stage. "You’ve got to go to law school instead." Dombi is retiring at the end of the year and was celebrated throughout this year's event, which was launched under the NAHC title, but actually took place as the National Alliance for Care at Home Home Care and Hospice Conference and Expo after NAHC and the National Hospice and Palliative Care Organization (NHPCO) merged in July. [Click on the title's link to continue reading.]

Enhabit Home Health & Hospice Becomes Age-Friendly Health Systems participant HomeCare, Dallas, TX; 10/21/24 Enhabit Inc., a home health and hospice provider, announced it has been recognized by the Institute for Healthcare Improvement (IHI) as an Age-Friendly Health Systems participant. The Age-Friendly Health Systems is an initiative of the John A. Hartford Foundation and the IHI, in partnership with the American Hospital Association and the Catholic Health Association of the United States. The Age-Friendly Health Systems aims to follow a set of evidence-based practices, cause no harm and align with what matters to the older adult and their family caregivers. Age-Friendly Health Systems participants are recognized for aiming to become an Age-Friendly Health System and have submitted examples of how they put four elements of care—the “4Ms”—into practice with older patients. ...

The powerful companies driving local drugstores out of business DNYUZ; 10/19/24 The small-town drugstore closed for the last time on a clear and chilly afternoon in February. Jon Jacobs, who owned Yough Valley Pharmacy, hugged his employees goodbye. He cleared the shelves and packed pill bottles into plastic bins. Mr. Jacobs, a 70-year-old pharmacist, had spent more than half his life building his drugstore into a bedrock of Confluence, Pa., a rural community of roughly 1,000 people. Now the town was losing its only health care provider. Obscure but powerful health care middlemen — companies known as pharmacy benefit managers, or P.B.M.s — had destroyed his business. This has been happening all over the country, a New York Times investigation found. P.B.M.s, which employers and government programs hire to oversee prescription drug benefits, have been systematically underpaying small pharmacies, helping to drive hundreds out of business.

Aging Mastery: 10 weeks, 10 topics to empower seniors for healthy living New Hampshire Union Leaders; by Kathleen D. Bailey; 10/20/24 Jen Brechtel, director of Community Health for the Granite VNA, said one of the biggest issues in the agency’s “Aging Mastery” program” is sleep. “It’s the topic people come in most for,” she said. “We partner with a sleep center to help them out. Another big one? Community engagement.” The Granite VNA and Hospice is interested in all factors affecting their senior clients. With a menu of data-driven programs, the agency is reaching out to help seniors master aging. The “Aging Mastery” program is a project of the National Council on Aging, according to Brechtel. ... The 10-week class, ongoing now in Sanbornton, has sessions devoted to the concepts that please (or plague) elders: navigating longer lives, exercise, sleep, healthy eating/hydration, financial fitness, advance planning, healthy relationships, medication management, community engagement and falls. Experts from the community take turns teaching the topics, with a VNA staffer as moderator.

Why home health providers want employees working at top of license Home Health Care News; by Audrie Martin; 10/17/24 As home health organizations fight for a margin in tough labor and payment environments, they are increasingly seeking ways to help employees practice at the top of their licenses. By applying top-of-license assignments in organizations, less complex work is handed off to the level below. This allows organizations to see more patients, bill for more services, reduce burnout and provide better care. The process helps employees feel more satisfied, and also could help with recruitment. “What we’ve got to do is improve our margins,” Pinnacle Home Care CEO Shane Donaldson recently said at Home Health Care News’ FUTURE conference. “That means we’ve got to get evaluating clinicians to do as many evaluations and assessments as possible, and we’ve got to get the non-evaluating clinicians doing the majority of straight visits.” 

The Tesla Bot is the future of at-home care, but not the way Elon wants you to think AndroidCentral; by Nicholas Sutrich; 10/17/24 Imagine waking up on your 91st birthday to a friendly robot companion that brings your morning coffee and a nice warm robe to start the day in. After making you breakfast, it bids you good day and heads back into the closet for a quick charge-up. At around 11 a.m., you realize there's a new pain in your leg that you haven't experienced before, so you make a quick phone call to the doctor, and, in a minute, your robot companion emerges from the closet, entirely remote-controlled by your doctor. They can run scans, have a full conversation, and even perform exams, all without you having to leave your home and go through the irritating task of trying to find transportation across town. ... Nothing replaces full face-to-face human interaction, but the ability for a fully remote-controlled robot that can be embodied by anyone with a VR headset like the Meta Quest 3 is a future I want to fully embrace.

Home health care and place of death in Medicare beneficiaries with and without dementiaGerontologist; Hyosin Dawn Kim , Paul R Duberstein, Anum Zafar, Bei Wu, Haiqun Lin , Olga F Jarrín; 11/24Home health care supports patient goals for aging in place. Use of home health care during the last 3 years of life was associated with reduced rates of inpatient death without hospice, and increased rates of home death with hospice. Increasing affordable access to home health care can positively affect end-of-life care outcomes for older Americans and their family caregivers, especially those with dementia.

Estes Park's only hospital joining UCHealth System Fort Collins Coloradoan; by Kelly Lyell; 10/17/24 Estes Park Health has started the process of joining the UCHealth System, with an expected starting date in the spring of 2025, the two organizations announced in a joint news release Wednesday. ... Estes Park Health has been financially challenged in recent years to maintain its services, the news release said, citing problems hospitals across the country have had keeping up with “dramatically increasing expenses, rising uncompensated care and minimal increases in reimbursements from Medicare and Medicaid.” As a result, the only hospital serving the Estes Valley, including visitors to Rocky Mountain National Park, has had to transfer or reduce its obstetrics, home health and hospice services.Editor's note: We've been following this story as but one of many examples of rural healthcare examples that result in reduced utilization for hospice services.

Dozens of CarePartners patients in Asheville transferred to other facilities after HCA temporarily shuts down rehab, hospice center Asheville Watchdog; by Andrew R. Jones; 10/14/24 Hundreds of employees uncertain about their jobs after facility is closed to ease pressure on Mission Hospital. Mission Health’s CarePartners Health Services is temporarily closed following the pressures Hurricane Helene put on Asheville’s health care system, disrupting rehabilitative care for more than 50 patients and forcing more than 250 employees to take temporary jobs elsewhere in the system, according to employees and internal emails obtained by Asheville Watchdog.  ... The closing affected nearly 50 inpatient rehab patients, several long-term acute care patients, and eight hospice patients, all of whom were sent to home caregivers, skilled nursing facilities, other inpatient rehab programs, and UNC Health Caldwell in Lenoir, more than an hour’s drive to the east, according to one employee.

Communication gaps among clinicians may limit conversations about prognosis, hospice Healio - HemOncToday; by Jennifer Byrne; 10/16/24 Clinicians in acute or post-acute care settings may delay or avoid serious illness conversations with patients whose cancer prognoses are worsening out of deference to the patient’s oncologist, according to study findings. Researchers conducted 37 semi-structured interviews with physicians and leaders in hospital medicine, oncology, palliative care, home health care and hospice. Investigators coded and analyzed the interviews using thematic content analysis. Evaluation of the responses yielded insights into how care silos, lack of clear clinical roles and other factors may affect communication between oncologists and other clinicians. ... "We know that the 3-month window after an older adult with cancer is discharged to a skilled nursing facility can be comprised of complex medical decision making and changing preferences of care. Lack of appropriate serious illness communication during this time can result in unwanted hospitalizations and unwanted, aggressive care at the end of life."

MD Home Health expands services with in-clinic, virtual care, remote patient monitoring, house calls and hospice Longview News-Journal, Phoenix, AZ; by MD Home Health; 10/15/24 Leading Home Health Agency in Arizona launches comprehensive onmnichannel healthcare approach. MD Home Health, a privately-held leading Arizona-based home health agency, today announced the expansion of its healthcare services to include in-clinic care, virtual care, remote patient monitoring, house calls, and hospice, making it one of the first privately-held home health agencies in Arizona to offer a full and comprehensive omnichannel healthcare approach. This expansion allows the firm to broaden its healthcare offering to significantly increase access to comprehensive, quality and convenient healthcare for residents across the Phoenix metro area. "Our new and comprehensive services are designed to ensure that patients have convenient and flexible options to access quality healthcare how, when and where they need it," said David P. Tusa, President and Chief Executive Officer of MD Home Health. 

Kaiser Health Care: Navigating Aging: Older men’s connections often wither when they’re on their own Tahlequah Daily Press; by Judith Graham; 10/12/24 At age 66, South Carolina physician Paul Rousseau decided to retire after tending for decades to the suffering of people who were seriously ill or dying. It was a difficult and emotionally fraught transition. … Seeking a change of venue, Rousseau moved to the mountains. … Soon, a sense of emptiness enveloped him. … His work as a doctor had been all-consuming. Former colleagues didn’t get in touch, nor did he reach out. His wife had passed away after a painful illness, … His isolation mounted as his three dogs, his most reliable companions, died. Rousseau was completely alone — without friends, family, or a professional identity — and overcome by a sense of loss. “I was a somewhat distinguished physician with a 60-page resume,” Rousseau, now 73, wrote in the Journal of the American Geriatrics Society in May. “Now, I’m ‘no one,’ a retired, forgotten old man who dithers away the days.” In some ways, older men living alone are disadvantaged compared with older women in similar circumstances. Research shows that men tend to have fewer friends than women and be less inclined to make new friends. Often, they’re reluctant to ask for help.

Home health providers, CMS raise red flags over delayed access Modern Healthcare; by Diane Eastabrook; 10/11/24 Delayed home health access for Medicare beneficiaries is increasingly raising alarms from the Centers for Medicare and Medicaid Services and the home health industry as providers place blame on staff shortages and the program's reimbursement rates. More than a third of Medicare fee-for-service beneficiaries referred to home health following hospitalizations did not receive services within seven days of discharge, according to an analysis of 2023 Medicare claims from healthcare analytics company CareJourney. The report echoes a similar study published by the Commonwealth Fund in July, as well as concerns CMS raised about access in its proposed 2025 home health pay rule. ... Years of low Medicare reimbursements are taking a toll on the home health companies trade groups represent, said William Dombi, president emeritus of the National Association of Home Care and Hospice, which is part of the National Alliance for Care at Home, and Cunningham.