Literature Review

[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks. Chief Healthcare Executive; by Ron Southwick; 5/9/24 With disturbing regularity, nurses in hospitals and other healthcare settings are being physically assaulted and verbally harassed. More than half of emergency nurses say they’ve been assaulted or threatened within the past 30 days, according to the Emergency Nurses Association. In a separate study, researchers found that healthcare workers faced at least one violent or aggressive incident for every 40 hours worked, according to findings published by The Joint Commission Journal on Quality and Patient Safety. With the observance of National Nursing Week, the increased violence in healthcare can’t be ignored. Nursing leaders say the regular exposure to violence or threatening behavior is one factor adding to stress and burnout of nurses and, in some cases, spurring them to seek new jobs.

Caring for the Caregiver: A Guide for Home Care Providers Forbes; by Joan Ekobena; 5/8/24This article proposes that nurturing the psychological and physical well-being of caregivers [employees] is essential. It’s not just a matter of ethical responsibility but a fundamental factor for maintaining quality care, promoting continuity of care and boosting employee retention. This can create a positive ripple effect, which can not only increase customer satisfaction but also boost business revenue. ... A recent decision by the Office of Inspector General (OIG) underscores the increasing awareness of the need to invest in caregiver wellness. Guides are listed as "Strategies for Supporting Caregiver Wellness and Mindset": ... [Note: "Caregiver" denotes employees who provide home care, not the family "caregiver" in the home.] 

Wide-ranging health care bill gets final approval from CT House CT Mirror - Connecticut's Nonprofit Journalism; by Jenna Carlesso; 5/6/24The House gave final passage Monday to a wide-ranging health care bill that would add protections for home care workers, boost preparedness for cyberattacks at medical facilities and establish new regulations for the state’s health information exchange, among other reforms. ... The sections on additional protections for home care workers were prompted by the murder of visiting nurse Joyce Grayson, who was killed in October while working at a halfway house in Willimantic. ... The bill requires home health aide agencies to collect certain client information upon intake and make it available to any employee assigned to the client. Information includes a history of violence against health care workers, domestic abuse, substance use, psychiatric history, any listing on a sex offender registry, the crime rate of the municipality the person lives in, and whether there are any weapons or safety hazards in the home. [Click on the title's link for more important information about this bill's safety measures.]

Terminal cancer: What matters to patients and caregivers Medscape Medical News; by Megan Brooks; 5/6/24 What's most important to patients with terminal cancer and their caregivers? New research found that patients and caregivers both tend to prioritize symptom control over life extension but often preferring a balance. Patients and caregivers, however, are less aligned on decisions about cost containment, with patients more likely to prioritize cost containment. ... As patients approached the end of life, neither patients nor caregivers shifted their priorities from life extension to symptom management.

Elara Caring, cited in death of visiting nurse Joyce Grayson, vows to contest violation McKnights Home Care; by Adam Healy; 5/3/24 The Department of Labor’s Occupational Safety and Health Administration (OSHA) has cited home health, hospice and personal care provider Elara Caring for failing to provide adequate safeguards to protect visiting nurse Joyce Grayson from workplace violence. Grayson, a licensed practical nurse, was killed last Oct. 28 while providing a home health visit for a client living in a halfway house in Willimantic, CT.  The DOL disclosed this week that its OSHA division cited New England Home Care, where Grayson worked, and Jordan Health Care Inc., which both do business as Elara Caring, with a “Willful-Serious” citation. Elara Caring faces up to $163,627 in penalties resulting from the citation. ...

Optum layoffs affect teams in Medicare Advantage I-SNP, IE-SNP business Skilled Nursing News; by Zahida Siddiqu; 5/2/24 Optum is paring back its workforce, including in the parts of the business related to Medicare Advantage plans for nursing home and assisted living residents. ... The recent layoffs at Optum number hundreds of people across various parts of the company, according to multiple news reports. The company is discontinuing its virtual care business, as Endpoints first confirmed. ... Multiple sources have shared that out of a roughly 20% to 30% of a 400-person workforce [in IE-SNP business] has been laid off in this part of Optum. ... The reduction in staff was across the board from senior leaders on the clinical end to low-level employees, industry sources said.

Doing the right thing for hospice patients Journal of Emergency Mediscal Services; by Abe Tolkoff, EMT, Daniel Tauber, NRP, and Amelia E. Breyre, MD, NRP; 5/2/24 Here is a novel solution in practice at the Yale New Haven Hospital Center for EMS; a paramedic hospice rotation. After being dispatched to a lift assist call, two novice EMTs proceeded to the address without lights or sirens. They grabbed their gear bag and walked up the stairs to the home. Knocking on the door, they announced “EMS!” and heard a frantic “Come in!” followed by, “he has a DNR.” ...

43 health systems ranked by long-term debt Becker's Hospital CFO Report; by Alan Condon; 4/29/24 Long-term debt has long been a staple in healthcare, but many hospitals and health systems are responding to the increasing cost of debt and debt service in the rising rates environment. Highly levered health systems are looking to sell hospitals, facilities or business lines to reduce their debt leverage and secure long-term sustainability, which creates significant growth opportunities for systems with balance sheets on a more solid financial footing. Forty-three health systems ranked by their long-term debt: ... [Click on the title's link for the list.]

Why health systems should embrace advanced in-home care models McKnights Home Care; by Marcy Carty, MD, MPH; 4/25/24Over the next two decades, the adult demographic over 50 years of age will increase by 25 million, and with over 75% expressing a strong desire to age in place, it’s imperative to champion care models that support safe, high-quality care within the home. Despite proactive care models to support aging in the home, acute needs still arise. Health systems stand to gain manifold by embracing the paradigm shift to care in the home. By moving more advanced care delivery into peoples’ homes, systems can effectively curb acute healthcare utilization, decreasing hospital-acquired conditions and drastically improving patient and family experience.

Signify Health President: ‘We’re just scratching the surface’ on what can be done in the home Home Health Care News; by Andrew Donlan; 4/26/24 Signify Health was purchased by CVS Health for $8 billion in March 2023. Now, it’s one of the core tenants of CVS Healthspire, the health care services segment that CVS executives are banking on to drive future growth for the company. Paymon Farazi, the president of Signify Health, recently joined Home Health Care News’ Disrupt podcast to talk about Signify’s direction over a year after the CVS deal was closed, how the company could work with traditional home-based care providers in the future and where Farazi sees Signify – and health care – headed in the near- and long-term future.

Federal Court halts lawsuit over Medicare home health payments Bloomberg Law; by Tony Pugh; 4/28/24 A federal court in Washington DC tossed a lawsuit against HHS over a disputed payment system that has slashed reimbursements for thousands of home health agencies since it was implemented in 2020. The US District Court for the District of Columbia ruled in a memorandum opinion on April 26 that plaintiffs in the suit by the National Association for Home Care & Hospice (NAHC) failed to exhaust their administrative rememdies because they "skipped the agency's process for seeking expedited judicial review." Because of that, the court "will grant the federal government's motion for summary judgment." [Additional content may require subscription.]

Payment cuts are having a compounding, dire effect on the home health industry Home Health Care News; by Andrew Donlan; 4/25/24 Home health providers’ fight against cuts to fee-for-service Medicare payment has become a year-by-year battle. But the yearly cuts are compounding, which is exactly what industry advocates are trying to illustrate to Congress prior to the next payment rule proposal. ... Many of the cuts CMS has implemented are permanent, and multiple cuts on top of each other moving forward – plus unsatisfactory adjustments for inflation – are putting significant pressure on providers.

NAHC expresses disappointment regarding Medicaid Access Rule HomeCare; 4/23/24 The National Association for Home Care & Hospice (NAHC) released a statement noting that it was, 'extremely disappointed that the Centers for Medicare and Medicaid Services (CMS) elected to finalize the “payment adequacy” provision in the Medicaid Access Final Rule (CMS 2442-F).' "This is a misguided policy that will result in agency closures, force providers to exit the Medicaid program, and will ultimately make access issues worse around the country," a statement from the organization read. "As NAHC and our partners across the homecare industry have demonstrated, such a provision is not only unworkable due to the varied nature of Medicaid programs across the country, CMS also lacks statutory authority to impose this mandate."