Literature Review

Local hospice care offers services The Tribune, Seymour, IN; by Chey Smith; 11/1/24 St. Croix Hospice has recently expanded its reach locally to those in the community who need the resources they provide, ... The firm provides hospice care throughout the Midwest including three other branches in Indiana — Jeffersonville, Newburgh and Indianapolis. While in Seymour, they are able to serve Jackson County as well as those residents from Bartholomew, Brown, Jennings, Lawrence, Monroe, Scott and Washington counties. Caregivers at each hospice location live in the communities they serve, allowing in-person care for patients whenever they need it. Services are available nights, weekends and holidays. Chris Thomas, regional director of clinical operations at St. Croix’s Indiana locations, talked about the importance of this closeness and flexibility. “We wanted to move to this location because we wanted to service the local community,” Thomas said. “Try to stay closer to the community for faster response time.” This phase of someone’s life can be scary, but Thomas says that it doesn’t have to be that way. “People are scared when they hear the word hospice. We just want to let the community know that it’s okay. It doesn’t mean you’re giving up,” he said. “We really want to focus on the time they have left.”

CCH, foundation working together again to look at possibility of reopening Hospice House Gillette News Record, Gillette, WY; by News Record Staff; 10/24/24 Campbell County Health and the Northeast Wyoming Community Health Foundation are back at the table again to explore the feasibility of reopening the Close to Home Hospice House. According to press releases sent out Wednesday from both groups, this initiative aims to enhance inpatient hospice services by reopening a home that facilitates end-of-life support, providing a compassionate space for individuals to receive care with dignity. “We are considering this in partnership with a third-party operator,  which will be discussed and decided upon collaboratively,” the press releases read. “Our primary focus is the well-being of our community, and we are committed to transparency as we engage in these preliminary discussions." 

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.

CMS updates guidance for rural emergency hospitals: 16 things to know Becker's Hospital CFO Report; by Alan Condon; 9/17/24 CMS has updated guidance for hospitals interested in converting to a rural emergency hospital, a Medicare designation that was made available Jan. 1, 2023. REHs are a provider type established by the Consolidated Appropriations Act, 2021, to address concerns over rural hospital closures and provide rural facilities a potential alternative to closure.  Since 2005, 106 rural hospitals have shut down, with another 86 facilities no longer providing inpatient services, according to data compiled by the University of North Carolina's Cecil G. Sheps Center for Health Services Research. Of those, 37 closures have occurred since 2020. Here are 16 things to know about REHs, including designation requirements, qualifying facilities, conditions of participation and how many hospitals have converted to REHs.  

Examining the relationship between rural and urban clinicians’ familiarity with patients and families and their comfort with palliative and end-of-life care communication

Emory receives $5 million grant to improve geriatric care and education Saporta Report; by Emory University, Atlanta, GA; 7/16/24 Emory University has been awarded a $5 million cooperative agreement by the U.S. Health Resources and Services Administration (HRSA) to enhance geriatric care and education for health care workers in Georgia’s urban and rural areas. This five-year funding will support Georgia Gear (Geriatrics Workforce Enhancement Program), operated through the Department of Family and Preventive Medicine at Emory University School of Medicine. ... The Georgia Gear program will partner with organizations including Georgia Memory Net, the Georgia Department of Public Health, Georgia Area Health Education Center, the Technical College System of Georgia, Emory Healthcare, the Atlanta VA Health Care System, and the American Academy of Hospice and Palliative Medicine (AAHPM).

States with the most rural hospital closures in the past 20 years Becker's CFO Report; by Mariah Taylor; 6/28/24 Since January 2005, 192 rural hospitals have closed or converted, according to data compiled by the University of North Carolina's Cecil G. Sheps Center for Health Services Research. Of those hospitals, 105 have completely closed, and 87 have converted, meaning the facilities no longer provide inpatient services, but continue to provide some services, such as primary care, skilled nursing care or long-term care. Since 2020, 36 hospitals have closed or converted. 

Governor on hand for PACE openingNews-ExpressKy, Pikeville, KY; by Terry L. May; 6/7/24Mountain View PACE (Program of All-Inclusive Care for the Elderly) was created to help adults 55 years old and older with complex care needs to avoid nursing homes and to receive care and services necessary to help them be safe, comfortable, and healthy while maintaining a more independent lifestyle, Mountain View PACE Medical Director Dr. James Rummel Jr. said. ... “For those of us who have aging parents, we see this cycle of people who are having a hard time living well at home so they tend to do this circle of home to the ER to the hospital to the nursing home for rehab then back home and it keeps repeating.” ... “We are not trying to replace anybody,” Rummel said. “We are trying to augment the system to fill the gaps. We are a niche type of healthcare system.” ... “What a great day in Pikeville and Pike County,” Governor Beshear said. “How we treat our seniors says something about us and our values as a people." 

Noncompete ban may squeeze rural hospitals, report shows Modern Healthcare; by Alex Kacik; 5/2/24 The federal noncompete ban may squeeze rural nonprofit hospitals that continue to see labor costs rise, a new report shows. Last week, the Federal Trade Commission voted to finalize a rule preventing most employers from enforcing or issuing contracts that restrict employees from working for a competitor. ... Larger hospitals are more likely to have the financial flexibility to offer clinicians and staff higher wages, likely at the expense of smaller, rural hospitals, Fitch Senior Director Kevin Holloran said.

Mississippi Capitol sees second day of hundreds rallying for ‘full Medicaid expansion now’Mississippi Today - Legislature; by Bobby Harrison and Geoff Pender; 4/17/24Hundreds of people rallied at the Mississippi Capitol for a second day Wednesday, urging lawmakers to expand Medicaid to provide health coverage for an estimated 200,000 Mississippians. ... Speakers recounted their struggles with access to affordable health care in Mississippi and chanted for the Legislature to, “Close the coverage gap now,” and for “Full Medicaid expansion now.” ... [Dr. Randy] Easterling recounted a story of two of his friends diagnosed with similar cancers. One was uninsured and self-employed, and did not get early diagnosis or treatment. He’s now in hospice and on death’s door. The other friend, with insurance, received an early diagnosis and treatment and is now cancer free.

City-country mortality gap widens amid persistent holes in rural health care access KFF Health News, by Jazmin Orozco Rodriquez; 4/9/24 The health disparities between rural and urban Americans have long been documented, but a recent report from the Department of Agriculture’s Economic Research Service found the chasm has grown in recent decades. In their examination, USDA researchers found rural Americans from the ages of 25 to 54 die from natural causes, like chronic diseases and cancer, at wildly higher rates than the same age group living in urban areas. ... In 1999, the natural-cause mortality rate for people ages 25 to 54 in rural areas was only 6% higher than for city dwellers in the same age bracket. By 2019, the gap widened to 43%.

[Rural Hospitals] A popular healthcare myth debunked Becker's Hospital CFO Report, by Laura Dyrda; 3/28/24Many in the healthcare industry assume rural hospitals are inherently worse off financially than urban hospitals. It's easy to see why. ... But a February Kaufman Hall report refutes the financial divide between rural and urban hospitals. When comparing rural and urban hospitals as a collective, the firm found no statistically significant difference in average operating margin. Rural and urban hospitals on average have similar operating margins and financial performance. So why do we often associate more dire financial struggles with rural hospitals over urban ones?

When the American Dream becomes survival: Short doc chronicles rural healthcare crisis PBS - KET, by Nathan Duke; 3/17/24 Director Ramin Bahrani’s acclaimed films ... focus on people struggling to survive due to economic challenges or failing to achieve the mythologized American Dream. His latest, the short documentary If Dreams Were Lightning: Rural Healthcare Crisis, is a startling look at the challenges facing rural communities in which hospitals are closing and leaving residents without options for care. The film incorporates themes from Bahrani’s previous work, but its subjects’ struggles are far from fictional.