Literature Review

The usage of family audiobooks as a legacy for grieving children — an exploratory quantitative analysis among terminally ill parents and close persons Springer Nature Link - Open Access; by Gülay Ate, Michaela Hesse and Henning Cuhls; 10/25/24Since 2017, terminally ill parents with dependent children under the age of 18 have been able to record an audiobook for their dependent children. This service allows them to narrate how they would like to be remembered in their voice. The family audiobook is a professionally supported, voluntary, free service that is unique in Germany. ... Conclusions: The family audiobook provides a valuable opportunity for terminally ill parents with dependent children under the age of 18 to tell their own biographical story, offer support to the bereaved in remembering, and preserve the voice of the deceased for the children. In addition, this approach could help healthcare professionals to reduce the stress associated with providing end-of-life care for terminally ill parents. Editor's note: While this service and this evaluation are located in Germany, it can be replicated easily with today's user-friendly technologies. First and foremost are patient empowerment, privacy, and ownership of these most personal messages. Examine using your spiritual care, social work, and/or grief counselors to facilitate this project.

I'm so glad I live in a world where there are Octobers. ~ L.M. Montgomery

Medicare Part D paid millions for drugs for which payment was available under the Medicare Part A Skilled Nursing Facility Benefit HHS Office of Inspector General; Report Highlights; 10/27/24 What OIG Found: ... On the basis of our sample results, for 2018 through 2020, we estimated that up to the entire Part D total cost of $465.1 million was improperly paid for drugs for which payment was available under the Part A SNF benefit. Of that amount, we estimated that approximately $245.4 million was for drugs that the medical records showed were administered to Part D enrollees during their Part A SNF stays.What OIG Recommends: We made five recommendations, including that CMS work with its plan sponsors to adjust or delete PDEs, as necessary, and determine the impact to the Federal Government related to the Part D total costs of $953,370 for drugs associated with our sample items for which payment was available under the Part A SNF benefit; work with its plan sponsors to identify similar instances of noncompliance that occurred during our audit period and determine the impact to the Federal Government, which could have amounted up to an estimated $465.1 million in Part D total cost; and provide plan sponsors with timely and accurate information, such as dates of covered Part A SNF stays, to reduce instances of inappropriate Part D payment for drugs for which payment is available under the Part A SNF benefit. ... CMS concurred with all five recommendations.

The case for stronger caregiver vetting in home care Home Health Care News; by Audrie Martin; 10/24/24 Direct care workers are, in many ways, the collective face of home-based care organizations. They are who clients and patients interact with. Therefore, regulators and providers are increasingly taking a closer look at who they’re hiring in the first place. While it is shocking to see caregivers commit crimes against clients, it does happen. About one in six people aged 60 and older experienced some form of abuse during 2023, according to the World Health Organization. Rates of abuse against older people have increased since the COVID-19 pandemic and are predicted to continue rising as many countries experience rapidly aging populations. To combat this trend, increased vetting is essential when hiring individuals to care for seniors in their homes. Editor's note: Related, disturbing articles we posted recently include ...

Doctor sues to save Medicare billing rights over hospice role Bloomberg Law; by Ganny Belloni; 10/24/24 A medical director designee at a California hospice sued the US Department of Health and Human Services to prevent the termination of his physician billing privileges after an independent contractor found his affiliation with the facility posed a fraud risk to the Medicare program. The lawsuit filed Wednesday by internal medicine physician Rami Shaarawy seeks injunctive relief from the US District Court for the Central District of California preventing the HHS’ Centers for Medicare & Medicaid Services from sanctioning the doctor until his dispute is resolved through Medicare’s internal appeals process.

Study: Hospice care provides major Medicare savings Medical Xpress; by Peter Dizikes, Massachusetts Institute of Technology; 10/24/24 Hospice care aims to provide a health care alternative for people nearing the end of life, by sparing them unwanted medical procedures and focusing on the patient's comfort. A new study co-authored by MIT scholars shows hospice also has a clear fiscal benefit: It generates substantial savings for the U.S. Medicare system. ... In recent decades, hospice care has grown substantially. That growth has been accompanied by concerns that for-profit hospice organizations, in particular, might be overly aggressive in pursuing patients. There have also been instances of fraud by organizations in the field. Yet, the study shows that the overall dynamics of hospice are the intended ones: People are indeed receiving palliative-type care, based around comfort rather than elaborate medical procedures, at less cost.Editor's note: This study limited its data to for profit hospice agencies. That said, its results cannot be miscontrued to provide any type of comparison between for profits and non profits, in that data from non profits was (apparently) not examined.

Large systems outsource home care to focus on 'core business' Becker's Hospital CFO Report; by Alan Condon; 10/25/24 A growing number of health systems are outsourcing home health and hospice operations to third-party specialists with broader geographic reach to reduce cost and administrative burdens and focus on core services. The regulatory environment for home health and hospice is complex, with stringent requirements for reimbursement, reporting and patient care standards. Partnering with an outsourced provider also helps systems mitigate the risks associated with non-compliance and operational issues. Here are four health systems that have outsourced or plan to outsource home health and hospicare care:

‘Let patients lead the way’: Hospice veterans’ advice for new nurses Hospice News; by Jim Parker; 10/25/24 ... A key barrier to building [the hospice and palliative care] workforce is that, with some exceptions, most clinicians receive little to no exposure to those types of care during their training. Nurses who are new to the hospice space often face a learning curve, according to Briana Hilmer, an Iowa-based admissions nurse for St. Croix Hospice.

Introducing Vivie: A new name with the same heart for service 1045 TheDan.com - Business Wire, Alexandria, MN; 10/24/24 Knute Nelson and Walker Methodist announce their new name and brand—Vivie. Vivie provides home health care, hospice, senior living, rehab, and more. ... With more than 150 years of combined service to older adults in their communities, Vivie unites two trusted legacies under one name and vision. As Vivie, the organization remains dedicated to the values that have made Knute Nelson and Walker Methodist pillars in their communities for generations. After merging in January 2024, the newly formed organization quickly began an extensive process to find a single, unifying name. "While our name is new, our heart for service remains the same," shared Mark Anderson, President and CEO. “We will continue to build on the solid foundation built by Knute Nelson and Walker Methodist, expanding our services to meet the evolving needs of those we serve.” The name “Vivie” is derived from the Latin root “viv” to paint a compelling picture of what it means to live. The new brand represents a vision for the future, rooted in our mission of enriching, empowering, and elevating people throughout life’s journey.

Bill introduced to increase access to advanced wheelchairs HomeCare, Nashville, TN; 10/24/24 U.S. Senators Marsha Blackburn (R-Tenn) and Tammy Duckworth (D-Ill.) introduced the Choices for Increased Mobility Act (S 5154) to increase access to wheelchairs made with advanced materials by allowing Medicare beneficiaries to upgrade to lighter, more functional wheelchairs without bearing the entire upfront cost. These manual wheelchairs help prevent shoulder injuries, enhance maneuverability and reduce overall pain and fatigue for users. ... When the Medicare billing code for ultra-lightweight manual wheelchairs was established in 1993, materials like titanium and carbon fiber were not considered, as they were not yet in use for wheelchairs. As a result, ... providers have struggled to supply wheelchairs with these advanced materials at the fee schedule amounts set by Medicare.

Hospice executives laser-focused on regulation, see change on horizon Hospice News; by Holly Vossel; 10/24/24 ... Hospice News spoke with c-suite executives who have recently stepped into their roles to learn more about what led them to the space and their top priorities. Regulatory challenges are among hospice leaders’ most significant concerns. They also envision opportunities to reform the Medicare Hospice Benefit and diversify their scope of services.

The ever-rising importance of hospital chaplains RNS; by Robert L. Klitzman; 10/24/24 Frequently, chaplains are the only hospital staff member who has time to sit and speak with patients and families. ... “My religion is watching CNN,” a feisty elderly woman with cancer recently told a hospital chaplain who had knocked on the patient’s door to introduce himself. ...  [After initial resistance, they] developed a rapport, and she described her deep loneliness and terror of dying. At the end of their conversation, she felt better, grasped the chaplain’s hand firmly and said, “Thank you!” ... In recent decades, the proportion of Americans who are “religiously unaffiliated” has risen sixfold, and the percentage of “Christian” individuals has dropped about a third. Partly as a result, chaplains have, at the same time, increasingly gained training in interfaith and nondenominational approaches, and frequently see their profession as “post-religious” — extending beyond the boundaries of any one particular faith; taking nondenominational, multifaith and humanistic approaches; and commonly receiving training in counseling. With these skills they aid patients, from evangelical to agnostic, atheist and “nothing in particular,” in resetting priorities and finding sources of connection, meaning, purpose and hope. Strongly committed to aiding vulnerable and underserved populations, chaplains remind doctors to uphold the dignity of every patient.