Literature Review

CMS submits 75,000 pages to federal court to justify nursing home staffing mandate McKnights Long-Term Care News; by Kimberly Marselas; 9/15/24 The Department of Health and Human Services filed more than 75,000 pages of rule-making records with a federal court Friday, beginning its formal defense of its controversial nursing home staffing mandate. The submission of the administrative record is the first significant advance in the case since the American Health Care Association brought its challenge to the minimum staffing standard in late May. The Texas Health Care Association, three Texas providers and LeadingAge are also part of the case. In another development, District Court for the Northern District of Texas Judge Matthew Kacsmaryk on Sept. 10 agreed to fold in a separate federal challenge against the staffing mandate filed by the state of Texas. He noted that the two cases “share common questions of law or fact, consist of similar parties, the same claims, and [have] the same relief sought.”

Walgreens to pay $107M fine for prescription billing fraud claimsModern Healthcare; by Katherine Davis; 9/13/24Walgreens Boots Alliance has agreed to pay a $106.8 million fine to the U.S. Department of Justice to settle allegations that it billed government healthcare programs for prescriptions never dispensed.

The patient care experience on full display Modern Healthcare; by Mary Ellen Podmolik; 9/13/24 Art exhibits can promote a visceral reaction. The one that just opened along a hallway of windows on Thomas Jefferson University’s health sciences campus certainly does just that. The installation includes five hospital beds, life-sized mannequins inside large pill bottles, personal possessions and deeply personal quotes from five unnamed people who’ve gone through life-threatening trauma — a miscarriage, a pulmonary embolism, a wait for a kidney transplant, a case of undiagnosed paralysis and cancer. The Philadelphia artist behind the exhibit, Pepón Osorio, is the cancer patient. “Convalescence” is a complex and compelling exhibit of patient pain, reliance on drugs and inequitable care — part of the patient experience that can get lost in the daily tussle between providers and payers. “It is a critique of the healthcare system,” Megan Voeller, director of health humanities at the university, told me.

As a nonprofit, Hospice of Dubuque among minority of similar entities Telegraph Herald; by Lavonne Noel; 9/15/24   Last month, HBO and Max aired an episode of “Last Week Tonight with John Oliver” in which the satirist discussed hospice care in America. Although raunchy, the episode highlighted some of the positives of hospice care with the commentator noting that “at its best, it’s great.” The episode also underscored concerns with fraud, abuse and program integrity, which stem from a profit motive that has taken hold in hospice. Oliver noted, “Hospices can be big business,” pointing out that “today, of the country’s nearly 6,000 providers, three-quarters are for-profit.” Unfortunately, this does not align with the roots of the hospice movement. ... [Click on the title's link to continue reading this important response to "Last Week Tonight with John Oliver" episode.] 

Phoenix Home Care and Hospice shares Medicare Mondays on Silver Notes NBC KSNF-16,  Joplin, MO; byWendi Douglas; 9/12/24 News segment for community education about Medicare for seniors, provided by a local hospice nurse.

Agape Care Group expands premier hospice services in Oklahoma, Missouri, Kansas and Georgia BusinessWire, Spartanburg, SC; 9/13/24 Agape Care Group, a portfolio company of Ridgemont Equity Partners and the premier provider of hospice and palliative care across nine states, has acquired select Crossroads Hospice locations in Oklahoma, Missouri, Kansas and Georgia. Crossroads Hospice will continue to operate in Tennessee, Ohio and Pennsylvania. ... Agape Care Group currently serves 5,000 patients in nine states and employs more than 2,000 team members. Kansas, Missouri and Oklahoma locations will operate under the ACG Hospice brand, while the Georgia location will operate under the Georgia Hospice Care brand.

More home health providers sunset relationships with largest Medicare Advantage players Home Health Care News; by Andrew Donlan; 9/13/24 Essentia Health--a regional nonprofit health system with a substantial home health arm--announced this week that it will no longer serve as an in-network provider for UnitedHealth Group. ... Dr. Cathy Cantor, Essentia’s chief medical officer for population health, said in a statement ... “The frequent denials and associated delays negatively impact our ability to provide the timely and appropriate care our patients deserve. This is the right thing to do for the people we are honored to serve.” Headquartered in Duluth [MN], Essentia Health provides care across Minnesota, Wisconsin and North Dakota. Its network includes about 15,000 employees, 14 hospitals, 78 clinics, six long-term care facilities, six assisted living and independent living facilities, and much more. It also has a robust home health and hospice business. The company has informed patients that it will no longer serve as an in-network provider for the above-mentioned MA payers beginning Jan. 1. ... Sanford Health, a health system based in Sioux Falls, South Dakota, announced a similar plan this week. 

Antitrust lessons for healthcare roll-ups – and everyone else Competition Policy International - CPI Columns US & Canada; by Lauren F. Dayton & Swara Saraiya; 9/12/24 ... The practice described in the U.S. Anesthesia Partners suit, known as a “roll-up,” is a common strategy employed by private equity firms through which smaller businesses in adjacent markets are acquired and consolidated. Large healthcare networks acquire smaller practices for similar reasons. That consolidation enables companies to build a greater presence, operate more efficiently, and can allow them to attract better talent. But that same consolidation can also create the risk of anticompetitive effects. The FTC’s suit is noteworthy because federal competition regulators have historically focused on the companies themselves, not their financial sponsors. The case is in step with statements by competition regulators about increased scrutiny of the healthcare industry, and of acquisitions by private equity firms, in particular. ...

Quality indicators for palliative care established European Cooperation in Sciene and Technology (COST); 9/12/24 Palliative care aims to improve the quality of life of patients and their families facing problems associated with life-threatening illnesses. The World Health Organization (WHO) reports that each year, an estimated 56.8 million people, including 25.7 million in the last year of life, need palliative care. ... To tackle these issues, the Council of Europe, WHO, and the United Nations have addressed these problems and established international standards and recommendations to improve palliative care worldwide. ... Teaching palliative care demands a culturally sensitive and inclusive curriculum, a specific mix of skills and expertise, and innovative teaching methods. European recommendations exist for undergraduate medical, nursing, psychology, and social work education and postgraduate training in medicine. ...

Age-friendly care: What it is and how reporters should cover itAssociation of Health Care Journalists; by Liz Seegert; 9/13/24You may have heard of age-friendly care... Age-friendly care, an initiative of The Institute for Health Care Improvement and The John A. Hartford Foundation, is modeled on the evidence-based 4Ms framework:

‘We did it!’: West Penn nurses celebrate their new contract Pittsburgh Union Press, Pittsburgh, PA; by Steve Mellon; 9/12/24 Before Joanne Germanos had a chance to approach a podium to make her announcement, someone in the crowd called out, “We did it!” ... What Germanos and her fellow union nurses at West Penn did was win a new contract that raises pay and addresses staffing and burnout issues that the nurses say have been pushing experienced nurses out of the profession. Ninety percent of the hospital’s union nurses voted to approve the contract Wednesday. Under the three-year deal, pay for nurses will rise an average of 24%, with some seeing increases as high as 35%. By contract’s end, all nurses will make at least $40 an hour; nurses with 20 years of experience will make at least $50 an hour. ... Pay, however, isn’t the only issue. At rallies, union nurses have called on hospital administrators to address staffing and scheduling problems that can affect patient care and cause nurse burnout. They took those concerns to the bargaining table and, on Thursday, said they were thrilled with the outcome.

Prepping for the hospice HOPE tool: Starting the journeyCHAP email; by Jennifer Kennedy; 9/6/24The Centers for Medicare and Medicaid Services (CMS) recently finalized the implementation date of the hospice HOPE assessment tool in the FY 2025 Hospice Payment Update final rule. This quality requirement signals a new beginning for hospice providers related to quality measurement and future payment reform. Implementation is scheduled for October 1, 2025, so the clock is ticking, and the interval is short for provider and software vendor preparation for compliance.Publisher's note: Excellent article with helpful resource links.

Dogs helping hospice patients WFMY News 2 - YouTube; Mountain Valley Hospice, Dobson, NC; 9/3/24 Mountain Valley Hospice in Surrey County has been using therapy dogs and with some really great results, the dogs provided in boost at a time when families and their loved ones are going through extremely tough times patients. If they're having a hard day and all they're seeing is these clinical teams coming in and doing things to them and then they just see a pet and they're missing their pet or they had pets in the past and they can just go to the bedside. If they're big dogs they can pet them, or if they're small dogs they can put a towel over on top of them and then put the little pet on top of the bed and they can pet it and just lay there.