Literature Review

Improving post-hospital care of older cancer patients Cancer Health; by University of Colorado Cancer Center and Greg Glasgow; 8/26/24 A few years ago, University of Colorado Cancer Center member and hospitalist Sarguni Singh, MD, began to notice a troubling trend: Older adults with cancer who were leaving the hospital for skilled nursing facilities after treatment were being readmitted to the hospital or having worse outcomes while in rehabilitation. ... Singh knew of an intervention called Assessing and Listening to Individual Goals and Needs (ALIGN) — a palliative care social worker-led protocol aimed at improving quality of life, aligning goals of care, and providing support to patients and caregivers — and she began using it for cancer care. ... The results were overwhelmingly positive, and patients and caregivers told us, ‘This was so helpful,’” says Singh, associate professor of hospital medicine in the CU School of Medicine.

My Dad had an Advance Directive. He still had to fight to die Newsweek - My Turn; by Maggie Schneider Huston; 8/26/24 My mom  died peacefully. My dad died 72 days later, angry at the doctors for ignoring his wishes. ... Dad had heart surgery on December 20, 2023. An hour after the surgery ended, his vital systems started shutting down. A cascade of interventions, one after another, kept him alive. Four days later, he said: "Put me on hospice." The doctor dismissed this request, rolling his eyes and saying: "Everyone on a ventilator says that." On Christmas Day, my father asked for hospice again. He was in pain. He knew his recovery would be long and ultimately futile. He would never have an acceptable quality of life again. ... Dad's care team insisted palliative care was the same as hospice care, but he knew the difference. He wanted hospice care. Finally, they reluctantly agreed and called for a social worker to make arrangements. It wasn't necessary. Once they removed his treatment and relieved his pain, he died five hours later. ... Editor's Note: This article is not about Medical Aid in Dying (MAiD). It is about honoring Advance Directives, person-centered care with communications and actions related to "palliative" vs. "hospice" care.

NPHI congratulates Dr. Steven Landers on his appointment as CEO of the NAHC-NHPCO AllianceNational Partnership for Healthcare and Hospice Innovation (NPHI); by Rom Koutsoumpas and Carole Fisher; 8/26/24 Senior leaders of the National Partnership for Healthcare and Hospice Innovation, the national voice for nonprofit advanced illness care, shared the following statement regarding the appointment of Dr. Steven Landers as the inaugural CEO of the newly merged NAHC-NHPCO Alliance:

Sophisticated caregiver training remains an underutilized retention, ROI tool Home Health Care News; by Audrie Martin; 8/22/24 ... [Only] 43.8% of home-based care staff and 55% of home health and hospice staff feel prepared to care for new clients, according to the 2024 Activated Insights Benchmarking Report. As a possible result, the annual care staff turnover rate has climbed 14% in the last two years to almost 80%. Organizations demonstrating a commitment to continuing education improve employee satisfaction by allowing caregivers to hone their skills and grow in their careers. Investing in employees’ long-term success will impart a sense of purpose and possibility within a role known for turnover and burnout. “The average home-based care provider offers five hours of orientation and eight hours of ongoing training,” the report read. “Those who offer at least eight orientation hours and 12 hours of ongoing training see an increase of $1,103,291 in revenue. However, while establishing a clear path is one of the top strategies to retaining long-term employees, only 39% of providers have one.”

False Claims Act decisions to know from Q2 2024 JD Supra; by Bass, Berry & Sis PLC; 8/22/24 In case you missed it, this post recaps some key False Claims Act (FCA) decisions and case updates from the second quarter of this year. Courts weighed in on the FCA’s anti-retaliation provision, its first-to-file bar, and issues around judgments and awards. ... In U.S. ex rel. Rosales v. Amedisys, Inc., the relator alleged that Amedisys, a hospice operator, falsely certified patients as terminally ill and submitted claims for reimbursement to Medicare and North Carolina Medicaid for patients who were not properly eligible for hospice care. Amedisys filed a motion to dismiss Rosales’ Amended Complaint for lack of subject-matter jurisdiction, ...

FOR IMMEDIATE RELEASE: Steve Landers, MD, MPH, Named Inaugural Chief Executive Officer of NAHC-NHPCO Alliance - Mon 8/26/24 9:36 am  NAHC-NHPCO Alliance Press Release, Alexandria, VA and Washington, DC; by Elyssa Katz and Thomas Threlkeld; 8/26/24, 9:36 am ET Steven Landers, MD, MPH, has been named the inaugural Chief Executive Officer (CEO) of the newly merged NAHC-NHPCO Alliance (The Alliance). A recognized national leader and innovator in home health, primary care and aging services, Dr. Landers brings almost two decades of experience as a physician, executive leader and health policy advocate to The Alliance, which represents care at home and community providers across the country. ... “The Alliance members provide a wide range of high-quality home- and community-based services that promote comfort, dignity and independence. I’m so proud to become a part of this organization, and am eager to serve,” said Dr. Landers. “I’ve had the opportunity in my career to see the health care industry from many vantage points, and in this new role with The Alliance, I will use all that I have learned to make a difference for our members as we continue to expand to meet the growing public needs for our care.”

Fraudulent hospices reportedly target homeless people, methadone patients to pad census Hospice News; by Jim Parker; 8/23/24 Fraudulent hospices in California reportedly have been targeting homeless people and methadone patients, promising them a steady supply of opioids in exchange for enrolling in hospice. Three hospice leaders came forward to Hospice News to report these practices. According to their reports, unscrupulous providers have canvassed both homeless encampments and methadone clinics seeking to sign up patients who are not terminally ill. In many cases, the sources said, these operators offer patients free access to board-and-care facilities and a daily supply of morphine. Another frequent practice among these hospices is to offer patients cash or other items in addition to drugs, they said. “This conduct raises serious fraud concerns on kickbacks or gifts to beneficiaries who do not appear to qualify for hospice,” Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), told Hospice News. “More importantly, this conduct is predatory, taking advantage of individuals in addiction. Jail time is not enough punishment for the harm that such conduct creates.”Editor's Note: This is abhorrable. Click on the title's link to read more. While John Oliver's "Last Week Tonight" episode on 8/18/24 gained criticism from many hospice leaders, these fraudulent unethical behaviors (and others') lay the groundwork for such dire distrust from the public. These organizations' behaviors must be stopped. These organizations must be held accountable.

What is Death?GeriPal podcast; by Eric Widera, Alex Smith, Winston Chiong, Sean Aas; 8/22/24We’ve talked about Brain Death before ... and in many ways today’s podcast is a follow up to that episode. Why does this issue keep coming up? Why is it unresolved? Today we put these questions to Winston Chiong, a neurologist and bioethicist, and Sean Aas, a philosopher and bioethicist.

Capitol Notebook: New study spotlights Iowa health care landscape TheGazette; by The Gazette-Lee Des Moines Bureau; 8/22/24 More Iowa health care facilities have closed than opened since 2008, and more Iowa hospitals are operating at a loss as workforce shortages and costs rise. ... Key findings of the report include: 

Home health care agency going through changes KSAL.com; by Todd Pittenger; 8/22/24 According to Memorial Health System of Abilene, Home Health & Hospice of Dickinson County (HH&H) has covered many miles throughout Dickinson, Morris, and Marion counties for many years. ... While it was never about profit  and more about going the extra mile to take care of the people in the community, the small agency can no longer support the supply and demand of what it takes to provide these services.  They have taken a loss for several years and can no longer sustain that loss. Home Health & Hospice of Dickinson County is not closing. Their local staff is proud to be the only agency in the community that provides the kind of quality care to neighbors, friends, and family, and  will continue to do so.  HH&H has been in contact with multiple agencies that can assist patients to locate agencies or individuals who can provide these types of services and they are ready to assist. [List of resources]

Dr. Joe Rotella, AAHPM: The importance of being human – Reflections of an aspiring medical humanist American Academy of Hospice and Palliative Medicine; Event Details; retrieved from the internet 8/23/24The Importance of Being Human - Reflections of an Aspiring HumanistDate: September 17, 2024Time: 4:00 pm - 5:00 pm CTGrand Rounds free; Non-Members $49.00 USD

Navigating the complexities of life and caregiving WorldHealth.net; by Pat Baker; 8/16/24 As individuals advance through different life stages, especially when tasked with caregiving or managing the challenges of aging, they encounter a complex web of intertwined challenges. ... This article explores the multifaceted nature of caregiving and aging, offering insights and strategies that can help individuals manage these demanding situations effectively. ... As the population ages and the demand for caregiving increases, it is crucial to continue developing strategies and policies that support caregivers and enhance the quality of care. Editor's Note: Examine 75+ caregiver education and support videos designed for hospices to use with the primary caregiver and family members they serve. Designed and delivered via our newsletter's sponsor, Composing Life Out of Loss.

5 DEI expectations organizations should have of all leaders Forbes; by Julie Kratz; 8/18/24 Without leadership support, diversity, equity and inclusion (DEI) efforts do not work. ... For organizations wrestling with holding leaders accountable for DEI, consider these questions: