Literature Review
Rescue from above: How drones may narrow emergency response times
08/12/24 at 03:00 AMRescue from above: How drones may narrow emergency response timesKFF Health News; by Michelle Andrews; 7/22/24Starting in September, if someone in Clemmons, North Carolina, calls 911 to report a cardiac arrest, the first responder on the scene may be a drone carrying an automated external defibrillator, or AED. “The idea is for the drone to get there several minutes before first responders,” such as an emergency medical technician or an ambulance, said Daniel Crews, a spokesperson for the sheriff’s office in Forsyth County, where Clemmons is located. The sheriff’s office is partnering on the project with local emergency services, the Clinical Research Institute at Duke University, and the drone consulting firm Hovecon. “The ultimate goal is to save lives and improve life expectancy for someone experiencing a cardiac episode,” Crews said.Publisher's note: As with all things tech, when and how might drones be used in hospice?
Today's Encouragement
08/12/24 at 03:00 AMTime zones were created for people much smarter than me…
New England hospital CEOs warn lawmakers of crisis in rural health care system
08/12/24 at 03:00 AMNew England hospital CEOs warn lawmakers of crisis in rural health care systemMainebiz; by Laurie Schreiber; 8/8/24MaineHealth’s CEO was one of three in the Northeast who recently told federal lawmakers that rural health care systems are in crisis. “As a family physician by training, it has been difficult to watch our rural communities struggle to maintain access to high-quality care for their residents,” said Dr. Andrew Mueller. “Our proposals align with, and support, our MaineHealth vision of ‘working together so our communities are the healthiest in America.’”
COVID-19 falls to No. 10 cause of death in US
08/12/24 at 03:00 AMCOVID-19 falls to No. 10 cause of death in USAP; 8/9/24U.S. death rates fell last year for all age groups compared with 2022, federal health officials said Thursday. Here’s what the Centers for Disease Control and Prevention data showed:
Hospice chaplain accused of sexually assaulting woman at Sacramento County care facility
08/12/24 at 03:00 AMHospice chaplain accused of sexually assaulting woman at Sacramento County care facilityKCRA (Sacramento, CA); by Lindsay Weber; 8/8/24A Placer County man was arrested on Thursday, accused of sexually assaulting a woman in a care facility he worked for as a hospice chaplain, the Sacramento County Sheriff's Office said. The sheriff's office said Arthur Apgar was arrested for four counts of sexual battery against a person who is seriously disabled or medically incapacitated. Apgar worked for a private company that contracts with hospice facilities, officials said. The assault happened within the past week and was captured on surveillance video.
Violent dementia patients leave nursing home staffers and residents ‘scared to death’
08/12/24 at 03:00 AMViolent dementia patients leave nursing home staffers and residents ‘scared to death’KFF Health News; by Jordan Rau; 8/9/24Violent altercations between residents in long-term care facilities are alarmingly common. Across the country, residents in nursing homes or assisted living centers have been killed by other residents who weaponized a bedrail, shoved pillow stuffing into a person’s mouth, or removed an oxygen mask. A recent study in JAMA Network Open of 14 New York assisted living homes found that, within one month, 15% of residents experienced verbal, physical, or sexual resident-on-resident aggression. Another study found nearly 8% of assisted living residents engaged in physical aggression or abuse toward residents or staff members within one month. Dementia residents are especially likely to be involved in altercations because the disease damages the parts of the brain affecting memory, language, reasoning, and social behavior.
Hospices face ‘hard roads’ in budgeting for sustainable growth
08/12/24 at 02:00 AMHospices face ‘hard roads’ in budgeting for sustainable growthHospice News; by Holly Vossel; 8/9/24Hospice budgeting practices hinge on several factors, according to Matt Chadwick, CFO of Well Care Health. Building a sustainable financial structure for end-of-life care delivery can be a challenging feat when navigating the impacts of patient care and staffing needs, referral streams, operational expenses, billing claim cycles and compliance factors, Chadwick said... Quality and compliance are also important pieces of a hospices’ budget and growth potential as providers experience. Case in point, hospices that fail to comply with new quality reporting requirements set forth in the 2025 payment rule face a 4% penalty... “The budget should not just be solely 100% of the financial person’s responsibility,” Rachael Feeback, revenue cycle senior product manager of home and hospice at MatrixCare by ResMed, said. “It should be a conversation with the clinical side, the operational side, so that you’re understanding your different measurements for hospice and how that translates to the budget and not solely focused on the pure dollars behind it.”
Becoming time rich with physician moms: Sarah Wittry and Nicole Perrotte
08/11/24 at 03:55 AMBecoming time rich with physician moms: Sarah Wittry and Nicole Perrotte MarketScale - Ripple of Change; by Todd Otten; 7/30/24 In today’s high-stress healthcare environment, physician mothers face the formidable challenge of balancing demanding careers with their personal lives. The conversation on work-life balance is more relevant than ever, with more women in medicine seeking ways to manage these dual responsibilities effectively. How can physician moms navigate this landscape to reclaim time for themselves without guilt? What strategies can physician moms employ to achieve a healthier work-life balance? This pressing question lies at the heart of today’s discussion on the Ripple of Change podcast. ... Key points of discussion:
Florida Blue boosts local bereavement support with donation
08/11/24 at 03:50 AMFlorida Blue boosts local bereavement support with donationAvow Hospice press release; 7/18/24In May 2024, Florida Blue Foundation announced a $20,000 grant in support of Avow’s bereavement programs, which are available at no cost to individuals of all ages. With this grant, Avow is able to pursue its mission of providing compassionate care through life’s hardest transitions. Florida Blue awarded this grant on the basis of promoting mental well-being for all individuals, one of the foundation’s strategic pillars, as grief counseling is essential for maintaining and advancing the mental well-being of individuals and families.
How the Hospice CARE Act could change respite services
08/11/24 at 03:45 AMHow the Hospice CARE Act could change respite services Hospice News; by Jim Parker; 8/1/24 The Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, if enacted, would make changes to the ways hospices provide respite care. Rep. Earl Blumenauer (D-Oregon) is in the process of drafting the bill that would represent the most significant reforms to date for hospice payment and oversight. The legislation is currently in a discussion draft phase, which has been circulated among the nation’s major industry trade associations and their members for feedback. ... “There’s evidence that people who take advantage of hospice care delivered properly, actually have a higher quality of life. Oftentimes, they live longer,” Blumenauer said at Elevate. “This is an opportunity to do something in this Congress that is concrete, specific, that will save money and improve the quality of care for some of our most vulnerable people.”
National plan on aging ‘essential’ to addressing key issues: AARP
08/11/24 at 03:40 AMNational plan on aging ‘essential’ to addressing key issues: AARPMcKnight's Senior Living; by Kimberly Bonvissuto; 7/18/24Aging, itself, isn’t a challenge - but being unprepared for aging is, according to AARP, which on Wednesday released a white paper that lays out a blueprint for developing a national plan on aging. The paper marks the launch of the organization’s Aging Well in America Initiative, for which the AARP took best practices from federal, state and local initiatives to create a blueprint for the development of a “robust” national plan to foster the well-being, quality of life and dignity of older Americans.
Avow Kids receives transformational gift from Naples Children & Education Foundation
08/11/24 at 03:35 AMAvow Kids receives transformational gift from Naples Children & Education FoundationAvow Hospice press release; 7/23/24Avow Foundation has received a generous grant of $115,000 from the Naples Children & Education Foundation (NCEF), the founding organization of the Naples Winter Wine Festival. The grant is specifically intended for Avow Kids, a program for children ages 5 - 17 that provides support and companionship to youth experiencing any type of grief. The grant will support Avow Kids’ various services, such as individual counseling, support groups, workshops, camps, music therapy, movie nights, and more.
Empath Health, American Health Plans launch ISNP joint venture
08/11/24 at 03:30 AMEmpath Health, American Health Plans launch ISNP joint ventureHospice News; by Jim Parker; 8/6/24The nonprofit senior care provider Empath Health is partnering with the Medicare Advantage organization American Health Plans (AHP), a division of American Health Partners to serve patients who are enrolled in Institutional Special Needs Plans (ISNP). ISNPs are Medicare Advantage plans that are designed to serve beneficiaries who live in skilled nursing facilities. Through the Empath partnership, members of AHP’s American Health Advantage of Florida ISNP will receive interdisciplinary services from TruHealth of Florida, the clinical arm of the ISNP. TruHealth is a newly established joint venture between AHP and Empath. Patients will also have access to Empath Health’s “full-life care” model.Notable mentions: Jonathan Fleece, Empath Health CEO.
Home health sees spending, utilization decline as hospice equivalents grow, MedPAC reports
08/11/24 at 03:25 AMHome health sees spending, utilization decline as hospice equivalents grow, MedPAC reportsMcKnight's Home Care; by Adam Healy; 7/19/24Though hospice spending and utilization appear to be on the rise, Medicare spending on home health has fallen amid declining utilization in recent years, according to a new report by the Medicare Payment Advisory Commission. In 2022, the year of the most recent available data, Medicare home health spending shrank to $16.4 billion. That compares to $17 billion the year prior, the report found. Meanwhile, the number of home health users declined by 6.3% from 2021, and the overall share of Medicare beneficiaries that use home health shrank by 3% from the year prior. The total number of in-person home health visits decreased by 9.6% year-over-year in 2022... Meanwhile, the hospice industry has experienced both reimbursement and utilization gains in recent years, MedPAC reported. Medicare hospice payments rose 2.7% year-over-year in 2022, while the number of beneficiaries using hospice services ticked up by 0.4%. These patients are also receiving more care; the total number of hospice days provided to beneficiaries increased by 2% in 2022.
Executive Personnel Changes - 8/2/24
08/11/24 at 03:20 AMExecutive Personnel Changes - 8/2/24
Help improve the PEPPER Program
08/11/24 at 03:15 AMHelp improve the PEPPER ProgramPEPPER email; 7/30/24There is a temporary pause in distributing Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) as the Centers for Medicare & Medicaid Services (CMS) work to improve and update the program and reporting system. This pause will remain in effect through the fall of 2024. We recognize the importance of these reports to your practice. Therefore, during this time, CMS will be working diligently to enhance the quality and accessibility of the reports. In fulfilling this commitment, CMS seeks responses to a series of questions listed in the Request for Information (RFI). These questions will provide CMS with information that may be used to reevaluate PEPPERs and improve the effectiveness and accessibility of the program. The RFI (PDF) is available here. Responses are due on or before 08/19/2024 and must be provided via online submission at the following address: CBRPEPPERInquiries@cms.hhs.gov.
Familial loss of a loved one and biological aging: NIMHD Social Epigenomics Program
08/11/24 at 03:10 AMFamilial loss of a loved one and biological aging: NIMHD Social Epigenomics Program JAMA Network Open; by Allison E. Aiello, PhD, MS; Aura Ankita Mishra, PhD; Chantel L. Martin, PhD; Brandt Levitt, PhD; Lauren Gaydosh, PhD; Daniel W. Belsky, PhD; Robert A. Hummer, PhD; Debra J. Umberson, PhD; Kathleen Mullan Harris, PhD; 7/29/24Is the experience of losing a loved one associated with accelerated biological aging? In a cohort study of 3963 participants from the National Longitudinal Study of Adolescent to Adult Health, nearly 40% experienced the loss of a close relation by adulthood. Participants who had experienced a greater number of losses exhibited significantly older biological ages compared with those who had not experienced such losses. These findings suggest that loss can accelerate biological aging even before midlife and that frequency of losses may compound this, potentially leading to earlier chronic diseases and mortality.
Pain Management at the End of Life
08/11/24 at 03:05 AMPain Management at the End of LifeJournal of Hospice and Palliative Nursing; HPNA position statement; 8/24Pain management is essential from the time of diagnosis of a serious illness and throughout the disease trajectory. Unfortunately, the prevalence of pain in those with serious illness remains unacceptably high. In most cases, pain experienced by people with advanced disease can be prevented or relieved through optimal care, yet studies reveal that patients continue to experience uncontrolled pain in the final weeks, days, and hours of their lives...
Today's Encouragement
08/11/24 at 03:00 AMThe trouble with steeling yourself against the harshness of reality is that the same steel that secures your life against being destroyed secures your life also against being opened up and transformed. ~Frederick Buechner, The Sacred Journey
CMS 2025 Hospice Final Rule [published 8/6/24]: Additional responses
08/11/24 at 03:00 AMCMS 2025 Hospice Final Rule [published 8/6/24]: Additional responses
Sunday newsletters
08/11/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
Hospital assets before and after private equity acquisition
08/10/24 at 03:40 AMHospital assets before and after private equity acquisitionJAMA; by Elizabeth Schrier, Hope E M Schwartz, David U Himmelstein, Adam Gaffney, Danny McCormick, Samuel L Dickman, Steffie Woolhandler; 7/24Private equity firms spent $505 billion on health care acquisitions between 2018 and 2023. Financial infusions may augment resources for care. However, firms have sometimes sold acquired hospitals’ land and buildings, repaying investors with proceeds and burdening hospitals with rent payments for facilities they once owned. We assessed changes in hospitals’ capital assets after private equity acquisition. After private equity acquisition, hospital assets decreased by 24% relative to that of controls during 2 years. Private equity acquisitions appear to have depleted, rather than augmented, hospital assets. Although funds from asset drawdowns might be redeployed to enhance care or efficiency, previous studies suggest such effects may not occur.
Changes in registered nurse employment plans and workplace assessments
08/10/24 at 03:35 AMChanges in Registered Nurse Employment Plans and Workplace AssessmentsJAMA Network Open; by Christopher R Friese, Barbara R Medvec, Deanna J Marriott, Lara Khadr, Marissa Rurka Wade, Melissa Riba, Marita G Titler; 7/24How have nurses’ workplace assessments and intention to leave their workplace changed from the 2022 to the 2023 Michigan Nurses’ Study? In this survey study of 9150 and 7059 nurse participants in the 2022 and 2023 surveys, respectively, significantly fewer nurses were planning to leave their workplace in 2023 than in 2022 (32.0% vs 39.1%). Workplace assessments improved in the 2023 survey; however, planned departure rates, abusive or violent events, and unsafe conditions remained high, and understaffing remained a primary concern. Findings of this study suggest that improved working conditions are likely to promote nurse retention; health system leaders and policymakers should prioritize initiatives that support nurse retention and reduce potential workforce instability.
AI and health insurance prior authorization: Regulators need to step up oversight
08/10/24 at 03:30 AMAI And Health Insurance Prior Authorization: Regulators Need To Step Up OversightHealth Affairs; by Carmel Shachar Amy Killelea Sara Gerke; 7/24Artificial intelligence (AI)—a machine or computer’s ability to perform cognitive functions—is quickly changing many facets of American life, including how we interact with health insurance. AI is increasingly being used by health insurers to automate a host of functions, including processing prior authorization (PA) requests, managing other plan utilization management techniques, and adjudicating claims. In contrast to the Food and Drug Administration’s (FDA’s) increasing attention to algorithms used to guide clinical decision making, there is relatively little state or federal oversight of both the development and use of algorithms by health insurers.
Kidney transplant outcomes from deceased donors who received dialysis
08/10/24 at 03:25 AMKidney Transplant Outcomes From Deceased Donors Who Received DialysisJAMA Network; by Yumeng Wen, Sherry G Mansour, Nityasree Srialluri, David Hu, Heather Thiessen Philbrook, Isaac E Hall, Mona D Doshi, Sumit Mohan, Peter P Reese, Chirag R Parikh; 5/24Are kidneys from deceased donors who underwent dialysis prior to kidney donation associated with adverse graft outcomes in kidney transplant recipients compared with kidneys from deceased donors who did not undergo dialysis? Compared with recipients of kidneys from deceased donors who did not undergo dialysis, receiving kidneys from deceased donors who underwent dialysis prior to donation was associated with a higher incidence of delayed graft function, but no difference in graft failure or death at longer-term follow-up.