Literature Review
How hospice valuations are shaping up in 2024
06/09/24 at 03:30 AMHow hospice valuations are shaping up in 2024Hospice News; by Jim Parker; 5/30/24When it comes to hospice acquisitions, buyers’ and sellers’ expectations on price tags are becoming more aligned. A surge of deals in 2021 and 2022 led to record-high valuations in the space with multiples reaching in excess of 30x in some instances. While many buyers were willing to pay that premium, some stepped out of the market due to the high valuations. But deal volume has largely declined in late 2023 and early 2024, and valuations are starting to come down.
Hawaiʻi is the first state to provide palliative care coverage
06/09/24 at 03:25 AMHawaiʻi is the first state to provide palliative care coverage EIN Presswire; by Governor Josh Green, MD; 6/4/24 Governor Josh Green, M.D., and the Department of Human Services (DHS) Med-QUEST Division are pleased to announce that the Centers for Medicare and Medicaid Services (CMS) approved a new State Plan Amendment (SPA) to cover community palliative care services through Medicaid, making Hawaiʻi the first state in the nation to do so. ... “After several years of hard work and collaboration with many community members and experts in the field, I am proud to announce that Med-QUEST is the first Medicaid program in the country to get this benefit approved,” said Governor Green. “This will greatly improve the quality of life and health outcomes for thousands of people who face serious medical conditions in our state. Hawaiʻi continues to lead the nation in innovations in health and health care.”
Controversial conversations: Key takeaways from The Jeffrey Fudin Debates on pain and palliative care practices
06/09/24 at 03:20 AMControversial conversations: Key takeaways from The Jeffrey Fudin Debates on pain and palliative care practices Pharmacy Times; Interview with Lee Kral, PharmD, FASHP, NBC-HWC, CPMC, CPE; 6/5/24In an interview with the Pharmacy Times®, Lee Kral, PharmD, FASHP, NBC-HWC, CPMC, CPE, clinical pharmacy specialist of pain management at the University of Iowa Hospitals and Clinics, shares her insights into pain management in palliative care for patients with cancer-related chronic pain. She highlights the crucial role of pharmacists in managing patient treatment regimens, including administration of opioids, the role of off-label prescribing, and the potential of deprescribing to improve patients’ quality of life.
Oregon reviews UnitedHealth deal for Amedisys home health, hospice
06/09/24 at 03:15 AMOregon reviews UnitedHealth deal for Amedisys home health, hospice The Lund Report; by Nick Budnick; 6/4/24State officials are asking members of the public to weigh on the proposed acquisition of Amedisys — a hospice and home health and company that operates in Roseburg, Salem and Portland — by an increasingly controversial health care giant called UnitedHealth Group. Inc. UnitedHealth operates Optum, a subsidiary whose takeover of a clinic chain in the Eugene area has sparked numerous complaints. The state recently approved the company's acquisition of The Corvallis Clinic, an 11-clinic company operating in three counties. Now, it proposes to take over the Oregon offices of a Amedisys, a publicly traded firm, and the transaction has federal officials contemplating a lawsuit to block it. UnitedHealth and Optum are under increasing scrutiny for their market dominance and allegations of anticompetitive conduct.
Get to know us even before you need us
06/09/24 at 03:10 AMGet to know us even before you need us[WV] The Journal; by Nikki Bigiarelli; 6/2/24Every day, we make decisions about how we want to live. What is most often not considered is how we want to live at the end of life. We can avoid a lot of uncertainty when we talk to those we love about our goals of care and end-of-life wishes before we encounter a serious illness.Publisher's Note: Helpful community outreach. Nikki Bigiarelli, CHPN, BSN, RN, is CEO of Hospice of the Panhandle.
Behavioral health patients a challenge to nursing homes
06/09/24 at 03:05 AMBehavioral health patients a challenge to nursing homesModern Healthcare; by Diane Eastabrook; 6/4/24Challenges providing care for nursing home patients with mental health and behavioral health issues are adding to discharge bottlenecks for hospitals, and the demand for such care has led some facilities to set up specialized units with additional staff just for those patients.Editor's Note: Hospice and palliative care leaders, what end-of-life, mental health and behavioral health specific education do you provide for your clinical teams, your volunteers, and family caregivers? For starters, you need to include dementia care training such as "Validation Therapy" by Naomi Feil and/or the "Positive Approach to Care" by Teepa Snow. For mental illness, examine the journal article "End-of-Life Care in Individuals with Serious Mental Illness." Click here to "Get Involved with Your Local Chapter" of the national Alzheimer's Association.
Today's Encouragement
06/09/24 at 03:00 AMWhen we are no longer able to change a situation, we are challenged to change ourselves. ~ Viktor Frankl, Man's Search for Meaning
Sunday newsletters
06/09/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!If you enjoy this newsletter, please share it with colleagues - they can subscribe (for free) here!If interested in becoming a sponsor, please contact us here!
Normandy Welcomes World War II Heroes - 80th Anniversary
06/09/24 at 03:00 AMNormandy Welcomes World War II Heroes - 80th AnniversaryU.S. Department of Defense; 6/4/24World War II veterans met with cheers and applause from throngs of well-wishers as they arrived in Normandy, France, for events commemorating the 80th anniversary of D-Day. ... The number of these heroes at D-Day anniversary events in Normandy each year is diminishing, but the gratitude and awe for their service and sacrifice endures.We Honor Veterans - NHPCONHPCO; retrieved from the internet on 6/5/24We Honor Veterans empowers end-of-life care partners to meet the unique needs of America’s Veterans and their families. Our guidance and resources are focused on respectful inquiry, compassionate listening and grateful acknowledgment so that veterans can be guided through their life stories toward a more peaceful ending.Editor's Note: Thank you NHPCO for your foresight in developing this program! You identified the massive generation of WWII veterans we would lose within a window of two decades. You educated hospice organizations nation-wide and equipped us with relevant resources, while we still had time to provide meaningful support. (Today's average age of surviving WWII veterans is 100.)
Stepped palliative care for patients with advanced lung cancer: A randomized clinical trial
06/08/24 at 03:00 AMStepped palliative care for patients with advanced lung cancer: A randomized clinical trialJAMA; by Jennifer S. Temel, MD, Vicki A. Jackson, MPH, MD, Areej El-Jawahri, MD, Simone P. Rinaldi, MSN, ANP-BC, ACHPN, Laura A. Petrillo, MD, Pallavi Kumar, MD, Kathryn A. McGrath, MD, Thomas W. LeBlanc, MD, Arif H. Kamal, MD, Christopher A. Jones, MD, Dustin J. Rabideau, PhD, Nora Horick, MS, Kedie Pintro, MS, Emily R. Gallagher Medeiros, RN, Kathryn E. Post, PhD, RN, ANP-BC, Joseph A. Greer, PhD; 6/24A stepped-care model, with palliative care visits occurring only at key points in patients’ cancer trajectories and using a decrement in QOL to trigger more intensive palliative care exposure, resulted in fewer palliative care visits without diminishing the benefits for patients’ QOL. While stepped palliative care was associated with fewer days in hospice, it is a more scalable way to deliver early palliative care to enhance patient-reported outcomes.Publisher's note: This article was reference earlier this week in Palliative care for cancer patients is found to be as effective given virtually as in person.
The role and professional standards of the Adult-Gerontology Nurse Practitioner in hospice and palliative care
06/08/24 at 03:00 AMThe role and professional standards of the Adult-Gerontology Nurse Practitioner in hospice and palliative careJournal of Hospice and Palliative Nursing; by Heather Coats, PhD, APRN-BC, Kelly Henrichs, Kelly DNP, RN, GNP-BC; 6/24The adult/gerontology (gero) nurse practitioner (NP) delivers primary and/or specialty palliative care to persons and their families who live each day with a myriad of serious illnesses. In this role, the adult/gero NP uses their skill set to address the whole person (physical, psychological, social, and spiritual/existential) to improve the quality of life for persons they care for. This article is the fourth in a series of 6 highlighting the different roles of the adult/gero NP and the advanced certified hospice and palliative registered nurse, and how these 2 roles overlap. The purpose of this article was to provide details of education and certification pathways for these NP roles, describe the overlaps in clinical care, and illustrate how the adult/gero NP in palliative and hospice care can contribute to leadership in program development for care of persons and their families who live with serious illness.
National Nurses Honor Guard Coalition
06/08/24 at 03:00 AMNational Nurses Honor Guard CoalitionJournal of Hospice and Palliative Nursing; by Betty Ferrell; 6/24As hospice and palliative care nurses, we are very familiar with the importance of rituals at the end of life or after death, which helps us to honor this sacred time. We know that funeral or memorial services offer a time to honor lives and to provide comfort to families. But how often do we pause to honor our own nursing colleagues for their lives of service?I recently learned of an incredible organization, the National Nurses Honor Guard Coalition, which is doing just this—honoring nurses through participation in their funeral services to celebrate these lives well lived and lives dedicated to our profession. ... Hearing about the Honor Guard Coalition brought tears to my eyes to think about this incredible tribute to nurses.Publisher's Note: Thanks for writing about this important group Betty! I also recently learned about the National (and state-specific) Nurses Honor Guard Coalition at the Nebraska Hospice & Palliative Care Association annual conference. A great group with a fantastic mission.
Mapped: The highs and lows of the world’s happiness landscape
06/08/24 at 03:00 AMMapped: The highs and lows of the world’s happiness landscapeBigThink.com; by Frank Jacobs; 6/3/24The Gallup World Poll reveals regional peaks and valleys of happiness across all of the continents. At a glance, we see that happiness levels are relatively high across the Americas, in Europe and Oceania, and generally lowest across Africa and South Asia. In North America, Canada (6.9) came out on top, happier than the U.S. and Mexico (both 6.7). The least happy country in North America is the Dominican Republic (5.8) — perhaps unfairly, as its bad-to-worse neighbor Haiti wasn’t surveyed.
Saturday newsletters
06/08/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Exposure to a loved one’s death and advance care planning: Moderating effects of age
06/08/24 at 03:00 AMExposure to a loved one’s death and advance care planning: Moderating effects of ageAmerican Journal of Hospice and Palliative Medicine; by Peiyuan Zhang, MS, Sarah Clem, MSW, Roderick Rose, PhD, John G. Cagle, PhD; 6/24Despite documented benefits of Advance Care Planning (ACP), it is still under-utilized in the U.S. Our study aimed to examine whether experiencing a loved one’s death is associated with one’s own ACP behavior among adults in the U.S. and the potential moderating effect of age. ... Exploring an individual’s previous experience with a loved one’s death might be an effective way to broach the concept of ACP among adults of all ages. This strategy may be particularly useful in facilitating discussions of end-of-life medical wishes with doctors among younger adults than older adults.
A moratorium on the euphemism MAID
06/08/24 at 03:00 AMA moratorium on the euphemism MAIDJournal of the American Medical Directors Association; by Richard W. Sams II MD, MA (Ethics), CMD, Peter Jaggard MD, CMD; 6/24It is essential for high-quality health care for providers to adhere to the principle of truth telling, speaking with clarity and honesty. The euphemism medical aid in dying, MAID, is being mainstreamed in the medical literature by proponents of physician-assisted suicide and euthanasia. ... We recommend standardized language that accurately denotes the context and process. Provider Assisted Death by Prescription (PAD-P) and Provider Assisted Death by Administration (PAD-A) are terms that most accurately describe the process, taking into account who is prescribing or administering a lethal substance and the outcome of the actions. ... The standardized language needs to be used on death certificates so we can most accurately assess the impact that provider-assisted death is having on society. Emphasizing truth telling in morally controversial practices will foster trust among health care providers and with patients.
Geriatric End-of-Life Screening Tool prediction of 6-month mortality in older patients
06/08/24 at 03:00 AMGeriatric End-of-Life Screening Tool prediction of 6-month mortality in older patientsJAMA Open Network; by Adrian D. Haimovich, MD, PhD, Ryan C. Burke, PhD, MPH, Larry A. Nathanson, MD, David Rubins, MD, R. Andrew Taylor, MD, MHS, Erin K. Kross, MD, Kei Ouchi, MD, MPH, Nathan I. Shapiro, MD, MPH, Mara A. Schonberg, MD, MPH; 5/31/24In this prognostic study of 82,371 ED encounters within a tertiary care emergency department, the Geriatric End-of-Life Screening Tool (GEST) performed robustly on external validation, identifying 11.6% of the population as having a 30% or greater mortality risk. Compared with serious illness diagnoses, GEST provided a greater net benefit as a screening tool using decision curve analysis. The findings of this prognostic external validation study highlight the opportunity to use pragmatic, prognostic electronic health record algorithms to identify older adults in the emergency department for end-of-life care interventions.Publisher's Note: See related article posted earlier this week from McKnight's Long-Term Care News, Screening tool predicts older adults’ need for end-of-life care intervention.
Lightways Hospice and Serious Illness Care grieves the death of hospice leader
06/07/24 at 03:30 AMLightways Hospice and Serious Illness Care grieves the death of hospice leaderThe Times Weekly; by Times Weekly Staff; 6/6/24 One of the former CEOs of Joliet Area Community Hospice, now known as Lightways Hospice and Serious Illness Care, has died. Duane Krieger was instrumental in the efforts to acquire land and build the first hospice residence in Illinois. Until this time, hospice care in this state was provided in patients’ homes and facilities. “Duane’s passion and dedication to building a free-standing hospice facility in Joliet was unwavering, said Mary Kay Sheehan, CEO of Lightways Hospice and Serious Illness Care. “Duane understood the need and knew who to talk to, in both the private and public sector, to secure funding and pass the regulations to build this hospice home and elevate the level of and access to hospice care. Duane always went above and beyond to ensure the residents of Joliet and the surrounding area had access to the care they needed. He was an inspiration and a true leader who will be missed.”
How fraudulent hospices evade regulators
06/07/24 at 03:00 AMHow fraudulent hospices evade regulators Hospice News; by Jim Parker; 6/5/24A slew of fraudulent hospices in California are dodging consequences by shuffling patients around between provider numbers. That’s according to multiple sources who spoke with Hospice News, expressing their concerns about patterns of fraud continuing even as government regulators crack down on the sector. Since 2021, numerous media and government reports have emerged of unethical or illegal practices among hundreds of newly licensed hospices, particularly among new companies popping up in California, Texas, Nevada and Arizona. Despite the best efforts of regulators and law enforcement, hospice leaders are concerned that many bad actors are slipping through the cracks.
Today's Encouragement: ... returning thanks ...
06/07/24 at 03:00 AMNo duty is more urgent than that of returning thanks. - James Allen
Leading healthcare transformation: Strategic growth through generative AI
06/07/24 at 03:00 AMLeading healthcare transformation: Strategic growth through generative AI Forbes; by Ashu Goel; 6/5/24 When ChatGPT was launched in November 2022, most of us experienced a “wow” moment. Its capabilities seemed magical. Generative AI (GenAI), led by ChatGPT, has taken the industry by storm, emerging as one of the most disruptive technologies of our era. Given the widespread discussion around GenAI, it's clear that its impact is profound and far-reaching. Yet, adopting generative AI has been a significant challenge for many organizations. Gartner's insight highlights this struggle, predicting that at least 30% of generative AI projects will be abandoned throughout the next year due to issues like poor data quality and unclear business value. This prediction alone paints a picture of the adoption hurdles. ... Editor's Note: This is not not a black and white right-wrong, good-bad conflict. Notice in numerous articles we post the valid concerns expressed by hospice and palliative clinical professionals. Practical, effective implementation must reconcile these differences.
Forcura and HealthRev Partners announce Ecosystem Partnership
06/07/24 at 03:00 AMForcura and HealthRev Partners announce Ecosystem Partnership Business Wire; 6/4/24 Forcura, a healthcare workflow management company, announces a strategic ecosystem partnership with HealthRev Partners, a prominent provider of revenue cycle management services for the home health, hospice, and palliative care sectors. This collaboration focuses on enhancing the referral process for agencies operating in these critical healthcare segments.
Kickbacks and medically unnecessary treatments: Five major qui tam settlements from May 2024
06/07/24 at 03:00 AMKickbacks and medically unnecessary treatments: Five major qui tam settlements from May 2024 JD Supra; by Geoff Schweller; 6/5/24 Under the FCA’s qui tam provisions, a crucial tool in combating healthcare fraud, whistleblowers have the power to file suits on behalf of the federal government if they possess the knowledge of an individual or company defrauding the government. The government may choose to intervene and take over the suit, but if a qui tam lawsuit results in a successful settlement, the whistleblower is eligible to receive between 15-30% of the monies collected. The settlements announced in May cover a wide range of alleged misconduct that violates the FCA, including cases concerning kickbacks and the billing of federal healthcare programs for medically unnecessary treatments. Each settlement represents a victory in the ongoing battle against fraud. ... [Non-hospice examples followed by this hospice case] $4.2 Million Settlement with Elara Claring for Allegedly Billing Medicare for Ineligible Hospice Patients ...
The latest research indicates massage therapy has benefits from birth to end of life
06/07/24 at 03:00 AMThe latest research indicates massage therapy has benefits from birth to end of life Cision PR Newswire; by American Massage Therapy Association; 6/5/24 The American Massage Therapy Association (AMTA) is sharing recent research on how massage therapy can provide benefits from infancy through end of life. Across all ages, massage therapy can be a therapeutic approach to enhancing physical and emotional well-being. Explore the latest studies on how massage therapy can help improve the quality of life for infants, middle-aged individuals, and older adults. ... A nationwide survey of physicians, physician assistants, and nurse practitioners in palliative care documented recommendation rates of integrative therapies to target symptoms of palliative care patients. The survey found that massage therapy was the third most recommended integrative care modality behind mind-body interventions like meditation and biofeedback. The integrative therapies aimed to reduce pain, anxiety, mood disturbances, and distress.Editor's Note: While hiring a professional massage therapist might not be practical for your budget, explore contracting with massage therapist who is trained in working with medically-fragile persons to provide simple trainings for your nurses and nurse aides. Additionally, professionally trained massage therapists might be interested in volunteering their services, within appropriate parameters (i.e., not transferring the medically-fragile patient to a massage table, having a caregiver present to assist with communication, etc.).