Literature Review

Medicare Advantage will 'sink' rural hospitals, experts warn Modern Healthcare; by Michael Mcauliff; 5/14/24Studies by Chartis [Center for Rural Heaalth] and others paint the bleak picture for rural hospitals. According to a recent estimate by the nonprofit Center for Healthcare Quality and Payment Reform, about 700 rural hospitals are at risk of closing. A recent Chartis report estimated 167 rural hospitals have closed since 2010, with another 418 vulnerable to closure now. [Click on the title's link for patient care examples and more stats.]

When families fight over a relative with dementia, it’s time to call in the mediator The New York Times; by Paula Span; 5/13/24 Trained negotiators can help families struggling with vexing elder-care issues.  The four adult children were in agreement. Their father, William Curry, a retired electrical engineer and business executive, was sinking deeper into dementia. ... [But their mother] remained determined to continue caring for her 81-year-old husband at home, despite the increasing toll on her own health. ... As the weeks passed, “we were really at an impasse,” [a daughter] said. “Do you override your mother?” ...  [Increasingly,] families seek elder mediation privately, before disputes land in court and imperil or destroy family relationships. [Continue reading for descriptions of how mediation differs from arbitration, from family therapy, and for cautions about this being "a fairly new field with no nationwide certification or licensing requirements."]Editor's Notes: Executive leaders, what community education and resources are you providing for Advance Directives? What family systems education and and problem-solving are you providing for your interdisciplinary team members and grief counselors? Family conflicts are inherent--in some form or fashion--with almost anyone needing dementia care, especially when paired with palliative or hospice care. (If in doubt, ask your seasoned, front-line professionals.)

Musician grants dying wish to hospice patient The Platte County Citizen; by Rimsie McConiga; 5/14/24 Jazz musician Stanton Kessler was surprised when he was contacted recently by his friend, a hospice nurse, who reached out to him with an unusual request. A patient at the Kansas City hospice where she works told her his last wish would be to hear his favorite song, ‘Feels So Good’ before he died. During their conversations Kessler’s impression was that this was his friend’s first experience with a request such as this. “There was an element of urgency,” Kessler said. “She said he was near death.” ... An incredibly emotional and rewarding moment followed when Kessler began to play the patient’s beloved song. The man’s eyes remained closed, but his fingers began to move. ...Editor's Note: For research-based, hospice clinical stories, and rich music metaphors for ways use music with the dying and bereaved, examine the book, Music of the Soul, Chapter 7 "The Final Cadence," in Routledge's international Series in Death, Dying, and Bereavement (series edited Robert A. Neimeyer), authored by Joy S. Berger, DMA, FT, BCC, MT-BC (editor for this newsletter).

Have EHRs been good for healthcare? Becker's Health IT; by Giles Bruce; 5/3/24 Fifteen years after meaningful use incentives propelled the shift to EHRs, health system leaders told Becker's that digitizing medical records has been a net positive for the industry — with some caveats. "Regardless of your position, there is no doubt that EHRs have changed the face of healthcare," said Sandra Hales, associate vice president for IT clinical applications at Phoenix-based Banner Health. "Patients now have timely access to records and data that is simplified for understanding, and there's a level of inclusivity and responsibility for patients to engage in their own care."

Upskilling and retraining for talent innovation in the AI ​​era Tech Trends Post; 5/13/24 According to a report from the IBM Institute for Business Value, more than 60% of executives say generative AI will disrupt the way their organizations design customer and employee experiences. Employees must change to meet these demands. Many are turning to AI upskilling – the act of providing the workforce with the skills and training to use AI to do their jobs. ... A 2024 Gallup poll found that about 25% of workers worry that their jobs could become obsolete due to AI. ... [This article outlines the following:]

Potential progress at Optum Tri-State complicated by corporate care crisis: It's bonuses for bodies' The Examiner News; by Adam Stone; 5/13/24 'It's Bonuses for Bodies' This is the 16th installment in an investigative series, launched in December 2022, about CareMount/Optum/UnitedHealth and broader concerns about corporate medical care. ... I know this piece is a long ride to the larger point but buckle up and pretend you’re reading a few book chapters instead of a newspaper column, because all of the context matters, and interconnects. ... 

800+ California nurses to receive 22.5% pay hike Becker's Hospital Review; by Kelly Gooch; 5/10/24Members of the California Nurses Association have approved a new labor contract with Washington Hospital Healthcare System in Fremont, Calif. The four-year agreement covers roughly 840 nurses, according to a union news release. It was approved by union members May 3 and by the Washington Township Health Care District board of directors May 8. ... According to the CNA, the new deal includes a 22.5% across-the-board increase in wages over four years. It also includes "precedent-setting standard expanding infectious disease protocols and workplace violence protections"; language that protects union members' ability to take meal and rest periods; and protections for part-time positions, according to the union.Editor's Note: These new terms reflect nationwide trends of healthcare/nurse strikes and reasons for leaving their jobs, ie., pay, patient safety, workplace violence, work/home life balance, and more.

CMS extends Medicaid waivers to 2025 Becker's Payer Issues; by Rylee Wilson; 5/13/24 CMS will extend flexibilities designed to help states keep more eligible individuals enrolled in Medicaid through June 2025. The waivers, previously set to expire at the end of 2024, will be extended for six more months, Daniel Tsai, deputy CMS administrator and director of the Center for Medicaid and CHIP services, wrote in a May 9 memo to states. Nearly all states were expected to complete the unwinding process by June 2024, Mr. Tsai wrote, but because several states took extension waivers from CMS, several states will continue renewals past June. 

Hospital CEOs ask patients to receive care at home Becker's Hospital Review; by Madeline Ashley; 5/14/24 Hospital executives are making the push to move more care, specifically recovery rooms and exams, out of the hospital and into patient homes, to potentially save money and improve finances as the country continues to move out of the pandemic, Politico reported May 11. And Congress is supporting these efforts by introducing legislation that would expand at-home care and to allow Medicare to continue funding telehealth. Here are five findings from the report: ... [Click on the title's link to read more.]

Nurse practitioners improve skilled nursing's dementia care outcomes, but regulatory barriers remain: studyMcKnights Long-Term Care News; by Josh Henreckson; 5/13/24[Nurse pracitioners'] NPs’ involvement can significantly improve end-of-life care outcomes for residents with Alzheimer’s disease and related dementias (ADRD), according to the results of a new study in JAMA Health Forum. ... Those benefits, however, were shrunk by state regulations on the scope of care NPs are allowed to provide. ...  Elizabeth White, PhD, assistant professor of health services, policy and practice at Brown University [describes,] “For example, when a state restricts NPs from signing Do Not Resuscitate orders, that can serve as a barrier to advance care planning and could contribute to unnecessary hospitalizations at the end of life.” Editor's Note: We posted this JAMA Health Forum article on : Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia. 

California to redirect more than $7B in healthcare funding Becker's Hospital CFO Report; by Mackenzie Bean; 5/13/24 California is seeking to divert more than $7 billion in funding from the healthcare sector to address a major funding deficit, according to a revised budget proposal released May 10. Gov. Gavin Newsom has proposed reallocating $6.7 billion from Medi-Cal provider rate increases planned for Jan. 1, 2025, to balance the state budget. This funding was generated by the managed care organization tax created last year. ... The proposed budget would also cut funding for healthcare workforce initiatives by $854.6 million through 2028. Funding for public health and various behavioral health programs would also be reduced. 

Maryland becomes sixth state to require salary, wage disclosures in job listings McKnights Senior Living; by Kathleen Steele Gaivin; 5/10/24 Maryland soon will join five other states and the Washington, DC, in requiring employers to disclose salary or wage ranges upfront in job listings. Maryland’s requirement goes into effect Oct. 1. The states of California, Colorado, Hawaii, New York and Washington have similar laws in place, with the requirement expected to go into effect in the nation’s capital, on June 30. ... After a first violation, the employer will receive a warning. Fines for noncompliance range then will range from $300 for the second violation to $600 for subsequent violations.