Literature Review

End-of-life care facility for people experiencing homelessness opens on Monona Drive [Wisconsin] Isthmus, Madison, WI, by Linda Falkenstein; 4/23/24It started as an idea from palliative care physician Dr. Ann Catlett. Catlett had experienced having to discharge terminally ill patients who had no housing onto the streets. And she had seen a model home where patients without a home could live out their days in peace, receive hospice services and other daily palliative care. ... Thus was born Solace Friends, a Madison-area nonprofit with the goal of opening a care facility for people with terminal illnesses who are unhoused or experiencing housing insecurity. ... The opening of the adult family home was celebrated Tuesday with a press conference and tour of the facility.

Hospice nurse reveals the most common deathbed regretsUnilad; by Niamh Shackleton; 4/24/24Bronnie Ware, a nurse who has spent a large majority of her career working in palliative care, found that there were five common things that people regretted about their lives upon reflection as they approached death.

Kisco Senior Living data breach could affect more than 26,000 McKnights Senior Living, by Lois A. Bowers; 4/22/24 More than 26,000 Kisco Senior Living residents and others could have been affected by a June hacking incident, legal counsel for the company said last week. The Carlsbad, CA-based operator, which manages 25 senior living communities across eight states and Washington, DC, said in an April 16 letter to those potentially affected that the data breach occurred around June 6. Names and Social Security numbers could have been revealed in the incident, according to counsel.

Employing telehealth to ease the hospice transition for kids with cancer mHelathIntelligence, by Anuja Vaidya; 4/23/24 ... In a study published in the Journal of Pain and Symptom Management last month, Children's Healthcare of Atlanta researchers detailed a telehealth-based intervention the hospital has employed to ease the transition to hospice for young cancer patients and their families. ... The intervention includes a series of coordinated telehealth visits during the first month of hospice enrollment for children or young adults, 29 or younger, with cancer. ... Hospice nurses participating in the pilot received a tablet equipped with mobile WiFi cellular service that they would take to the family's home, which enabled the [hospital/pediatric specialty] nurses and families to join the call. ... The most important finding of the study was that coordinated telehealth visits between the hospital, hospice, and the families during the first month of hospice enrollment were feasible and acceptable to all participants.

States lack resources to support new Medicaid waiver programs, association asserts McKnights Home Care, by Adam Healy; 4/22/24 Medicaid 1115 waivers, which are commonly used to improve or expand home- and community-based services, face serious challenges as understaffed state programs are increasingly incapable of moving proposals through the administrative “pipeline,” the National Association of Medicaid Directors said in a recent letter. “The tough reality is that the Center for Medicaid and CHIP Services, which has taken many steps to streamline its administrative processes, simply does not have the staff resources to move forward all of the waivers in its pipeline,” Kate McEvoy, executive director of NAMD, wrote in the letter. 

Leadership's perceptions of palliative care during the COVID-19 pandemic: A qualitative study Journal of Pain and Symptom Management, by Tamara Vesel, Audrey Covaleski, Veronica Burkarth, Emma Ernst, Linda Vesel; 4/19/24Background: This study aimed to explore the perceptions, understanding, and utilization of palliative care before compared to during the COVID-19 pandemic among health system leadership. Results: ... Emerging themes included the role of palliative care before compared to during the COVID-19 pandemic, facilitators and barriers to palliative care delivery, and recommendations for future practice. Participants reported that the COVID-19 pandemic increased palliative care utilization, reinforced positive perceptions of the specialty, and emphasized its role in maximizing healthcare efficiency. Many participants found palliative care financing to be a barrier to delivery; ... 

UPMC lays off 1,000 employees, citing market challengesModern Healthcare, by Caroline Hudson; 4/24/24UPMC is laying off about 1,000 employees, or slightly more than 1% of its workforce. The layoffs are effective immediately, a spokesperson said Wednesday. The cuts mostly affect non-clinical, non-member-facing and administrative employees, Paul Wood, chief communications officer at UPMC, said in a statement. ... Pittsburgh-based UPMC operates 40 hospitals and 800 doctor's offices and outpatient sites in Pennsylvania, New York, Maryland and some international locations. Its insurance division covers more than 4 million members. The nonprofit health system reported a $31 million net loss in 2023, compared with a more than $1 billion loss the prior year. Operating losses for 2023 totaled $198 million.

Nurses protest AI at Kaiser Permanente Becker's Health IT, by Giles Bruce; 4/22/24 Hundreds of nurses gathered April 22 to protest the use of artificial intelligence at Oakland, Calif.-based Kaiser Permanente. The California Nurses Association held the demonstration at Kaiser Permanente's San Francisco Medical Center to coincide with the beginning of KP International's Integrated Care Experience conference. "It is deeply troubling to see Kaiser promote itself as a leader in AI in healthcare, when we know their use of these technologies comes at the expense of patient care, all in service of boosting profits," said Michelle Gutierrez Vo, BSN, RN, a president of the California Nursing Association and registered nurse at Kaiser Permanente Fremont (Calif.) Medical Center, in a statement. ...

The cancer caregiving burden trajectory over time: varying experiences of perceived versus objectively measured burden The Oncologist, by Laura A Siminoff, Maureen Wilson-Genderson, Marcin Chwistek, Maria Thomson; 4/23/24 Conclusions: Cancer caregiving is dynamic; [caregivers] CGs must adjust to the progression of the patient's disease. We found an association between subjective and objective burden both within and between CGs. Black CGs were more likely to report lower subjective burden compared to their White counterparts. More detailed investigation of the sociocultural components that affect caregiver experience of burden is needed to better understand how and where to best intervene with targeted supportive care services.

Extra: CMS publishes rule outlining final staffing requirements McKnights Long-Term Care News, by Kimberly Marselas; 4/22/24 The Centers for Medicare & Medicaid Services said it would exempt nursing homes from having registered nurse coverage for up to 8 out of 24 hours a day “under certain circumstances,” unveiling a critical new detail in the second part of today’s staffing rule rollout. A director of nursing also can count toward the rule’s 24/7 RN requirement, CMS said, noting a change that providers will likely appreciate given their persistent challenges hiring RNs across the country. “The RN onsite 24 hours a day, seven days a week requirement ensures that there is an RN available to help mitigate, and ultimately reduce, the likelihood of preventable safety events, particularly during evenings, nights, weekends, and holidays,” CMS said. ...

CMS increases hours to 3.48 in final staffing rule McKnights Long-Term Care News, by Kimberly Marselas; 4/22/24 Nursing homes will be required to deliver 3.48 hours of daily direct care per patient under a final staffing mandate issued this morning. A White House statement on the rule [4/22] said that 3.0 hours must be split between registered nurses at 0.55 hours and 2.45 hours for certified nurse aides. The remaining time was not immediately defined by the White House release, and the full rule text was not available.

Operator hopes to expand residents’ digital literacy with unique tech concierge program McKnights Senior Living, by John O'Connor; 4/22/24Beginning in June, residents in some BHI Senior Living communities will be able to take advantage of a unique tech concierge program. For residents, the new service will feature on-demand tech support, alongside virtual assistance, in-home appointments and a curriculum of tailored enrichment classes and training sessions. For the operator, the program will deliver immediate tech support while also gathering and analyzing data that can be used to inform future technology investments and strategic moves.Editor's Note: How might you adapt this creative service for the persons you serve? What differences might it make in patient care? In hospice caregiver/family satisfaction? What tech support do you have for your staff, especially when they are making home or other in-the-field visits? Relating this to today's articles on the importance of "trust" and "nurses' negativity about AI," do your innovative technologies improve or impede the patient/family's needs and experiences with you?

What the ‘fundamentally contradicting’ Medicaid Access Rule includes Home Health Care News, by Andrew Donlan; 4/22/24 The White House teased the finalized Medicaid Access Rule early Monday, and the Centers for Medicare & Medicaid Services (CMS) later revealed more intricate details attached to the rule. [The] timeline of the rule is now clear. Specifically: ... [Click on the title's link for more]