Literature Review
Retired hospice worker now a hospice volunteer
04/29/24 at 03:00 AMRetired hospice worker now a hospice volunteer Sanford Health; by Jason Anschutz; 4/25/24"It's always been in my heart," says Nicolle Aukland of Fargo, ND. ... Aukland began her professional career as a medical social worker at MeritCare before the hospital merged with Sanford Health. She then transitioned into a similar role with Hospice of the Red River Valley. She would eventually leave the health care industry, but her passion for hospice never left her. ... Now in retirement, Aukland dedicates her free time to hospice patients as a companionship volunteer at two different organizations, including Sanford Hospice House in Fargo.Editor's Note: Do you encourage your retired employees to volunteer? Or perhaps retired employees from your community's other healthcare systems? They provide you with rich experience; you can provide them with meaningful volunteering. If so, be sure to orient them to the differences between their prior professional roles and the scope of practice for your organization's volunteer roles.
Living well to the end: Singapore ramps up palliative and hospice care capacity
04/29/24 at 03:00 AMLiving well to the end: Singapore ramps up palliative and hospice care capacityThe Straits Times; by Joy Teo; 4/26/24 Singapore is increasing its palliative care and hospice capacity to allow more people with life-threatening illnesses to live well till the very end, and die with dignity and comfort. By 2025, there will be 300 inpatient palliative care beds, 140 day hospice places and capacity for palliative home care for 3,600 patients. In Singapore, the term palliative care is often used interchangeably with hospice care, though there are subtle differences.
Terror and LGBTQIA+ identity: Thoughts on Dr. Candrian’s Newsweek reflection
04/29/24 at 03:00 AMTerror and LGBTQIA+ identity: Thoughts on Dr. Candrian’s Newsweek reflection Anschutz Medical School (Univ of Colorado); by Melissa C Palmer, JD LCSW ACHP-SW APHSW-C; 4/23/24 ... When reflecting on the intersection of LGBTQIA+ culture, being a woman, and the medical community, I have experienced gaslighting and marginalization because of my own identity. Things have changed a little in the past years, particularly in younger generations where sexuality and gender identity are more fluid and accepted. But in healthcare, unconscious bias due to the indoctrination by our elders can cause patients identifying as LGBTQIA+ to receive disparate care. ... Editor's Note:
Remedy or gateway drug? Doctors, police differ on path forward for medical marijuana
04/29/24 at 03:00 AMRemedy or gateway drug? Doctors, police differ on path forward for medical marijuana The State; by Anna Wilder; 4/25/24 Medical marijuana blurs lines across law enforcement and the medical community, where advocates and opponents don’t agree whether it is a gateway drug or necessary medical device. With days left in the 2024 session, [South Carolina] House members are hearing from doctors, law enforcement, researchers, pharmacists and others on the highly contested issue. Out of 17 speakers at a Ad Hoc committee meeting Tuesday, eight opposed the bill, nine supported it and one was relatively indifferent.
1st state passes law to decriminalize medical errors
04/29/24 at 02:15 AM1st state passes law to decriminalize medical errors Becker's Hospital Review; by Erica Carbajal; 4/25/24Kentucky Gov. Andy Beshear recently signed a bill into law that shields healthcare providers from being criminally charged for medical errors, making it the first state to do so. HB 159 ensures that healthcare providers, including nurses, "shall be immune from criminal liability for any harm or damages alleged to arise from an act or omission relating to the provision of health services." It includes exceptions for negligence and intentional harm. ... In wake of [this article's cited] case, nurses and medical groups nationwide — including the American Nurses Association and the Institute for Healthcare Improvement — have called for systemwide workforce and safety reforms to focus on harm prevention, arguing that the criminalization of errors would discourage workers from reporting mistakes. ... The Kentucky Hospital Association said it supports the new law.
The Dos and Don’ts of enhanced service contracts
04/29/24 at 02:00 AMThe Dos and Don’ts of enhanced service contractsSpecialty Pharmacy Continuum; by Marcus A. Banks; 4/25/24 ... Any pharmacy that interacts with patients—an independent pharmacy, an ambulatory infusion clinic, a health system or specialty pharmacy—can enter an enhanced service contract with a pharmaceutical company. All services offered under these contracts should be documented, auditable and offered at fair prices. Before approaching the company about partnering, Mr. Suchanek advised understanding the distinction between basic and enhanced services. ... “Pharmacy leaders need to demonstrate that they are credible partners,” [David] Suchanek said [Executive Vice President for Biotech & Specialty Services at D2 Solutions].
Palliative care’s value-based future
04/29/24 at 02:00 AMPalliative care’s value-based future Hospice News; by Jim Parker; 4/24/24 Many believe that the fee-for-service model does not sufficiently support a robust palliative care program, meaning that providers must turn to value-based systems for sustainable reimbursement. But primarily, Medicare still reimburses for palliative care through fee-for-service payment programs that cover physician and licensed independent practitioner services. That model does not sufficiently cover the full range of interdisciplinary care, Dr. Julia Friedman, palliative care medical director at Thyme Care, said at the Home Health Care News Cap+Strat Conference.
Across the nation, the fight’s on to protect physician-led care
04/29/24 at 02:00 AMAcross the nation, the fight’s on to protect physician-led careAmerican Medical Association - AMA; by Kevin B. O'Reilly; 4/25/24After helping state medical associations and national specialty societies defeat more than 100 bills to inappropriately expand nonphysicians’ scope of practice in 2023, the AMA is again relentlessly joining its allies in organized medicine to continue the fight for physician-led, team-based care in this year’s legislative session. This intensive and effective advocacy effort has ranged across the country, as the AMA has helped battle scope creep in Alaska, Connecticut, Georgia, Oklahoma, New Hampshire and elsewhere.
Hospice fraud must be stopped!
04/29/24 at 02:00 AMHospice fraud must be stopped!Hospice Action Network; via email; 4/26/24Across multiple states, the same story is playing out: Criminals are defrauding Medicare, getting licensed and certified to operate as hospices when they have no intent of providing care. This flagrant abuse of vulnerable patients and our healthcare system must be stopped in its tracks. We need your help! Ask your representatives to support a letter demanding answers from CMS. We need as many signatures as possible to keep the pressure on CMS.Take action today!
Home care industry slams finalized 80-20 Rule, warns agency closures are coming
04/28/24 at 03:45 AMHome care industry slams finalized 80-20 Rule, warns agency closures are coming Home Health Care News; by Andrew Donlan; 4/22/24 The “Ensuring Access to Medicaid Services” rule has been finalized. Most importantly, the bemoaned “80-20” provision has gone through as proposed, meaning providers will eventually be forced to direct 80% of reimbursement for home- and community-based services (HCBS) to caregiver wages. ... Organizations like the National Association for Home Care & Hospice (NAHC) and LeadingAge immediately condemned the rule being finalized on Monday. ...
Breaking News: Labor Department announces final overtime rule
04/28/24 at 03:40 AMBreaking News: Labor Department announces final overtime rule McKnights Senior Living; by Kimberly Bonvissuto; 4/23/24 The Department of Labor on Tuesday announced a final rule that expands overtime protections to millions of salaried workers beginning this summer. The overtime rule increases the salary thresholds necessary to exempt a salaried executive, administrative or professional employee from federal overtime pay requirements. Effective July 1, the salary threshold will increase to the equivalent of an annual salary of $43,888 and will increase to $58,656 on Jan. 1. The July 1 increase updates the current annual salary threshold of $35,568, which is based on a 2019 overtime rule update.
Hospice boss warns of funding challenges
04/28/24 at 03:35 AMHospice boss warns of funding challenges BBC News; Josh Sandiford; 4/28/24[United Kingdom] A West Midlands hospice boss has warned it faces a "huge challenge" under the current funding model. Acorns Children's Hospice, which is based in Birmingham, told the BBC the situation was not sustainable despite demand for its services growing. It came after Hospice UK said there was a £77m funding deficit at centres across the UK. Editor's Note: We highlighted this recurring theme from the United Kingdom in posts on 4/16/24 and 4/17/24 in our "International" section. Pairing this critical, ongoing financial crisis with our article on 4/19/24, "Will Assisted Dying in Europe Impact Living With Dignity?", how might these potential losses of effective hospice care impact patients' desires for assisted dying? What similar trends are we seeing in the United States?
Kisco Senior Living data breach could affect more than 26,000
04/28/24 at 03:30 AMKisco 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.
States lack resources to support new Medicaid waiver programs, association asserts
04/28/24 at 03:25 AMStates lack resources to support new Medicaid waiver programs, association asserts McKnights Home Care; by Adam Healy; 4/22/24Medicaid 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.
New York State Bar Association backs expansion of end-of-life-options
04/28/24 at 03:20 AMNew York State Bar Association backs expansion of end-of-life-options Brooklyn Daily Eagle - Courts and Law; by Robert Abruzzese; 4/23/24 The New York State Bar Association (NYSBA) has endorsed the Medical Society of the State of New York's recent support for medical aid in dying. ... The proposed New York bill (A995a/S2445), which will be considered in the 2024 legislative session, includes comprehensive safeguards to ensure that the process is voluntary, informed and free from coercion. These include the confirmation of terminal illness by two independent physicians, mandatory mental health evaluations if needed and detailed counseling on all available end-of-life care options. ...
Remote access technologies expose home care firms to cybersecurity vulnerabilities, experts say
04/28/24 at 03:15 AMRemote access technologies expose home care firms to cybersecurity vulnerabilities, experts sayMcKnights Home Care; by Adam Healy; 4/18/24 Some of the most commonly used technologies in home care are also among the easiest for criminals to exploit. ... Remote access systems include any technology that allows users to connect to and access a computer, server or network remotely. Within home care, this could be tools such as remote patient monitoring devices, secure messaging apps, telehealth platforms, cloud-based applications or systems that allow users to remotely access patient data, according to the Department of Health and Human Services. And while these technologies bring efficiency, they can also expose providers and their patients to risk.
CMS increases hours to 3.48 in final staffing rule
04/28/24 at 03:10 AMCMS 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.
Extra: CMS publishes rule outlining final staffing requirements
04/28/24 at 03:05 AMExtra: 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. ...
Sunday newsletters
04/28/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
Today's Encouragement
04/28/24 at 03:00 AMPeople who have come to know the joy of God do not deny the darkness, but they choose not to live in it. They claim that the light that shines in the darkness can be trusted more than the darkness itself and that a little bit of light can dispel a lot of darkness. They point each other to flashes of light here and there, and remind each other that they reveal the hidden but real presence of God. ~Henri Nouwen, The Return of the Prodigal Son.
Examining how improper payments cost taxpayers billions and weaken Medicare and Medicaid
04/28/24 at 03:00 AMExamining how improper payments cost taxpayers billions and weaken Medicare and Medicaid HHS-OIG; by Christi A. Grimm, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services; 4/16/24 HHS Inspector General Christi A. Grimm Testifies Before the U.S. House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations on April 16, 2024. IG Grimm briefs members on HHS-OIG's work to address improper payments in Medicare and Medicaid managed care programs. Click here to watch the testimony.
Hospice satisfaction among patients, family, and caregivers: A systematic review of the literature
04/27/24 at 03:00 AMHospice satisfaction among patients, family, and caregivers: A systematic review of the literatureAmerican Journal of Hospice and Palliative Medicine; Timothy Hoff, PhD, Kathryn Trovato, MPH, Aliya Kitsakos, BA; 6/24Thirty-eight studies were included in the review. Key findings were: (a) higher levels of hospice care satisfaction among patients, families, and other caregivers; and (b) correlates of hospice care satisfaction falling into the categories of communication, comfort, and support. The published literature had fewer findings related to demographic correlates of satisfaction such as age or race/ethnicity and was lacking in comparative research examining satisfaction across different types of hospice care settings.
"It's a heavy thing to carry": Internal medicine and pediatric resident experiences caring for dying patients
04/27/24 at 03:00 AM"It's a heavy thing to carry": Internal medicine and pediatric resident experiences caring for dying patientsAmerican Journal of Hospice and Palliative Medicine; by Lindsay M Gibbon, Laura Buck, Lauren Schmidt, Jori F Bogetz, Amy Trowbridge; 5/24Our data suggests a model for the process by which residents learn affective skills critical to EOL care: residents (1) notice strong emotion, (2) reflect on the meaning of the emotion, and (3) crystallize this reflection into a new perspective or skill. Educators can use this model to develop educational methods that emphasize normalization of physician emotions and space for processing and professional identity formation.
Saturday newsletters
04/27/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Environmental comfort in promoting sleep in critically ill patients: A scoping review
04/27/24 at 03:00 AMEnvironmental comfort in promoting sleep in critically ill patients: A scoping review[Portugal] Dimensions of Critical Care Nursing; by Derek Braga Moura, Débora de Fátima Sousa Andrade, Carla Rodrigues Silva, Igor Emanuel Soares-Pinto; 5/24It is important to understand the concept of comfort as a whole to build an assistance intervention plan that meets the person's needs. Therefore, it is necessary to monitor and assess the person's sleep by considering the surrounding environment, to provide a comfortable environment that is quiet and provides privacy, especially in contexts of difficult management of environmental factors in the approach to the person in critical condition.Publisher's note:
