Literature Review

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.

New 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. ...

Deadly shove at assisted-living center in Hugo investigated as homicide StarTribune, Minneapolis, MN, by Paul Walsh; 4/24/24 An assisted-living center resident in Hugo was pushed by another resident and died in what officials are calling a homicide, according to a court filing. Linda S. Steen 75, was shoved on March 11 at Good Life Assisted Living & Me and suffered a broken hip, the Washington County Sheriff's Office said in a search warrant affidavit filed Tuesday. Steen was put in hospice care and died on March 30, read the affidavit, which cleared the way for a sheriff's detective to collect the medical records of the 74-year-old resident who is suspected of pushing Steen.

Skepticism is healthy, but in medicine, it can be dangerous The New York Times, Guest Essay, by Dr. Daniela J. Lamas; 4/24/24 I arrived at the hospital one recent morning to find a team of doctors gathered just outside a patient room. The patient was struggling — his breaths too fast and too shallow. For days we had been trying to walk the line between treating the pain caused by his rapidly growing cancer and prolonging his life. [The author describes interactions with the family.] ... We are at a crossroads in medicine when it comes to public trust. After a pandemic that twisted science for political gain, it is not surprising that confidence in medicine is eroding. ... Our medical system relies on trust — in face-to-face meetings as well as public health bulletins. Distrust can lead doctors to burnout and can encourage avoidable negative outcomes for our patients.Editor's Note: For a patient/caregiver/family to agree to a hospice admission, they must first trust the physician who refers them to your organization. Before that, the referring physician must trust your organization. Too often, "trust" is diluted as a "soft skill." "Trust"--as described in this article--is a cornerstone, a foundation of strength, endurance, and integrity in the hardest, most conflicted times of decisions about living and dying that a person (and family) might face.

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?

30 systems sign on to new effort to advance age-friendly care Becker's Clinical Leadership, by Erica Carbajal; 4/17/24Thirty health systems are participating in a new collaborative through the Institute for Healthcare Improvement that aims to accelerate the adoption of age-friendly care for older adults. The Age-Friendly System-Wide Spread Collaborative is billed as a learning and action community through which systems will focus on embedding four evidence-based elements of high-quality care for older adults: what matters, medication, mentation and mobility, known as the 4Ms. Participants — which include Los Angeles-based Cedars Sinai, New York City-based Mount Sinai Health System and Atlanta-based Grady Health — will share data and collaborate to advance their own improvements in scaling age-friendly care across their sites of care. Participants also have the opportunity to be among the first to achieve a new IHI recognition for systemwide adoption of the 4Ms. 

[Maine] Attention Section 43 Hospice Services Providers: Electronic Visit Verification (EVV) implementation delayed until further noticeState of Maine Department of Health and Human Services; 4/22/24 As of March 15, 2023, MaineCare temporarily excluded hospice services from EVV requirements as a delayed enforcement of our approved State Plan requirements. On December 1, 2023, we announced our plan to implement EVV requirements for hospice services starting July 1, 2024. following enactment of P.L. 2023, ch. 576 (LD 2055), An Act to Prohibit the Department of Health and Human Services from Implementing Electronic Visit Verification for Hospice Providers Within the MaineCare Program Unless Mandated by the Federal Government, the Department is delaying the implementation of EVV requirements for hospice services until further notice.

Medicare Advantage fight shifts to 340B arena Modern Healthcare, by Alex Kacik; 4/22/24Hospitals' fight to boost Medicare Advantage reimbursement has extended to plans' pay for 340B drugs. The hospitals’ plea to adjust Medicare Advantage pay stems from regulation aimed at making providers that participate in the drug discount program whole after the Supreme Court reversed 340B rate cuts that were in place from 2018 to 2022.

Professor shines light on life incarcerated

Analysts not ruling out Cigna, Humana mergerBecker's Payer Issues, by Rylee Wilson; 4/22/24A merger between Humana and Cigna could still be in the cards according to one analyst, Bloomberg reported April 22. "The math now works for a [Cigna and Humana] fusion," Jeffries analyst David Windley wrote April 22. Since the two companies abandoned a proposed merger in December, Cigna's stock prices have risen by 37% and Humana is down 31%, according to Bloomberg. Cigna could strike a deal to acquire Humana for around $420 per share, Mr. Windley wrote in a note to clients. An acquisition would add to Cigna's growth if it does not pay more than $470 per share for the company, according to Jeffries.

Providence employees awarded $98M in wage suit Modern Healthcare, by Hayley Desilva; 4/22/24 A jury awarded more than $98 million to Providence Health and Services employees in a class action lawsuit over claims the health system illegally denied meal breaks and pay for time worked. King County Superior Court Judge Averil Rothrock, who presided over the case, also ruled Thursday that the health system willfully withheld wages, which under Washington state law could entitle workers to double the amount of damages awarded.