Literature Review

My Dad had an Advance Directive. He still had to fight to die Newsweek - My Turn; by Maggie Schneider Huston; 8/26/24 My mom  died peacefully. My dad died 72 days later, angry at the doctors for ignoring his wishes. ... Dad had heart surgery on December 20, 2023. An hour after the surgery ended, his vital systems started shutting down. A cascade of interventions, one after another, kept him alive. Four days later, he said: "Put me on hospice." The doctor dismissed this request, rolling his eyes and saying: "Everyone on a ventilator says that." On Christmas Day, my father asked for hospice again. He was in pain. He knew his recovery would be long and ultimately futile. He would never have an acceptable quality of life again. ... Dad's care team insisted palliative care was the same as hospice care, but he knew the difference. He wanted hospice care. Finally, they reluctantly agreed and called for a social worker to make arrangements. It wasn't necessary. Once they removed his treatment and relieved his pain, he died five hours later. ... Editor's Note: This article is not about Medical Aid in Dying (MAiD). It is about honoring Advance Directives, person-centered care with communications and actions related to "palliative" vs. "hospice" care.

Fraudulent hospices reportedly target homeless people, methadone patients to pad census Hospice News; by Jim Parker; 8/23/24 Fraudulent hospices in California reportedly have been targeting homeless people and methadone patients, promising them a steady supply of opioids in exchange for enrolling in hospice. Three hospice leaders came forward to Hospice News to report these practices. According to their reports, unscrupulous providers have canvassed both homeless encampments and methadone clinics seeking to sign up patients who are not terminally ill. In many cases, the sources said, these operators offer patients free access to board-and-care facilities and a daily supply of morphine. Another frequent practice among these hospices is to offer patients cash or other items in addition to drugs, they said. “This conduct raises serious fraud concerns on kickbacks or gifts to beneficiaries who do not appear to qualify for hospice,” Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), told Hospice News. “More importantly, this conduct is predatory, taking advantage of individuals in addiction. Jail time is not enough punishment for the harm that such conduct creates.”Editor's Note: This is abhorrable. Click on the title's link to read more. While John Oliver's "Last Week Tonight" episode on 8/18/24 gained criticism from many hospice leaders, these fraudulent unethical behaviors (and others') lay the groundwork for such dire distrust from the public. These organizations' behaviors must be stopped. These organizations must be held accountable.

False Claims Act decisions to know from Q2 2024 JD Supra; by Bass, Berry & Sis PLC; 8/22/24 In case you missed it, this post recaps some key False Claims Act (FCA) decisions and case updates from the second quarter of this year. Courts weighed in on the FCA’s anti-retaliation provision, its first-to-file bar, and issues around judgments and awards. ... In U.S. ex rel. Rosales v. Amedisys, Inc., the relator alleged that Amedisys, a hospice operator, falsely certified patients as terminally ill and submitted claims for reimbursement to Medicare and North Carolina Medicaid for patients who were not properly eligible for hospice care. Amedisys filed a motion to dismiss Rosales’ Amended Complaint for lack of subject-matter jurisdiction, ...

Elder abuse is unreported. City employees will now be trained to recognize it. San Antonio Report, TX; by Iris Dimmick; 8/21/24 City of San Antonio employees will soon be trained on how to identify and report elder abuse thanks to a collaborative effort to increase awareness of the underreported “crisis” gripping the community. City Council’s Public Safety Committee greenlit the policy Tuesday, which directs the city’s Department of Human Services and Texas Adult Protective Services (APS) to develop training curricula for staff. ... The largest share of elderly abuse cases in Bexar County is reported by medical personnel, followed by relatives, community agencies and the victims themselves. In 2022, a woman died in a local hospital after her three adult children allegedly neglected her hospice care. In 2018, a caretaker in San Antonio was charged with several felonies after police found an elderly, disabled woman was languishing in soiled clothes for months at a time.Editor's Note: What elder neglect and abuse training do you require for your hospice and palliative care interdisciplinary team members and volunteers? What incident reporting and follow-up systems do you have in place? The CMS Hospice Conditions of Participation requires the patient's comprehensive assessment to include "a thorough evaluation of the caregiver's and family's willingness and capability to care for the patient." Subpart A, § 418.3 

AI's no-fly zones: 5 executives weigh in Becker's Health IT; by Kelly Gooch; 8/16/24 It is clear that healthcare leaders are engaged in the artificial intelligence space. ... Below, five executives answer the question: What specific parts of healthcare delivery, operations and decision-making are best left to human judgment? ...

YoloCares: Overregulated California skips key regulations Our Community Now (OCN); by Craig Dresang, Special to The Enterprise; 8/17/24 California is the most heavily regulated state in the country. According to the Mercatus Center at George Mason University, the Golden State has 420,434 regulatory restrictions which is more than double the national average. ... So, it seems ironic that certain critically important sectors in California that impact the well-being, health and quality of life for millions of seniors are grossly unchecked and mis-regulated. My husband, who has owned and operated salons for nearly 30 years, pointed out that California’s Board of Barbering and Cosmetology (BBC) appears to have more rigorous rules and regulations for nail technicians than it does for board-and-care (B&C) owners or privately owned hospice companies. ... [Click on the title's link to continue reading.]

Hospice care for those with dementia falls far short of meeting people’s needs at the end of life University of Michigan; by Maria J. Silveira; 8/18/24 ... Strikingly, only 12% of Americans with dementia ever enroll in hospice. Among those who do, one-third are near death. This is in stark contrast to the cancer population: Patients over 60 with cancer enroll in hospice 70% of the time. In my experience caring for dementia patients, the underuse of hospice by dementia patients has more to do with how hospice is structured and paid for in the U.S. than it does patient preference or differences between cancer and dementia. ... In the U.S., ... Medicare’s rules and regulations make it hard for dementia patients to qualify for hospice when they and their families need support the most – long before death. In Canada, where hospice is structured entirely differently, 39% of dementia patients receive hospice care in the last year of life. ...

Navigating the complexities of life and caregiving WorldHealth.net; by Pat Baker; 8/16/24 As individuals advance through different life stages, especially when tasked with caregiving or managing the challenges of aging, they encounter a complex web of intertwined challenges. ... This article explores the multifaceted nature of caregiving and aging, offering insights and strategies that can help individuals manage these demanding situations effectively. ... As the population ages and the demand for caregiving increases, it is crucial to continue developing strategies and policies that support caregivers and enhance the quality of care. Editor's Note: Examine 75+ caregiver education and support videos designed for hospices to use with the primary caregiver and family members you serve: Family Support through Serious Illness; Hospice Training for Caregivers and Families; Want to Understand Your Grief? Includes 10 hospice & 11 grief videos in Spanish. Designed and delivered via our newsletter's sponsor, Composing Life Out of Loss.

How Texas healthcare facilities can prepare for new workplace violence prevention standards for healthcare workers JW News; by Jeffrey H. Frost; 8/14/24 ... On May 15, 2023, Governor Abbott signed SB 240, relating to workplace violence prevention in certain healthcare facilities. ... Texas healthcare facilities must meet Chapter 331 workplace violence prevention requirements by September 1, 2024. ... Covered facilities [which includes hospice] must establish a workplace violence prevention committee, prevention plan, and policy. ... At a minimum, the prevention plan must: (i) be tailored to the practice setting; (ii) define “workplace violence”; (iii) provide for annual training; (iv) review physical security and safety; (v) create a reporting system; and (vi) adjust the care assignments (if possible) of employees and providers who have been assaulted or threatened. Editor's Note: For non-Texas hospice and palliative providers, what Workplace Violence Prevention Plan do you have in place, or not? This article provides excellent information and action plans for you to use.

On-demand talent can push key objectives forward amid an increase in M&A deals Forbes; by Sunny Ackerman; 8/14/24 As we settle into the latter half of 2024, mergers and acquisitions and other business transformation initiatives are likely to be top of mind for many business leaders. Consider EY’s May 2024 “Deal Barometer,” which predicts that in the United States, “corporate M&A deal volume will increase 20%.” The firm also estimated that M&A deal volume will increase by 16% in the private equity world. ... Given the projected increase in M&A deal activity, I expect to see an increased need for on-demand talent in 2024 and beyond to push key objectives forward, executing strategic goals to close deals and facilitate seamless transitions post-closure. ...

Staff education an anchor amid widespread hospice audits Hospice News; by Holly Vossel; 8/14/24 ... More than half of hospice providers reported having multiple types of audits within a six-month span in a survey earlier this year. ... Supplemental Medical Review Contractor (SMRC) and Targeted Probe and Educate (TPE) audits are among the most common types of audits that hospices undergo simultaneously alongside others. ... Staff need a firm understanding around the potential red flags on regulators’ radars and how to avoid common compliance errors in their roles, ... Compliance training should be focused on staff’s overall responsibilities alongside the larger bottom line of quality, she said. ... Notable mentions: Jason Bring, co-chair of post-acute and long-term care at the law firm Arnall Golden Gregory LLP (AGG)l; Megan Turby, vice president of quality and compliance at Gulfside Healthcare Services; Dr. Lisa Barker, chief medical officer at Gulfside Healthcare Services

The tangled web of pediatric palliative care payment and policy Hospice News; by Holly Vossel; 8/13/24 A complex web of state regulations and reimbursement systems can challenge pediatric palliative care access for seriously ill children and their families. The nation’s fragmented health care system lacks clear guidance when it comes to navigating chronic, complex conditions in children, adolescents and young adults, according to Jonathan Cottor, CEO and founder of the National Center for Pediatric Palliative Care Homes. Much of the current state palliative regulations and reimbursement pathways focus on adult patient populations, representing a significant barrier to improved quality and support in the pediatric realm, Cottor said.