Literature Review

[Recommendations] OIG Report finds that the Medicare Program improperly paid acute-care hospitals for outpatient services provided to hospice enrollees JDSupra; by Michelle Huntsman; 12/3/24 On November 12, 2024, OIG published a report concluding that the Medicare program overpaid acute-care hospitals an estimated $190 million over five years for outpatient services provided to hospice enrollees. ... OIG made six recommendations to CMS to prospectively address the issues identified:  

40 largest health systems in the US | 2024 Becker's Hospital Review; by Laura Dyrda; 11/27/24 Some large health systems grew while others shrunk over the last year, and more consolidation could be ahead. But changes were minimal in either direction, and the largest health systems this year remain relatively similar to previous years. Becker's compiled a list of the largest health systems in the U.S. based on the number of hospitals reported on the system's website. ... Note: The list below is not a ranking. Data includes all hospitals within the system. [Click on the title's link for the full list of 40 health systems.]

18 questions for CEOs to ask themselves Becker's Hospital Review; by Molly Gamble; 11/25/24 McKinsey senior partners developed a CEO performance questionnaire informed by in-depth interviews with more than 70 successful chief executives across industries. The checklist is meant to assess CEOs' performance in six dimensions: setting direction, aligning the organization, mobilizing through leaders, engaging the board, connecting with stakeholders and managing personal effectiveness. "Sure, CEOs have an abundance of financial, operational, and organizational metrics to look at, but what CEOs should be doing to influence those metrics wasn't exactly clear," the authors noted. The checklist serves as both a self-assessment tool and a framework for gathering honest feedback from board members, executives and trusted advisors. [Click on the title's link for] a condensed list of the questions, with commentary and more explanation of each available in the full article from McKinsey here. [Questions address:] 1. Vision. ... 2. Strategy. ... 3. Resource allocation. ... 4. Culture. ... 5. Organizational Design. ... 6. Talent. ... 7. Team composition. ... 8. Teamwork. ... [More]

Giving Tuesday is tomorrow!We'd like to highlight several ways you can particpate in Giving Tuesday tomorrow, including:

Thanksgiving reflections: Gratitude and grieving in hospice care Faith  Hope Hospice & Palliative Care, Pasadena, CA; 11/20/24Thanksgiving is traditionally a time for joy and gratitude, but it can bring mixed emotions for families with a loved one in hospice care. In the diverse communities of Los Angeles, Beverly Hills, and Hollywood, Faith and Hope Hospice provides compassionate guidance on how to balance grief with gratitude, helping families find moments of peace and connection during this reflective time. ... Gratitude can be a healing force, offering comfort to those grappling with loss. In hospice care, where families confront profound challenges, finding space for gratitude can significantly impact emotional and psychological well-being, fostering resilience and a sense of peace.

OIG issues nursing facility industry segment-specific Compliance Program Guidance; first in a series in Furtherance of its Modernization Initiative Butzel - Attorneys and Counselors Client Alerts; 11/22/24 On November 20, 2024, the U.S. Department of Health & Human Services, Office of Inspector General (“OIG”) issued the first Industry Segment-Specific Compliance Program Guidance (“ICPG”), which applies to the Nursing Facility Industry. This follows from the OIG’s Modernization Initiative to update publicly available resources for the healthcare industry first announced in September 20211 and finalized in April 2023. This ICPG comes just over a year after the OIG issued the General Compliance Program Guidance (“GCPG”) that kicked off the OIG’s efforts to modernize and consolidate numerous Compliance Program Guidance documents issued between 1998 and 2008. Editor's note: Click here to download the U.S. HHS OIG's 59-page November 2024 "NURSING FACILITY Industry Segment-Specific Complicance Program Guidance." A word search finds 30 references to "hospice."

If my dying daughter could face her mortality, why couldn’t the rest of us? DNYUZ, appearing first in The New York Times; Ms. Wildman; 11/25/24 The first week of March 2022, I flew to Miami with my 13-year-old daughter, Orli; her 8-year-old sister, Hana; and my partner, Ian. We were, by all appearances, healthy. Robust, even. In reality, we were at the end of a reprieve. Orli’s liver cancer had by then been assaulted by two years of treatments — chemotherapy, a liver transplant, more chemotherapy, seven surgeries. Now new metastases lit up a corner of one lung on scans, asymptomatic but foreboding. We asked her medical team if we might show her a bit of the world before more procedures. Our oncologist balked. Hence, this brief weekend away. When we arrived at the beach Orli ran directly to the water, then came back and stretched out on a lounge chair. She turned to me and asked, “What if this is the best I ever feel again?” Three hundred and seventy-six days later, she was dead. In the time since she left us, I have thought often of Orli’s question. All that spring, Orli asked, pointedly, why did we think a cure was still possible, that cancer would not continue to return? Left unspoken: Was she going to die from her disease? It was a conversation she wanted to have. And yet what we found over the wild course of her illness was that such conversations are often discouraged, in the doctor’s office and outside it. ... [Click on the title's link to continue reading this profound story.]Editor's note: While families are gathered for Thanksgiving, many health changes will be observed since this time last Thanksgiving, with countless unknowns to unfold until Thanksgiving next year. Tune into the wide scope of conversations that people do want to have, don't want to have, and--perhaps--that your own family needs to have, with grace and care for all.

Dialysis facility staffing ratios and kidney transplant access among adolescents and young adultsJAMA; Alexandra C. Bicki, MD, MPH; Barbara Grimes, PhD; Charles E. McCulloch, PhD; Timothy P. Copeland, MPP, PhD; Elaine Ku, MD, MAS; 10/24In this study of adolescents and young adults treated at US dialysis facilities, patients at facilities with higher patient to staff ratios had lower incidence of waitlisting and kidney transplant compared with those receiving care at facilities with lower patient to staff ratios. The effect size for the incidence of transplant was similar with respect to both patient to nurse and patient to social worker staffing ratios, but patient to nurse ratio was not statistically significantly associated with the incidence of waitlisting.

Hospice of Baton Rouge: New grief center opens offering vital support and healing Unfiltered With Kiran, Baton Rouge, LA; by Megan Kelly; 11/25/24 As the holiday season approaches, a time often filled with joy and togetherness, it can also be a profoundly challenging period for those experiencing grief. The Hospice of Baton Rouge has recognized this need and has transformed a property into a haven of healing: The Retreat at Quarters Lake. This newly established grief center aims to address the significant gap in resources for grieving individuals, a void that became especially apparent during the COVID-19 pandemic. “The Retreat at Quarters Lake provides hope, healing, and connectivity for the grieving through counseling, support groups, alternative grief therapies, and community education,” reads a statement on their website. The facility offers both traditional grief services, such as individual counseling and support groups, and unique, holistic approaches that include art therapy, music therapy, and pet therapy. The goal is to provide a comprehensive support system that caters to individuals of all ages and backgrounds. “We are focusing on some alternative therapies like yoga, meditation, gardening, and even fishing,” said Catherine Schendel, CEO of The Hospice of Baton Rouge. “We want to utilize the beautiful landscaping here to offer non-traditional grief support as well.” 

Thanksgiving Day is a good day to recommit our energies to giving thanks and just giving. ~Amy Grant, quoted here

How to manage sibling relationships strained by family caregiving AARP; by Christine A. Di Pasquale; 11/25/24 ... Conflict around caregiving is not unusual, especially between sisters, says Megan Gilligan, Ph.D., an associate professor of Human Development & Family Science at the University of Missouri. Gilligan is a co-author of the longitudinal Within-Family Differences Study that looks at understanding the “relationships between parents and their adult children and grandchildren, as well as between siblings in adulthood.” Gilligan and her colleagues found that sisters tend to be more critical of one another than sons when it comes to parental caregiving. “Daughters are raised with a sense of expectation, obligation, of wanting to provide that care and wanting that care to look a certain way,” she explains. “And we found that when multiple daughters were involved in care, maybe sometimes they’re kind of stepping on each other’s toes whereas … sons were more likely to kind of step back and let sisters navigate that,” she says. ... Gilligan suggests that we replace the idea of equality with equity in caregiving. Siblings should ask what the parents want each child to do and then divide that work equitably if not equally in order to reduce sources of stress for the ailing parent and among siblings.

The Alliance applauds Gerald’s Law passing through Congress National Alliance for Care at Home (the Alliance; formerly NAHC and NHPCO); Press Release; 11/19/24 The National Alliance for Care at Home (the Alliance) celebrates the historic passage of H.R. 8371, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act in the U.S. House of Representatives last night with a bipartisan vote of 389-9. This landmark legislation includes Section 301, Gerald’s Law, which addresses a critical gap in benefits impacting seriously-ill veterans and their families receiving hospice care. The story of Gerald “Jerry” Elliott, a U.S. Army veteran, underscores the importance of this legislative achievement. Diagnosed with cancer, Jerry was admitted to his local Veterans Affairs (VA) hospital in 2019 before transitioning to VA hospice care at home to be surrounded by his family. After his passing, his family discovered they were ineligible for full burial and funeral financial support because Jerry died outside of a VA facility.

Navigating the aftermath of natural disasters Teleios Collaborative Network (TCN); by Lara McKinnis; 11/15/24 This morning I woke up to two bears outside, a little cub sitting on our front steps eating the pumpkin that my daughter recently carved, the mom nearby completely sprawled out lounging in the sun in a bed of freshly fallen yellow and orange oak leaves.  This is the “fall” that I look forward to every year in Asheville. I wanted to hold onto this feeling, all of us standing at our screened-in window talking to the bears as if they understood us, our dog enthusiastically joining in the conversation.  This feeling is alive and vibrant; however, so is the visceral awareness of the horrific despair that has engulfed my beloved community and so many communities in Western North Carolina. ...  Adjusting to a natural disaster is nuanced and layered.  [Click on the title's link to continue reading this hospice leader's reflections and professional guidance.]Editor's note: We thank Lara McKinnis for raising our awareness to what matters most--large and small. We alert you to the needs of hospice and other healthcare needs as the Associated Press reports "Wildfire threat continues in much of the US Northeast as dry conditions persist."