Literature Review

Measuring decision aid effectiveness for end-of-life care: A systematic reviewPEC Innovation; M. Courtney Hughes, Erin Vernon, Chinenye Egwuonwu, Oluwatoyosi Afolabi; 4/24A total of 715 articles were initially identified, with 43 meeting the inclusion criteria. Outcome measures identified included decisional conflict, less aggressive care desired, knowledge improvements, communication improvements, tool satisfaction, patient anxiety and well-being, and less aggressive care action completed. The majority of studies reported positive outcomes especially when the decision aid development included International Patient Decision Aid Standards.Publisher's note: Also by these co-authors, please see The effectiveness of community-based palliative care program components: A systematic review (Age and Ageing, 2023) and Measuring effectiveness in community-based palliative care programs: A systematic review (Social Science & Medicine, 2022).

Hospice care scam has FBI issuing warning after 'huge increase in complaints'ABC TV 13, Houston, TX; by Samica Knight; 4/29/24The Federal Bureau of Investigations is warning about a scam in which crooks sign people up for hospice care without their knowledge. The FBI has received numerous reports from victims in the Houston area about this costly scam. "It's a little bit more egregious and distasteful than some of the other Medicare frauds we typically deal with," FBI Supervisory Special Agent Shannon Brady said. "We've had a huge increase in complaints." Fraudsters are actually signing mostly elderly victims up for end-of-life hospice care when they don't need it and without the victim even knowing about it.

HHS issues new rule to strengthen nondiscrimination protections and advance Civil Rights in health careHHS Press Office; 4/26/24Today, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS) issued a final rule under Section 1557 of the Affordable Care Act (ACA) advancing protections against discrimination in health care. By taking bold action to strengthen protections against discrimination on the basis of race, color, national origin, sex, age, and disability, this rule reduces language access barriers, expands physical and digital accessibility, tackles bias in health technology, and much more.

Minnesota’s new labor board votes for nearly $23.50 an hour minimum wage for nursing home workers Minnesota Reformer; by Max Nesterak; 4/29/24 'Today has been a long time coming,’ said nursing home worker Nessa Higgins at a news conference after Minnesota’s first labor standards board voted on April 29, 2024, to raise the minimum wage for nursing home workers to $20.50 per hour by 2027. Minnesota’s new workforce standards board took its first significant vote on Monday, agreeing to raise the pay floor to $23.49 per hour on average in 2027 for nursing home workers, while guaranteeing 11 paid holidays. The worker and government representatives on the board approved the minimum wages without the support of the board’s nursing home industry representatives, who abstained.

Palliative care nursing: Podcast with Betty Ferrell about ELNECGeriPal Podcast; by Alex Smith, Eric Widera, and Betty Ferrell; 4/26/24As Betty Ferrell says on our podcast today, nurses play an essential role in care of people with serious illness. Who spends the most time with the patient in the infusion center? Doing home care? Hospice visits? In the ICU at the bedside? Nurses. ELNEC (End-of-Life Nursing Education Consortium) celebrates it’s 25th anniversary in 2025. We talk today with Betty Ferrell, who has been a nurse for 47 years, and is the founder and PI of ELNEC.

Home 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. ...

Hospice 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?

States 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. 

Remote 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.

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. ...

45 top healthcare workplaces for mental well-being: Newsweek Becker's Hospital Review, by Alexis Kayer, 4/22/24Newsweek has named 45 hospitals and health systems among its 750 greatest employers for mental well-being. The publication partnered with data researchers Plant-A to rank the top U.S. workplaces "making a positive difference in the mental wellness of their workers," according to a five-stage evaluation. ... Here are the 45 hospitals and health systems included on the list, excluding organizations that exclusively provide long-term, hospice, rehabilitative and medical care, or staffing and management services: [Click on the title's link for the list.]Editor's Note: Is your organization on the list? Or perhaps a colleague's organization? Forward this to them with your congratulations! Invite them to join our newsletter for free at www.HospicePalliativeCareToday.com/registration.

How the FTC's ban on noncompetes will shake up healthcare workforce strategiesHealthleaders; by Jay Asser; 4/25/24CEOs will have to adjust their strategies to maintain their workforce if the final rule stands. Key Takeaways: