Literature Review

Why repeat offender nursing homes elude accountability Modern Healthcare; by Diane Eastabrook and Tim Broderick; 12/10/24 Fallbrook Rehabilitation and Care Center stands out as one of the worst among the more than 1,200 nursing homes in Texas and the nearly 15,000 facilities nationwide. Over a three-year period at the skilled nursing facility in Houston, one patient died after staff did not notice her ventilator had disconnected.  ... The Texas Department of Health and Human Services cited Fallbrook for more than 50 other health and safety violations. Fallbrook was fined about $640,000 between April 2021 and July 2023, according to Modern Healthcare analysis of April 2024 CMS data. The amount was among the top 30 fines paid by nursing homes nationally and was more than six times the average fine other Texas nursing homes with CMS one-star ratings were assessed during that period. Yet the 200-bed nursing home collected more than $20 million in reimbursements from Medicare, Medicaid and health insurance companies in 2021 and 2022, ... The ownership groups can control facilities through convoluted webs of individuals, private equity investors, limited liability companies, real estate investment trusts and other trusts that often transfer money to related companies or third parties with ownership interests in the nursing homes. The Human and Human Services Department Office of Inspector General has identified this as a problem.

From sleeping in cars to having an apartment: Season for Caring helps once-homeless families Austin American-Statesman; Austin, TX; by Nicole Villalpando; 12/8/24 When Thamairis Canales Yanez learned this year that she had been selected for the Austin-American Statesman's Season for Caring program, "what I did was thank God," she said. ... The 45-year-old and her 14-year-old daughter, Ivanna, came to the U.S. from Venezuela after Yanez's dental business was taken away by the government, and she feared for her daughter's life. She is trying to rebuild her life in America, but it has been difficult. At one point, she and Ivanna were living in her car. She has breast cancer that has spread to her brain. She is unable to work. Often when Season for Caring comes into the lives of the featured families, it is during one of their darkest times.  ...  "I have seen the impact on families," said Robin Clemons, chief development officer at Hospice Austin. "Imagine facing the end of life, and they can't pay their rent. (With Season for Caring funds) they don't have to worry about those types of needs. The stress for the caregiver, it relieves that burden."

Resources are expanding for older adults on their own California Healthline; by Judith Graham; 12/9/24 Jeff Kromrey, 69, will sit down with his daughter the next time she visits and show her how to access his online accounts if he has an unexpected health crisis. Gayle Williams-Brett, 69, plans to tackle a project she’s been putting off for months: organizing all her financial information. ... Until a few years ago, few resources were available for this growing slice of the older population. Now, there are several Facebook groups for solo agers, as well as in-person groups springing up around the country, conferences and webinars, a national clearinghouse of resources, and an expanding array of books on the topic. [Click on the title's link to read more.]

All-inclusive elder care for aging at home: This nursing home alternative is on the rise Caring.com; by Dom DiFurio; 11/25/2024 ... PACE centers, or Programs of All-Inclusive Care for the Elderly. As of August 2024, 177 programs across 33 states and the District of Columbia are in operation, allowing aging people to stay within their home communities while still receiving the elevated care they would need as older adults living with disabilities or chronic illnesses. A PACE facility is a kind of "one-stop shop" that offers services like dental care, social services, occupational therapy, prescription medication, and nutritional counseling. ... Caring.com examined data maintained by the National PACE Association to see which states have the most programs available to serve their aging populations and how they can impact the quality of care for adults who want to live independently outside a clinical setting for as long as possible. ... Several states are also undergoing trials, expansion, or establishing new PACE programs for their aging residents. Minnesota and South Dakota are considering starting PACE programs. Nevada is in the process of establishing its own program after using COVID-19 funding to experiment with the system to address the health needs of people ages 55 and older who need nursing facility-level care but can still live safely in their communities. Georgia's governor also signed a bill into law earlier this year creating the state's first PACE.

Homebound seniors living alone often slip through health system’s cracks KFF Health News; by Judith Graham; 12/2/24 Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern. “What’s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’s Visiting Doctors Program. “I don’t know,” she answered, so softly it was hard to hear. “Going from here to the bathroom or the door, I get really winded. I don’t know when it’s going to be my last breath.” Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’s fallen several times and dropped to 85 pounds, a dangerously low weight. And she lives alone, without any help — a highly perilous situation. Across the country, about 2 million adults 65 and older are completely or mostly homebound, while an additional 5.5 million seniors can get out only with significant difficulty or assistance. ... It’s a population whose numbers far exceed those living in nursing homes — about 1.2 million — and yet it receives much less attention from policymakers, legislators, and academics who study aging.

This Scottsdale art class helps adults with memory loss 'live in the moment' AZCentral, Scottsdale, AZ; by Alexandra Hardle; 12/1/24 ... Anne Halvorson and her mother, Nancy Halvorson, have been attending Memory Lounge since 2022. Nancy was diagnosed with Alzheimer's the year prior, Anne said. Nancy lives in an assisted living facility, but she spent much of her career as a music therapist working with children with special needs in the public school system, Anne said. Since her mother was already naturally drawn to art, the two became frequent attendees of Memory Lounge after hearing of the program through Hospice of the Valley. "It's been a lifesaver for us. It has given my mother an outlet for all of her creativity, which she has in abundance," Anne said. Memory Lounge also allows Anne's mother the chance to use a different part of her brain and to learn something new. It's also a space for her to simply socialize and talk about something other than her doctor's appointments and where she's living, Anne said.

Seen Health invests $22m for PACE Care Centers HomeCare, Los Angeles, CA; by Seen Health; 11/26/24 Seen Health, a health care organization focusing on aging-in-place services and culturally-focused care models, announced it has invested $22 million in funding to expand access to its culturally-focused care centers for eligible seniors. The company said [its] first center is set to open in California and will be built upon the Program of All-Inclusive Care for the Elderly (PACE) model. The PACE model aims to deliver comprehensive medical and social support for seniors with chronic conditions who are covered by Medicaid or Medicare. The care model intends to provide an alternative method of care to nursing homes by enabling seniors to stay in their homes and age in place. ... The first Seen Health center, which is set to open in Los Angeles County's San Gabriel Valley, intends to serve the local Asian and Pacific Islander community.

Be a Santa to a Senior helps homebound seniors during holiday season The Joplin Glove; 11/26/24 Home Instead Senior Care is offering a chance to play Santa this year to homebound seniors who might be overlooked during the holidays. The Be a Santa to a Senior is a national program with Home Instead, a company that offers services for homebound seniors. These seniors might not have a family member close by or might not be able to travel to see family. Adam Bokker, owner of Home Instead in Joplin, said hundreds of thousands of gifts have been collected and given to seniors nationally during the holiday season over the years. "It's an opportunity for them to have a little gift, a little joy, some companionship even with someone delivering that gift," Bokker said. "We call it Be a Santa to a Senior because our seniors really benefit from having that extra gift, extra companionship when many times they're not able to go see their families."

Hospice expands compassionate care for nursing home residents McKnights Long-Term Care News; by Liz Barnett and Mat Zucker; 11/22/24 Nursing homes are places of care, community and compassion, particularly for residents in their final stages of life. As we recognize National Hospice and Palliative Care Month, it’s an opportune time to consider how nursing homes can broaden the support they provide by better incorporating hospice services. Hospice offers a path to comfort and dignity at the end of life, yet many families have insufficient information about these services. Our mother, Leslie, benefited from hospice care early this year when her gallbladder cancer no longer responded to treatment. This journey revealed just how powerful hospice can be, not only for the patient but for our entire family. Nursing home staff and administrators can play a crucial role in helping families like ours make informed, compassionate choices like this for their loved ones.

Nursing homes with more black residents lag in care goal discussions Medical Xpress; by Columbia University Irving Medical Center; 11/20/24 New research from Columbia University School of Nursing published in the American Journal of Hospice and Palliative Medicine shows that timely goals of care discussions are less likely to take place in nursing homes with a higher percentage of Black residents. These discussions are crucial to ensuring that nursing home residents receive care that aligns with their wishes, postdoctoral research fellow Jung A. "Chloe" Kang, Ph.D. '24, Professor Patricia Stone, Ph.D., and their colleagues note in the report, published online September 15, 2024. But these conversations are often delayed until patients experience life-threatening events, the authors add, which can lead to unwanted therapies and unnecessary hospitalizations. ... 

BREAKING: CMS issues ‘significant’ survey changes for 2025 [long-term care] McKnights Long-Term Care News; by Kimberly Marselas; 11/19/24 The Centers for Medicare & Medicaid Services on Monday issued “significant revisions” to its long-term care surveyor guidance, with changes affecting everything from admission and discharge standards to the use of psychotropic medications and newly adopted infection prevention practices. CMS released an advance copy of the 900-page document online, including new critical element pathways, to give providers and surveyors time to adjust to the new requirements before they go into effect Feb. 24, 2025. A significant portion of the changes is related to chemical restraints and unnecessary psychotropic medication.

Sweet success: Chet's rose garden gets official dedicationIdaho Press; by Jeanne Huff; 11/16/24 Chet Bishop and his wife, Betty, moved to the Keystone center in Eagle about five years ago. The 50+ community for seniors had "two little patches of roses," said Betty — and that's when Chet became the unofficial gardener. ... Chet, who has now been in hospice for about six months, was recently surprised when the community commemorated the rose garden in his name. ... "When our hospice team first met him and his family, we started asking questions about his life — and what brought him joy. That rose garden made him tick as a person … it made him grounded," Henry said.  It also gave Henry joy to be able to make the dedication an event that 87-year-old Chet could witness. On the day of the dedication, Chet was surrounded by his family, his community and his hospice team to celebrate his contributions to the Chet Bishop Memorial Rose Garden. ... [He] saw the plaque on the bench, and it all became clear. The inscription read: “Chet Bishop Memorial Garden. Chet Bishop, thank you for making our world more beautiful through your countless hours of love and care for these roses.”

Baystate Health eliminates 134 leadership positions Modern Healthcare; by Hayley Desilva; 11/13/24 Baystate Health [in Massachusetts] has eliminated 134 leadership positions as part of a larger cost-saving effort amid financial challenges. The cuts will affect less than 1% of the system's workforce, the system said in a statement Wednesday. Some of the affected positions are vacant roles that will not be filled. Baystate accumulated an estimated $300 million in operating losses between 2020 and 2023, which led it to reevaluate finances and eliminate the leadership positions. "As a system, we are driving toward transformational change to deliver core operations improvements of more than $225 million over the next two years," Baystate Health said. "Our transformation will allow us to invest $1.2 billion back into our team members, renovations, growth, access, and our community over the next six years."