Literature Review

10 strategies for positive company culture in long-term careMcKnight's Home Care; by Julie Rupenski; 9/11/24Creating a great home care, senior living or other long-term care or organizational culture doesn’t happen by accident. It’s deliberate and requires intentional leadership strategies that foster positive, productive and inclusive work environments. Your leadership has a profound impact on company culture. Strong leaders inspire others with a feeling of direction, purpose, and team collaboration... Here are 10 strategies:

Rita and Alex Hillman Foundation announces $500,000 in funding for nine projects to improve serious illness and end of life care Globe Newswire; by Rita & Alex Hillman Foundation; 9/10/24 The Rita and Alex Hillman Foundation ... announced nine grants to support innovative, early-stage interventions that address the serious illness and end of life needs of marginalized populations. The $500,000 in funding, part of a collaborative effort with The Arthur Vining Davis Foundations, will advance nursing-driven initiatives that improve care for diverse populations and expand access to high-quality end of life services. ... This year’s grants demonstrate a commitment to the design, development, and delivery of better and more equitable care. The 2024 HSEI grant recipients are:

Changes in nursing home ownership may depress care and staffing, report findsMcKnight's Long-Term Care News; by John Roszkowski; 9/4/24Changes in nursing home ownership may have a small, but statistically significant, negative impact on staffing levels and the overall quality of patient care at nursing homes, according to new research. Investigators from the University of Pennsylvania and the Department of Veterans Affairs Medical Center in Philadelphia conducted a retrospective study of changes in nursing home ownership between 2016-2022 and how they impacted nursing home quality of care. Findings appeared in the Journal of the American Geriatrics Society. The researchers used data from the Centers for Medicare & Medicaid Services from 2016-2022 of nearly 3,600 nursing homes that changed ownership to determine if there were noticeable shifts in quality ratings after the properties changed hands.Publisher's note: This study might have interesting implications in the hospice field.

10 ways to improve cancer patients' transition to skilled nursing facilities: Viewpoint Becker's Hospital Review; by Elizabeth Gregerson; 9/5/24Physicians from the New York City-based Memorial Sloan Kettering Cancer Center have shared insights on how to better manage care when an oncology patient transfers from the hospital to a skilled nursing facility setting. ... The authors are oncologist Daniel Lage, MD, palliative care physician Craig Blinderman, MD, and emergency medicine physician Corita Grudzen, MD. ... [Among the] 10 recommendations from the editorial: ... Documentation should be provided to the skilled nursing facility team if an oncologist believes harm from future cancer treatment outweighs potential benefits or believes the patient has a poor prognosis. This will allow palliative care or hospice conversations to occur more urgently. Oncologists and palliative care clinicians can schedule, with hopeful reimbursement for,  telehealth visits for patients in skilled nursing facilities.

Bay Bluffs opens hospice wing as end-of-life care models change Interlochen Public Radio; by Michael Livingston; 9/4/24 Three new beds for hospice care opened in Harbor Springs today marking the end of a year-long pivot for an end-of-life care organization in the region. Last year, McLaren Health System closed hospice facilities in Petoskey and Cheboygan. Combined, the facilities provided more than a dozen beds for hospice in the region. At the time, McLaren called the decision to close "difficult" but necessary due to staffing constraints and said it would move to prioritizing outpatient hospice care - when a nurse visits patients in the home rather than a facility. But a group of advocates in Petoskey said residential hospice is needed in the region - especially for people with serious terminal illnesses. David McBride leads the newly renamed group, Friends of Hospice of Little Traverse Bay. It used to be called the Friends of Hiland Cottage for the facility in Petoskey. ... That’s what led to a partnership with skilled nursing facility Bay Bluffs in Harbor Springs. It’s the Emmet County Medical Care Facility and owned by the county health department. Bay Bluffs is not a licensed hospice provider but it is able to outsource hospice from other companies while providing rooms for families to gather with their loved ones and trained nursing. This newer model of end-of-life care is a growing trend and has been tried in other places such as Arbor Hospice in Ann Arbor which closed its residential facility in 2022.

Employer educational assistance programs can help long-term care workers pay off student loansMcKnight's Senior Living; by John Roszkowski; 9/3/24Employer-based educational programs still can be used to help pay off worker students’ loans through the end of next year, potentially enabling long-term care employers to provide relief to their workers who are struggling to pay off such debt. The IRS issued a reminder last week that employers who offer educational assistance programs also can use them to help pay for their employees’ student loan obligations through Dec. 31, 2025. Although educational assistance programs have been available to employees for many years to help them pay for tuition, books, supplies and other educational expenses, the option to use them to help workers pay off student loans has only been available for payments made after March 27, 2000, according to the IRS. The student loan provision will expire at the end of 2025. The student loan payment initiative may be one way for senior living, nursing home, home care and hospice employers to attract and retain employees, many of whom may be trying to pay off student loans.Publisher's note: Some hospices offer employer-based educational programs - does yours?

Year-over-year health spending growth highest ‘by far’ for home healthcare McKnights Senior Living; by Lois A. Bowers; 7/28/24 Year-over-year growth in national health spending in June was highest “by far” for home healthcare, at 20.9%, compared with other major healthcare categories, according to a brief issued late Tuesday by Altarum. Most of the growth, 18.5 percentage points, was due to changes in utilization rather than price, George Miller, PhD, Altarum fellow and research team leader, told the McKnight’s Business Daily. “Nursing home care spending was a distant second, at 10.0% year-over-year growth,” Miller said. By comparison, year-over-year spending growth was 8.3% for prescription drugs, 8.2% for hospital care, 7.3% for dental services and 6.6% for physician and clinical services, according to the report. Overall, spending on healthcare goods and services grew by 8.1% between June 2023 and June 2024, with utilization growth continuing to outpace price growth.

Improving post-hospital care of older cancer patients Cancer Health; by University of Colorado Cancer Center and Greg Glasgow; 8/26/24 A few years ago, University of Colorado Cancer Center member and hospitalist Sarguni Singh, MD, began to notice a troubling trend: Older adults with cancer who were leaving the hospital for skilled nursing facilities after treatment were being readmitted to the hospital or having worse outcomes while in rehabilitation. ... Singh knew of an intervention called Assessing and Listening to Individual Goals and Needs (ALIGN) — a palliative care social worker-led protocol aimed at improving quality of life, aligning goals of care, and providing support to patients and caregivers — and she began using it for cancer care. ... The results were overwhelmingly positive, and patients and caregivers told us, ‘This was so helpful,’” says Singh, associate professor of hospital medicine in the CU School of Medicine.

Palliative care is a viable option for frail elderly patients with neurocognitive disorders admitted for hip fractures BMC Musculoskeletal Disorders; by Justine Boulet, Etienne L Belzile, Norbert Dion, Chantal Morency, Mélanie Bérubé, Alexandra Tremblay, Stéphane Pelet; 8/10/24 Most patients presenting with a hip fracture regardless of their comorbidities are surgically treated. A growing body of research states that a certain type of elderly patient could benefit more from a palliative approach. ... The presence of [a nuerocognitive disorder] NCD and diminished prefracture autonomy strongly support counseling for palliative care. The high rate of complications when surgery is proposed for frail patients with multiple comorbidities suggests that the concept of palliative surgery needs to be revisited. 

‘Lean into your superpowers’: Bayada COO champions women in home health leadership Home Health Care News; by Audrie Martin; 8/20/24 Heather Helle, president and chief operating officer of Bayada Home Health Care, believes that home-based care could benefit from having more women in leadership roles. Founded in 1975 and headquartered in Moorestown, New Jersey, Bayada provides in-home clinical care and support services for children and adults, including hospice, behavioral health, and rehabilitation in 21 states and five countries. ... In 2022, women accounted for approximately 80% of workers in health care occupations, a figure higher than the percentage of women in all other employment sectors, as reported by the Bureau of Labor Statistics. ... However, women are underrepresented in leadership roles, comprising only 25% of health care leadership positions in 2022. ... Gender equity is crucial for developing resilient health systems and gender-transformative health and social care policies, according to The World Health Organization. 

Commentary: Prognostication in Alzheimer's disease and related dementias Journal of the American Geriatrics Society / Early View; by Natalie C. Ernecoff PhD, MPH, Kathryn L. Wessell MPH, Laura C. Hanson MD, MPH; 8/8/24  ... Hospice provides comfort-oriented care, emphasizing patient-tailored elements of quality of life, including time with family, access to nature, and music. In late-stage ADRD, studies show that a majority of families prioritize comfort-oriented treatment, and understanding prognosis may help them align treatments accordingly. Yet, only 15% of people enrolled in hospice with a primary diagnosis of ADRD. This is due to difficulty estimating 6-month prognosis required for hospice eligibility—ADRD carries a prognosis of 12–18 months in the latest stage. While low rates of live discharges from hospice are a regulatory requirement for hospices, people who are increasingly experiencing ADRD progression lose access to those beneficial hospice services. ...

Alzheimer’s prognosis models should expand data sources McKnights Senior Living; by Kristen Fischer; 8/12/24 Integrating data from nursing home electronic health records and claims in addition to the minimum data set — data required for nursing home residents — could be better than just relying on the MDS sources to produce an accurate prognosis for nursing home residents with Alzheimer’s disease and related dementias, according to a report published Thursday in the Journal of the American Geriatrics Society. ... The authors of the report noted that a recent review of prognostic models for late-stage ADRD found that assessments commonly used to evaluate prognosis-based eligibility for hospice weren’t reliable. ... Only 15% of people enrolled in hospice have a primary diagnosis of ADRD. That’s because it’s challenging to estimate the six-month prognosis required to be eligible for hospice, and dementias have a prognosis of 12 to 18 months when they are in the late stage, the authors pointed out.