Literature Review

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.

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.

Ensign Group expands with new Colorado and Kansas acquisitions Investing.com, San Juan Capistrano, CA; by AI and reviewed by an editor; 9/3/24 The Ensign Group , Inc. ... has expanded its portfolio with the acquisition of seven skilled nursing facilities in Colorado and one in Kansas, effective September 1, 2024. These facilities, which are now subject to long-term, triple net leases, bring Ensign's total operations to 323 healthcare facilities across fourteen states. The Colorado acquisitions include Desert Willow Health and Rehabilitation Center in Pueblo, Junction Creek Health and Rehabilitation Center in Durango, Pelican Pointe Health and Rehabilitation Center in Windsor, Riverbend Health and Rehabilitation Center in Loveland, Broadview Health and Rehabilitation Center and Westlake Lodge Health and Rehabilitation Center both located in Greeley, and Linden Place Health and Rehabilitation Center in Longmont. In addition, Ensign has acquired Prairie Ridge Health and Rehabilitation in Overland Park, Kansas. These latest acquisitions reflect the company's ongoing strategy to grow its presence in the healthcare sector by acquiring both well-performing and underperforming facilities.

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?

$83M fraud case against nursing home group may proceed, with no defendants excusedMcKnight's Long-Term Care News; by Jessica R. Towhey; 8/27/24A New York Supreme Court judge threw out all arguments from lawyers for an embattled group of nursing homes that sought to have charges dismissed in a case accusing the owners and operators of $83 million in Medicare and Medicaid fraud. Judge Melissa Crane ruled that the owners of Centers Health Care, along with numerous other individuals, did not make sufficient arguments for dropping charges of fraud, “saddling” nursing homes with “excessive debts,” colluding to pay “sham vendors,” and paying themselves “inflated” salaries.

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. 

Factors associated with Do Not Resuscitate status and palliative care in hospitalized patients: A national inpatient sample analysis Palliative Medicine Reports; by Jean-Sebastien Rachoin, Nicole Debski, Krystal Hunter, Elizabeth CerceoIn the United States, the proportion of hospitalized patients with DNR, PC, and DNR with PC increased from 2016 to 2019. Overall, inpatient mortality and LOS fell, but hospital charges per patient increased. Significant gender and ethnic differences emerged. Black patients and males were less likely to have DNR status and had higher inpatient mortality, LOS, and hospital charges.

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.

Four Years And More Than 200,000 Deaths Later: Lessons Learned From The COVID-19 Pandemic In US Nursing HomesHealth Affairs; by R. Tamara Konetzka, David C. Grabowski, Vincent Mor; 7/24Nursing home residents and staff were disproportionately affected by the COVID-19 pandemic, drawing attention to long-standing challenges of poor infection control, understaffing, and substandard quality of care in many facilities. Evolving practices and policies during the pandemic often focused on these challenges, with little effect. Despite the emergence of best practices to mitigate transmission of the virus, even the highest-quality facilities experienced outbreaks, indicating a larger systemic problem, rather than a quality problem at the facility level. Here we present a narrative review and discussion of the evolution of policies and practices and their effectiveness, drawing on evidence from the United States that was published during 2020–23.

No prison for nursing home owner who botched Hurricane Ida evacuation, leading to 7 resident deathsMcKnight's Long-Term Care News; by Josh Henreckson;7/23/24Bob Dean has been sentenced to three years of probation and must pay more than $1.3 million in restitution and penalties for his role in the disastrous emergency evacuation of nearly 850 residents from his seven Louisiana nursing homes during Hurricane Ida. The 2021 emergency evacuation to a warehouse Dean owned near New Orleans left the residents of his nursing homes in a state of overcrowding and neglect. Seven died within days of the storm — with hundreds more rescued by state officials. Dean pleaded no contest to 15 state criminal charges, including multiple counts each of cruelty to the infirmed, obstruction of justice and Medicaid fraud.

A blood test accurately diagnosed Alzheimer’s 90% of the time, study finds The New York Times; by Pam Belluck; 7/28/24 The New York Times says researchers “reported that a blood test was significantly more accurate than doctors’ interpretation of cognitive tests and CT scans in signaling” Alzheimer’s disease. The study “found that about 90% of the time the blood test correctly identified whether patients with memory problems had Alzheimer’s,” while “dementia specialists using standard methods that did not include expensive PET scans or invasive spinal taps were accurate 73% of the time” and “primary care doctors using those methods got it right only 61% of the time.” The findings were published in JAMA and presented at the Alzheimer’s Association International Conference.