Literature Review

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.

Despite past storms’ lessons, LTC residents again left powerless: How a long-term care facility prepares for and handles power outages is one of the first questions potential residents should ask KFF Health News - Rethinking65; by Sandy West; 7/29/24 ... Even after multiple incidents of extreme weather — including a 2021 Texas winter storm that caused widespread blackouts and prompted a U.S. Senate investigation — not much has changed for those living in long-term care facilities when natural disasters strike in Texas or elsewhere. ... [While] nursing homes face such federal oversight, lower-care-level facilities that provide some medical care — known as assisted living — are regulated at the state level, so the rules for emergency preparedness vary widely. ... Editor's Note: While this article is written for the public, its content applies to all hospices that (1) provide hospice facility care, and/or (2) partner with senior care facilities: nursing homes, long-term care, assisted living, senior living communities, and PACE. This can be an important QAPI analysis and gap improvement. 

No One Dies Alone: a movement against isolation and loneliness in the final hours The Optimist Daily; by The Optimist Daily Ediorial Team; 7/27/24 The fear of dying alone is one of the most powerful and agonizing feelings that many harbor, especially during the COVID-19 pandemic. For some, this fear sadly becomes a reality. To address this issue, the No One Dies Alone (NODA) initiative trains and supports volunteers who provide companionship to people in their final hours. ... The NODA concept began in 1986 in Oregon, United States [by] Sandra Clarke, a nurse. ... [Alison] Bunce founded Compassionate Inverclyde (CI) in 2016 as an Ardgowan Hospice-funded project, where she worked as director of care. Starting with 20 volunteers, CI sought to sit with people who were dying alone, initially in hospices and local hospitals before extending to private homes. Today, CI has grown substantially, with over 100 volunteers available to provide companionship at a moment’s notice.

Baptist Health taps 3 vendors to build a population health system that works Healthcare IT News; by Bill Siwicki; 7/26/24With help from Oracle, Innovaccer and Salesforce, the South Florida provider is scoring big population health wins, including a 7% increase in coding gap closure rate and a 17% increase in annual wellness visit completion rates. Baptist Health South Florida operates a network of 11 hospitals covering four counties. It also includes numerous ambulatory facilities, urgent care centers and emergency departments to provide comprehensive healthcare services across the region. ... "One of our primary issues was the fragmented nature of patient data across multiple provider organizations and electronic health record systems," said Milady Cervera, vice president, population health and physician integrated networks, at Baptist Health South Florida. "This lack of interoperability made it difficult to gain a comprehensive view of our patients' health status, care history and ongoing needs. ..."

Millions burdened by the cost of long-term care AHCJ - Association of Health Care Journalists; by Breanna Reeves; 7/18/24 ... [Robert] Ingenito shared the mounting costs of caring for his father, who became really sick in 2023. During the panel, Ingenito shared the estimated total cost of caring for his father for just a few months: $57,000. ... [In the U.S.] 8 million people over age 65 need long-term care services, but 3 million were not receiving them. ... Most people in the U.S. are cared for by unpaid caregivers, which are oftentimes spouses and daughters who have no prior experience in caregiving.

Innovative program for veterans aims to combat dementia and feelings of social isolation and loneliness by distributing animatronic pets nationwide Cision PRWeb; by Capital Caring Health; 7/18/24 Capital Caring Health, part of the nation's largest not-for-profit advanced illness care and hospice provider—Chapters Health System, and Ageless Innovation, the makers of the award-winning Joy for All™ Companion Pets, are distributing companion pets to Veterans with dementia, and those suffering from feelings of social isolation and loneliness as part of their innovative "Pets for Vets" program. ... To date, Capital Caring Health's "Pets for Vets" program has distributed more than 3,000 robotic companion pets – which provide joy, companionship, emotional support, and more to Veterans, will expand to deliver 1,000+ companion pets to Veterans living in Long-Term Care Centers across the nation.

Why CommonSpirit Health is investing in the home Becker's Helath IT; by Giles Bruce; 7/18/24 Chicago-based CommonSpirit Health has grown into the country’s largest Catholic provider of care at home. ... Becker's recently sat down with Trisha Crissman, interim executive director of CommonSpirit Health at Home, to discuss the metamorphosis of at-home care. ... [In 2010] ... we established hospice as another service line for the organization. ... And that brings us to where we find ourselves today — as the largest Catholic care-at-home provider in the country, with 84 locations and soon to be about 15 states, serving about 15,000 patients daily, with skilled home healthcare, hospice, palliative care, home infusion. We have many solution models, including "hospital at home," SNF [skilled nursing facility] at home, and ED [emergency department] diversion solutions.

Risky business: Home sweet home or nursing home? American Nurse - Perspectives; by Christopher Hirschler, PhD, MCHES; 7/18/24 In 2018, “Nursing homes: Good intentions, sad realities” chronicled Rita Hirschler’s experience in a nursing home after decades of being a private care nurse. In response to the ideas espoused in the article, namely that a person has a right to live and die in their home and risks are unavoidable whether one lives at home or in a nursing home, a commentator asked, “What is the solution?” ... According to the Center for Medicare Advocacy and Lu and Lu, ownership and sponsorship type have been shown to significantly impact the quality of care in nursing homes, with for-profits generally having lower staffing levels and poorer patient outcomes. The Centers for Disease Control and Prevention, Meyer, and KFF Health News say for-profit nursing homes now account for approximately 72% of the more than 15,000 U.S. nursing homes, and they provide varying levels of care to 1.3 million residents. 

Cedar Rapids nursing home worker needlessly exposed to infectious disease, judge rules The Gazette; by Clark Kauffman, Iowa Capital Dispatch; 7/16/24 A social worker for an Iowa nursing home was justified in quitting after the facility failed to inform her and others of residents who had serious, contagious diseases, according to a judge’s ruling. State records indicate Mary Lovejoy Castaneda was employed by the nursing home chain Care Initiatives as a full-time social worker at Cedar Rapids’ Heritage Specialty Care from March through May of this year. She resigned after citing “stress and anxiety” related to the job, which entailed working with hospice patients. ... [Additionally,] when Care Initiatives hired Castaneda the company assured her it would refrain from assigning her hospice patients, only to later begin doing so. Editor's Note: Yes, lack of information about patients with "serious, contagious diseases" with the need to wear PPE is a significant offense. However, the social worker employee requesting [refusing?] to serve hospice patitents within a nursing home facility raises significant ethical concerns about care for patients and their families. The staff/patient ratio for social workers in a nursing facilities requires extensive, broad coverage. Click on the title's link to continue reading.

Fewer deaths after serious illness in veterans treated with PARC Care Model U.S. Medicine; by LaTina Emerson; 7/11/24 After a serious illness, veterans who received medical care via the Post-Acute Recovery Center (PARC) model experienced fewer deaths and more days outside of the hospital compared to those not treated with PARC, according to a recent study. ...  Using telehealth, PARC is administered by nurse practitioners to address the complex needs of intensive care unit (ICU) survivors as they transition from hospital to home and improve access to post-ICU care for high-risk veterans, ... Each year, “more than 100,000 veterans transition from ICUs to their home after treatment for life-threatening illnesses, but this transition presents many challenges, including unresolved acute medical issues and the lingering effects of acute organ dysfunction,” according to the study authors. ... 

Caregiver charged with abusing dementia patient The Freeman, Waukesha County, WI; by Freeman Staff; 7/9/24 A West Allis woman has been charged after she allegedly struck a dementia patient in her care and put a pillow over the woman’s face out of frustration. Erica Junger, 22, was charged Monday in Waukesha County Circuit Court with a count of intentionally abusing a patient, and faces up to six years in prison if convicted. She made an initial appearance in court Monday, where she was released on a $2,500 signature bond and ordered by Court Commissioner David Herring not to work in any job where she is responsible for the health care and safety of others. ... She said she "snapped" and did things she wasn’t supposed to do, but didn’t mean anything by it. ... The complaint did not identify the facility where the incident took place. But it did identify Junger as an employee of Agrace Hospice, which contracts with the facility.