Literature Review

Study: People with dementia more apt to be admitted to nursing homes with lower star ratings McKnights Long-Term News; by Kristen Fischer; 11/5/24 People living with dementia are less likely to be admitted to high-rated nursing homes compared to people who don’t have the disease, a new study finds. Researchers looked at admission to nursing homes with higher staffing ratings after hospitalization and how individuals fared in the nursing homes based on having or not having dementia. The report was published on Oct. 29 in Alzheimer’s & Dementia. The team evaluated traditional Medicare beneficiaries discharged to nursing homes between 2011 and 2017 along with the relationship between facility staffing star-ratings, short-term readmission and mortality. The number of vacant beds in nursing homes with high ratings was also considered. Data was derived from 5.6 million people who were discharged to nursing homes; 23.1% of the people had dementia.

Why home health deserts are spreading across rural states Modern Healthcare; by Diane Eastabrook; 11/1/24 Home health deserts are increasing at an alarming rate across some rural states as home health companies close or reduce services due to financial challenges. Home health companies in Maine, Nebraska and Minnesota say a proposed Medicare rate cut, low Medicare Advantage reimbursements and workforce shortages are forcing them to make difficult business decisions — leaving many communities with limited access or no access to post-acute care in the home. ...  Approximately 800 home health providers have closed over the past five years, according to the National Alliance for Care at Home, a trade group that represents the industry. Alliance CEO Dr. Steve Landers mostly blames a Medicare home health payment model that went into effect in 2020 for reducing Medicare reimbursements and causing financial stress for providers. “While closures are significant, we are also getting reports that providers are restricting the territory they serve as a first step to addressing their financial stresses,” Landers said in an email. “This appears to be especially concerning in rural areas where no other provider is available to step in.”

BrightSpring CEO: Home health, hospice acquisitions offer ‘high return on investment’ Home Health Care News; by Audrie Martin; 11/1/24 The newest home-based care face on the public market, BrightSpring Health Services (Nasdaq: BTSG), is making strides. The company announced a successful third quarter during its earnings call Friday. Leaders reported an overall increase in business and raised 2024 revenue and adjusted EBITDA guidance. Provider service segment revenue grew across service lines for the Louisville, Kentucky-based company. This was primarily attributed to billable hours growth and its Rehab in Motion program supporting Medicare Part B outpatient rehab patients. ... “From an acquisition strategy perspective, I think it’s going to be consistent with what we’ve done over the past couple of years,” he said. “On the provider side, it’s been rehab, home health and hospice, and then home-based primary care as well. We currently have three or four very small tuck-ins for home health and hospice, which are high returns on investment. On the de novo side, it’s really on home health, hospice and rehab.”

‘Stop Requested’: To Lakeview, Oregon’s ‘Mile High City’ OPB (Oregon Public Broadcasting); by Lillian Karabaic; 10/27/24 Lakeview isn‘t close to much, but locals figure out how to get ’er done. ... OPB “Weekend Edition” host Lillian Karabaic and producer Prakruti Bhatt experience the joys and difficulties of rural transit and talk to many people along the way. ... To reach Lakeview, we turn to the Lake County Cloud, a transit service run by the Lakeview Senior Center. Lake County Cloud doesn‘t have any fixed route services. Its crew of eight part-time drivers mostly do by-reservation trips to medical appointments and a few shopping trips. This became even more important after Lakeview’s only specialty clinic and hospice closed in 2023. ... Because the nearest city is Klamath Falls, more than 90 miles away, Lake County Transit puts in a lot of miles. It also goes up to Medford, down to California, and even all the way to Portland for chemotherapy. “We do about 30,000 [or] 40,000 miles a month … it’s a lot for a little town and little crew," says Linda Mickle, transportation coordinator for Lake County Transit.

Walgreens layoffs hit 256 workers in another round of cuts Modern Healthcare; by Katherine Davis; 10/29/24 Walgreens Boots Alliance is laying off more employees in another round of corporate personnel cuts. The struggling pharmacy chain is laying off 256 employees, or 3.6%, of its support center team employees and cutting about 215 open and unfilled roles, Walgreens spokesman Fraser Engerman confirmed Tuesday in a statement to Crain’s. Engerman said the cuts reflect Deerfield-based Walgreens’ efforts to turn around the business and its recent decision to focus on its core retail pharmacy business. ... This latest round of layoffs follows a fiscal year full of billion-dollar losses, store closure announcements and cost-cutting initiatives.

Pinnacle home care CEO: Home health margins will increase ‘significantly’ with AIHome Health Care News; by Andrew Donlan; 10/22/24If you don’t like change, you’re going to hate extinction. That’s a phrase that should be hung up on home health providers’ walls across the country, according to Pinnacle Home Care CEO Shane Donaldson. There’s traditional Medicare rate cuts, Medicare Advantage (MA) penetration, staffing shortages and regulatory challenges in the home health market. But Donaldson sees solutions to most of those problems on the horizon. Emerging technologies – and in particular, artificial intelligence – will alleviate some of the contemporary pressures in the space, he believes. And when those pressures are alleviated, margins will skyrocket.

How home-based care providers survived devastating hurricanes in the SoutheastHome Health Care News; by Joyce Famakinwa; 10/23/24Hurricane Helene and Hurricane Milton forced home-based care providers in the impacted areas to up their games, to go even further to care for their clients and patients.

Large systems outsource home care to focus on 'core business' Becker's Hospital CFO Report; by Alan Condon; 10/25/24 A growing number of health systems are outsourcing home health and hospice operations to third-party specialists with broader geographic reach to reduce cost and administrative burdens and focus on core services. The regulatory environment for home health and hospice is complex, with stringent requirements for reimbursement, reporting and patient care standards. Partnering with an outsourced provider also helps systems mitigate the risks associated with non-compliance and operational issues. Here are four health systems that have outsourced or plan to outsource home health and hospicare care:

The case for stronger caregiver vetting in home care Home Health Care News; by Audrie Martin; 10/24/24 Direct care workers are, in many ways, the collective face of home-based care organizations. They are who clients and patients interact with. Therefore, regulators and providers are increasingly taking a closer look at who they’re hiring in the first place. While it is shocking to see caregivers commit crimes against clients, it does happen. About one in six people aged 60 and older experienced some form of abuse during 2023, according to the World Health Organization. Rates of abuse against older people have increased since the COVID-19 pandemic and are predicted to continue rising as many countries experience rapidly aging populations. To combat this trend, increased vetting is essential when hiring individuals to care for seniors in their homes. Editor's note: Related, disturbing articles we posted recently include ...

Saint Francis Hospital’s Healthy Village creates national social-services healthcare model DelawareLive, Wilmington, DE; by Jarek Rutz; 10/23/24 Saint Francis Hospital hopes a new, unique initiative will be a national model for healthcare. As it celebrates 100 years of service, the hospital is expanding its community outreach to the Wilmington community by launching the Healthy Village at Saint Francis Hospital, which aims to deliver essential social services to those in need. Located in economically challenged neighborhoods, Healthy Villages are designed to enhance the traditional safety net hospital model. “The goal is to create the ultimate one-stop care setting that promotes synergy, diversity, and equity,” said Lillian Schonewolf, executive director of the Healthy Village at Saint Francis, in a YouTube video. Editor's note: See the article we posted yesterday about the importance of community, "Who gets access to a good death?"

Retiring NAHC President Bill Dombi exhorts advocates to keep fighting HomeCare; 10/22/24 The departing leader shares his vision for the future of home health & hospice at his final conference. Bill Dombi met his first bully in kindergarten. It only took a day for him to fight back, leaving the bully with a bloody nose and Dombi punished in a corner, the retiring president emeritus of the National Association for Homecare and Hospice (NAHC) said as he bid farewell on the last day of the organization’s annual conference in Tampa, Florida. "I was smiling the entire time—and learning that’s not the way to do it," Dombi told the crowd during his last moments on the convention stage. "You’ve got to go to law school instead." Dombi is retiring at the end of the year and was celebrated throughout this year's event, which was launched under the NAHC title, but actually took place as the National Alliance for Care at Home Home Care and Hospice Conference and Expo after NAHC and the National Hospice and Palliative Care Organization (NHPCO) merged in July. [Click on the title's link to continue reading.]

Enhabit Home Health & Hospice Becomes Age-Friendly Health Systems participant HomeCare, Dallas, TX; 10/21/24 Enhabit Inc., a home health and hospice provider, announced it has been recognized by the Institute for Healthcare Improvement (IHI) as an Age-Friendly Health Systems participant. The Age-Friendly Health Systems is an initiative of the John A. Hartford Foundation and the IHI, in partnership with the American Hospital Association and the Catholic Health Association of the United States. The Age-Friendly Health Systems aims to follow a set of evidence-based practices, cause no harm and align with what matters to the older adult and their family caregivers. Age-Friendly Health Systems participants are recognized for aiming to become an Age-Friendly Health System and have submitted examples of how they put four elements of care—the “4Ms”—into practice with older patients. ...