Hickory, NC—As a top-ranking employer in the health care industry nationwide, Carolina Caring, which serves Iredell County, has been recognized for its commitment to employee engagement, transparent communication from leadership, and navigation of the challenges brought by the COVID-19 pandemic. For the second year in a row, Modern Healthcare has selected Carolina Caring, a leading Hospice and palliative care provider, as one of Modern Healthcare’s Best Places to Work in Health Care. Ranking No. 5 in this year’s distinguished list represents a jump from the company’s No. 18 ranking in 2019 and reflects its ongoing commitment to employee satisfaction. “We are thrilled to be named among the nation’s top health care employers,” says Carolina Caring President and CEO Dave Cook. “We remain focused on creating an environment that helps our dedicated staff feel valued, happy and motivated to go above and beyond for our patients, which is vitally important to our mission.”
As CMS, OIG Audits Continue, Hospices Prepare Themselves
Providers are focused on compliance as regulators increasingly zero in on the hospice space. With auditory action on the rise in the industry and anticipated to continue, hospices will need to be proactive in compliance planning and education to position themselves for success. ... New hospice investigations are forthcoming from the OIG that address the ways that the inpatient aggregate payment cap is calculated, as well as payments that are made outside of the Medicare Hospice Benefit. The office is also looking at specific providers’ compliance with law and regulation and Medicare payments for chronic disease management. ... “Auditing is the new norm. It is not ‘if’ you get an audit, it is ‘when’ will you get an audit,” said Kelly Murray [senior director of integrity at Ohio-based Bella Care Hospice] in a presentation at the National Hospice and Palliative Care Organization Interdisciplinary Conference. “Be prepared. Start taking actions now. ... “It’s incredibly important to know what the compliance issues are and what the rules are,” Murray stated. “The rules change all the time and educating your staff is your best defense against audits.”
West Palm Beach, FL—A Palm Beach County man and his four-legged best friend are helping terminally ill patients find something to smile about during tough times. Between the calming water and soothing music, hospice staff members work hard to create a relaxing environment for patients entering the final chapter of their lives. “I feel safe,” said Jubane Vargas, a hospice patient who has cancer. Sometimes that comfort comes from man’s best friend. Pet therapy is one of many options for patients at Trustbridge in Palm Beach County. WFLX tagged along for a special session that Vargas had with Floyd Greco and Tia, a 6-year-old doberman. ... The feeling is one that Greco knows well. He got Tia as a puppy to help him cope while his wife of 37 years was dying in the hospital. ... “She helped me tremendously, absolutely. Oh, I was mad at the world and you know, there’s a void and I’d just sit at home and didn’t know what to do. But she was there and even talking about it now it brings chills to me,” Greco said. Greco wanted to share that feeling with others going through difficult periods. That led him to find an outlet in volunteering.
Number of MA Plans Offering In-Home Support Services to Increase by 93% in 2021
Home Health Care News
The U.S. Centers for Medicare & Medicaid Services last month released new Medicare Advantage figures highlighting a massive expansion of plans offering home-focused supplemental benefits in 2021. The agency shared additional data on Wednesday—and it now appears the ongoing home care MA movement is even bigger than originally anticipated. ... Of the 738 plans operating in the primarily health-related MA pathway in 2021, 430 are offering “in-home support services,” or services that typically fall under a home care agency’s core business mix. For context, just 223 plans offered in-home support services through the primarily health-related MA pathway in 2020. ... In addition to those offering in-home support services and home-based palliative care in 2021, 127 plans will offer adult day health services, 176 will offer therapeutic massage and 95 will offer some type of service aimed at caregiver support. In terms of geography, the MA plans offering in-home support services under the primarily health-related pathway next year operate in 36 states and Puerto Rico. On a county level, there appears to be a particularly strong concentration in New York, Michigan, Indiana, Maine and a handful of other states. ... Exactly 11 states have MA plans offering home-based palliative care in at least one county in 2021 ...
Tidewell Hospice is using technology to enhance its care programs and provide patients and their loved one’s moments of joy and relief from pain and social isolation. The virtual reality platform allows groups of people to leave the four walls of their residence and engage with the world in ways they never thought possible. Patients are encouraged to experience their immersive life review, an important process for anyone facing end of life, by revisiting significant places from their past, and check off bucket list items—all through the immersive experience that VR offers. The technology is provided through Rendever, the leading provider of VR for seniors. Tidewell clinical staff members have trained to use VR headsets in the home, assisted-living, long-term care and hospice house settings.
Global Atlas Launched for World Hospice & Palliative Care Day
Working in cooperation with the World Health Organisation, The Worldwide Hospice Palliative Care Alliance [on World Hospice & Palliative Care Day] will also be launching a second edition of the Global Atlas of Palliative Care, a highly influential report on the status of palliative care worldwide. Data on palliative care need and serious health-related suffering in the Global Atlas were produced by the University of Miami Institute for the Advanced Study of the Americas and the International Association for Hospice and Palliative Care as part of follow-up to the Lancet Commission on Global Access to Palliative Care and Pain Relief. Dr Stephen R. Connor the WHPCA Executive Director, said, “In the landscape of the coronavirus pandemic and as global coronavirus deaths reach 1 million, palliative care has never been more important. By pulling together international research, The Global Atlas paints a picture of palliative care across the globe. It defines palliative care and who needs it, outlines why it is a human rights issue and highlights the access barriers to palliative care.”
Key Messages On Global Palliative Care—2020 ...
Approximately 7 million patients received palliative care in 2017 (up from 3 million in 2011) with only about 12% of the need being met globally Almost 69% of people needing palliative care suffer from non-communicable diseases like cancer, dementia, stroke, heart-liver-kidney failure, lung diseases, or injuries Almost 25% suffer from communicable diseases like HIV, TB, and even COVID-19 64% of countries have no or very limited provision of palliative care and only 15% of countries have good integration into health care systems
Why is it so hard to get home care at the end of life?
By Charlotte Grinberg
With the rise of an aging population and the number of people with serious illnesses, the field of palliative and hospice care is growing. One of the many roles of palliative and hospice care providers is to learn the communication skills necessary to help patients navigate their wishes for end-of-life care. Also growing is the preference of patients, caregivers, and clinicians for patients to live their final days in the warmth of a home, away from the incessant interventions of hospitals. At least for now, though, our medical system does not financially support caring for dying people at home the same way it supports caring for them in a hospital, rehabilitation facility, or long-term care facility. Patients who choose to leave the hospital for home hospice receive only limited services from their medical insurance through the hospice benefit. Families must provide or privately pay for all personal care services: bathing, dressing, eating, toileting, administering medications, and moving around, all of which are physically and emotionally exhausting for a caregiver and occur throughout the day. When patients and families realize they must provide this care, some elect for ongoing hospital interventions or discharge to a rehabilitation center or long-term care facility. These options are paid for and so seem like the next logical step, even though their preference, and the patient’s, is to be at home. It took a week to figure out a safe discharge plan for Susan. Her family members needed to visit the long term-care facilities covered by her insurance. Then they had to choose one, and the insurance company had to authorize her stay there. Given a mean hospitalization cost of $2,543 per day, this one-week delay may have cost the insurance company on the order of $18,000. What Susan’s family really needed was assistance at home for 10 hours a day while they worked. Round-the-clock care costs an average of $480 per day, meaning that seven days in the hospital could have covered a home health aide’s salary for a month. ... I’ve seen this situation again and again, and I’ve only been doing this for a few years: the patient is too weak or medically unstable to go to a rehab facility and no one is available to safely care for them at home. And now, in the era of coronavirus, which has called into question the nursing home industry, it is even more important to look into alternative insurance funding models for hospice at home as a potential win-win for insurers and patients.
[Editor’s Note: The author is an oncology-hospitalist at Beth Israel Deaconess Medical Center in Boston.]
Lunchtime music therapy reduces agitation in nursing home trial
McKnight’s Long Term Care News
Group music therapy in an eldercare setting reduces agitation and may be a useful tool in managing aggressive behavior, according to a new study. Investigators examined agitation in 30 nursing home residents aged 60 to 85 years at the Hyde Park Convalescent Hospital in Los Angeles. They used the Cohen Mansfield Agitation Inventory to assess resident behavior pre- and post-intervention. Caregivers played familiar calming music such as ballads and lullabies through a speaker while residents ate lunch for approximately 30 to 45 minutes. The intervention took place over an eight-week period with three weekly sessions. All 30 participants attended each of the 24 sessions, supervised by a music therapist. Nurses completed the CMAI two weeks prior to intervention and at the end of the study. Compared with residents who did not receive music therapy, the 30 residents who participated in the study exhibited fewer agitated behaviors at the end of the eight weeks. ... The study was presented at the American Psychiatric Nurses Association 34th Annual Conference, which wrapped up on October 4th.
Parkinson—CARES Act Will Keep Nursing Homes ‘Above Water’ in 2020, But Closures Loom in 2021
Skilled Nursing News
Though more resources on the governmental level are necessary for operators to continue in the midst of the pandemic, there are some bright spots, Mark Parkinson, the president and CEO of the American Health Care Association, told Skilled Nursing News on October 8. Those include better access to testing and personal protective equipment (PPE) and improved knowledge on how to care for COVID-19 patients in the event of an outbreak. ...
Skilled Nursing News: Something that you have mentioned is the need for operators to reflect on ways that things can improve. What are some of the necessary internal changes that have been highlighted by COVID, whether it’s how the operating business is structured or how things like sick leave are handled? ...