Report calls for changes in Medicare's hospice policy | Health system uses Code Comfort for DNR patients | Fla. hospitals seek to enter Tampa Bay hospice market
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December 12, 2014
Hospice and Palliative Medicine SmartBrief
News for physicians caring for the seriously ill

Top Story
Report calls for changes in Medicare's hospice policy
Medicare's hospice benefit should better support nursing home beneficiaries, who tend to have longer hospice stays compared with people living in a community setting, according to a study from the Regenstrief Institute and the Indiana University Center for Aging Research. Researcher Kathleen Unroe said Medicare eligibility criteria are a poor fit for nursing home patients, even though almost one-third of hospice patients reside in the facilities. McKnight's Long-Term Care News (12/11)
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Palliative & Hospice Care Update
Health system uses Code Comfort for DNR patients
Hospital staff often face a treatment dilemma when end-of-life patients are suffering but have a do-not-resuscitate order in place. Novant Health officials describe the system's Code Comfort, which is based on rapid-response teamwork, as a specific formula for assessing and treating symptoms, including pain, agitation and dyspnea. Harvard Business Review (tiered subscription model) (12/2014)
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Fla. hospitals seek to enter Tampa Bay hospice market
Florida officials say Hillsborough and Pasco counties could benefit from more hospices, and applicants to fill the need include several existing hospice companies, along with three hospital systems. "Hospitals now provide end-of-life care, but it's not necessarily the best or most cost-effective environment. By moving into hospice care, we can provide a new model," said John Dunn of Tampa General Hospital. Tampa Bay Times (St. Petersburg, Fla.) (12/10)
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Other News
Patient & Family Perspective
Employee caregivers want more job flexibility
Employees who also are family caregivers want their companies to give them more flexibility for managing their work time, Kenneth Matos of the Families and Work Institute said at the Gerontological Society of America conference. The institute found employers have been reducing options for taking time off to handle personal issues, but Matos said lost productivity costs of having employees handle elder-care crises are about $1.6 billion annually. U.S. News & World Report (12/10)
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Business Tips and Advice
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Medical Research
Low blood oxygen in sleep tied to dementia-related brain changes
A study in Neurology suggests that older men who had low blood oxygen levels during sleep and who spent less time in deep sleep were more likely to have tiny abnormalities in the brain that can precede dementia. The study adds to evidence that poor sleep may contribute to mental decline in some older people, experts said. News (12/10)
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Health Policy & Practice
CMS proposes new rules for gay spouses in hospitals, hospices
The CMS has proposed that hospitals, hospices, nursing homes and other health care facilities treat gay married spouses the same as straight couples as long as their marriage is legal somewhere in the U.S. Spouses often are asked to make medical decisions, and the U.S. Supreme Court has said a law prohibiting federal recognition of same-sex marriages is not constitutional. The agency is soliciting feedback on the draft for 60 days. Bloomberg Businessweek (12/11)
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Report on race-based health care disparities shows mixed results
Black Medicare patients overall are less likely than whites to have controlled hypertension, cholesterol and blood sugars, but data show by 2011 these racial disparities seem to have disappeared in the western U.S., University of Michigan researchers reported in the New England Journal of Medicine. Older Hispanic patients were on par with their white counterparts by 2011, and Asian seniors were doing better than whites, data showed. A second study in the same journal that involved hospitals found narrowing racial disparity gaps in access to recommended care. HealthDay News (12/10), The Atlantic online (12/10)
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Nurse: End of geriatric certification is unfortunate
The decision by the American Nurses Credentialing Center to stop offering new geriatric nursing certifications contradicts a 2008 study that found a continuing need for nurse practitioners specializing in geriatrics, writes Mara Aronson, a geriatric clinical nurse specialist. GNP and GCNS certifications have been replaced with credentials for adult-gerontology acute care nurse practitioner, adult-gerontology primary care nurse practitioner and adult-gerontology clinical nurse specialist. Medscape (free registration) (12/9)
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Trends & Technology
Study examines tablet, smartphone use by providers
A study by HIMSS Analytics found that 69% of 139 clinicians use smartphone and tablet health applications to view clinical data at work, while one-third of respondents believe the adoption of mobile devices will boost overall care efficiencies. However, the study also revealed that only 33% of respondents said they can use their mobile devices to access most of the clinical technologies they need. (12/11)
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Follow AAHPM online
Stay connected with AAHPM via Facebook; LinkedIn; LinkedIn Hospice Medical Directors Group; LinkedIn AAHPM & HPNA Annual Assembly Group; Twitter; Flickr; and the AAHPM Blog. Help others understand hospice and palliative medicine. Share the video, "You're Sick. It's Serious."
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Primer of Palliative Care, 6th edition
This book is the essential introductory text for those who care for patients with serious illness and their families. Contents include an introduction to hospice and palliative care, pain management, dyspnea, gastrointestinal symptoms, and special considerations for infants and children. Available as an ebook or soft cover book. Purchase at
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Who's Hiring?
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Palliative Care Nurse Practitioner Opportunity – Charlottesville, VA –Martha Jefferson HospitalCharlottesville, VA
Palliative Care PhysicianNewton-Wellesley HospitalNewton, MA
Palliative Care Physician/FacultyIcahn School of Medicine at Mount Sinai - Elmhurst Hospital CenterElmhurst, NY
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You cannot create experience. You must undergo it."
-- Albert Camus,
French philosopher
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