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LOS Challenges and Changes in the Industry Welcome to our latest newsletter focusing on recent developments affecting LOS. This edition covers a range of topics, from facility closures and staffing issues to policy changes and their impacts. Let's dive into the key stories: Montana Nursing Home Closure Montana's largest nursing home is preparing to close following patient safety violations.?This closure, affecting the Ivy nursing home, is due to federal violations, and residents are being relocated.?The situation highlights the ongoing challenges faced by nursing facilities in maintaining standards and operational viability. Nursing Home Staffing Study A recent study on nursing home staff types reveals interesting findings. Higher presence of Registered Nurses (RNs) in nursing homes is associated with increased use of antipsychotic drugs but reduced hospitalizations and emergency department visits.?This research underscores the complex relationship between staffing decisions and patient outcomes. Nursing Home Failures An analysis of how and why nursing homes fail provides insights into the industry's challenges.?The report, focusing on Montana, examines the factors contributing to nursing home closures and the impact on communities. Gunshot Wound Discharges to Skilled Nursing Facilities A scholarly publication from Duke University explores the factors associated with discharging gunshot wound patients to skilled nursing facilities.?This study sheds light on the intersection of acute trauma care and long-term skilled nursing needs. Hurricane Ida Aftermath In a notable case, nursing home owner Bob Dean received three years of probation following a botched hurricane evacuation.?This incident highlights the critical importance of emergency preparedness in nursing homes. Missouri Nursing Home Advocacy Missouri faces challenges in funding for nursing home advocates.?This development raises concerns about the support and oversight available for nursing home residents in the state. Medicaid Expansion and Healthcare Access Several articles discuss the impact of Medicaid expansion decisions: In 10 states that didn't expand Medicaid, 1.6 million people can't afford health insurance. Georgia faces issues with people earning too much for Medicaid but not enough for private insurance. Georgia's Medicaid work requirements have resulted in high costs and low enrollment. Link to the articles will be posted in the comments below.

LOS Challenges and Changes in the Industry Welcome to our latest newsletter focusing on recent developments affecting LOS. This edition covers a range of topics, from facility closures and staffing issues to policy changes and their impacts. Let's dive into the key stories: Montana Nursing Home Closure Montana's largest nursing home is preparing to close following patient safety violations.?This closure, affecting the Ivy nursing home, is due to federal violations, and residents are being relocated.?The situation highlights the ongoing challenges faced by nursing facilities in maintaining standards and operational viability. Nursing Home Staffing Study A recent study on nursing home staff types reveals interesting findings. Higher presence of Registered Nurses (RNs) in nursing homes is associated with increased use of antipsychotic drugs but reduced hospitalizations and emergency department visits.?This research underscores the complex relationship between staffing decisions and patient outcomes. Nursing Home Failures An analysis of how and why nursing homes fail provides insights into the industry's challenges.?The report, focusing on Montana, examines the factors contributing to nursing home closures and the impact on communities. Gunshot Wound Discharges to Skilled Nursing Facilities A scholarly publication from Duke University explores the factors associated with discharging gunshot wound patients to skilled nursing facilities.?This study sheds light on the intersection of acute trauma care and long-term skilled nursing needs. Hurricane Ida Aftermath In a notable case, nursing home owner Bob Dean received three years of probation following a botched hurricane evacuation.?This incident highlights the critical importance of emergency preparedness in nursing homes. Missouri Nursing Home Advocacy Missouri faces challenges in funding for nursing home advocates.?This development raises concerns about the support and oversight available for nursing home residents in the state. Medicaid Expansion and Healthcare Access Several articles discuss the impact of Medicaid expansion decisions: In 10 states that didn't expand Medicaid, 1.6 million people can't afford health insurance. Georgia faces issues with people earning too much for Medicaid but not enough for private insurance. Georgia's Medicaid work requirements have resulted in high costs and low enrollment. Link to the articles will be posted in the comments below.

A short review of some of the articles related to LOS and post-acute care that caught our eye. Please check out the comments for links to the articles. UC study finds better cardiovascular health outcomes with home hemodialysis. Patients on home hemodialysis have lower incidence of cardiovascular disease compared to those using peritoneal catheter for dialysis at home. The study led by Dr. Silvi Shah analyzed outcomes of 68,645 dialysis patients in the United States. Home hemodialysis is associated with a 42% lower risk of stroke, 17% lower risk of acute coronary syndrome, 22% lower risk of cardiovascular death, and 8% lower risk of overall death[1]. Dialysis centers require 4 to 6 hours per day, while home hemodialysis is costly and needs proper training; peritoneal dialysis is easier to administer and offers flexibility[2]. Changes to Home Health Conditions of Participation The U.S. Centers for Medicare Medicaid Services (CMS) released a home health proposed payment rule for 2025, leading to reactions from providers and stakeholders. The proposal includes OASIS updates for the home health quality reporting program starting in January 2027, with additional questions focusing on living situation, food security, and utilities. Providers are advised to start preparing early for the upcoming changes and consider training staff to collect the required information effectively. Can Palliative Care Consults in Hospitals Improve EoL Care? The study aimed to determine the impact of automatically ordering palliative care for seriously ill hospitalized older adults. Researchers conducted a pragmatic cluster randomized trial in 11 community hospitals across eight U.S. states, involving 34,239 participants aged 65 and older with serious illnesses. One group had palliative care consults ordered by default, while the other group received usual care where clinicians decided on consults. Data analysis focused on outcomes like consultation rates, length of hospital stay, hospice discharges, DNR orders, and in-hospital mortality rates. Results showed that default palliative care orders increased consultation rates and expedited consultations but did not reduce hospital stay lengths. In Stroke patients, disparities in PAC depends on insurance status. Racial and ethnic disparities, as well as regional variations, exist in post-acute service utilization after stroke, based on a study published in Neurology: Clinical Practice. The study analyzed data from patients hospitalized for ischemic stroke and intracerebral hemorrhage in 2017 to 2018, highlighting disparities in discharge outcomes based on insurance status and ethnicity. Uninsured patients had the lowest odds of facility discharge and home healthcare compared to those with private insurance, with variations observed among Hispanic patients and different regions in the U.S.

A short review of some of the articles related to LOS and post-acute care that caught our eye. Please check out the comments for links to the articles. UC study finds better cardiovascular health outcomes with home hemodialysis. Patients on home hemodialysis have lower incidence of cardiovascular disease compared to those using peritoneal catheter for dialysis at home. The study led by Dr. Silvi Shah analyzed outcomes of 68,645 dialysis patients in the United States. Home hemodialysis is associated with a 42% lower risk of stroke, 17% lower risk of acute coronary syndrome, 22% lower risk of cardiovascular death, and 8% lower risk of overall death[1]. Dialysis centers require 4 to 6 hours per day, while home hemodialysis is costly and needs proper training; peritoneal dialysis is easier to administer and offers flexibility[2]. Changes to Home Health Conditions of Participation The U.S. Centers for Medicare Medicaid Services (CMS) released a home health proposed payment rule for 2025, leading to reactions from providers and stakeholders. The proposal includes OASIS updates for the home health quality reporting program starting in January 2027, with additional questions focusing on living situation, food security, and utilities. Providers are advised to start preparing early for the upcoming changes and consider training staff to collect the required information effectively. Can Palliative Care Consults in Hospitals Improve EoL Care? The study aimed to determine the impact of automatically ordering palliative care for seriously ill hospitalized older adults. Researchers conducted a pragmatic cluster randomized trial in 11 community hospitals across eight U.S. states, involving 34,239 participants aged 65 and older with serious illnesses. One group had palliative care consults ordered by default, while the other group received usual care where clinicians decided on consults. Data analysis focused on outcomes like consultation rates, length of hospital stay, hospice discharges, DNR orders, and in-hospital mortality rates. Results showed that default palliative care orders increased consultation rates and expedited consultations but did not reduce hospital stay lengths. In Stroke patients, disparities in PAC depends on insurance status. Racial and ethnic disparities, as well as regional variations, exist in post-acute service utilization after stroke, based on a study published in Neurology: Clinical Practice. The study analyzed data from patients hospitalized for ischemic stroke and intracerebral hemorrhage in 2017 to 2018, highlighting disparities in discharge outcomes based on insurance status and ethnicity. Uninsured patients had the lowest odds of facility discharge and home healthcare compared to those with private insurance, with variations observed among Hispanic patients and different regions in the U.S.

You are a social worker at a busy level one trauma center. Your hospital is near capacity, and you are working with the ED case manager to identify patients that can be diverted or care for at home with services. See how many patients you can identify in the picture below to screen prior to admission.

You are a social worker at a busy level one trauma center. Your hospital is near capacity, and you are working with the ED case manager to identify patients that can be diverted or care for at home with services. See how many patients you can identify in the picture below to screen prior to admission.

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Some recent article of interest related to length of stay and transitioning to post-acute care. Hospital Length of Stay 1. Becker’s reports Hospital executives are increasingly focusing on reducing length of stay to improve their bottom line. With average adjusted expenses per inpatient day reaching $2,883 in 2021, hospitals are streamlining discharge processes and improving care coordination to optimize patient throughput. 2. The Washington Post warns that reducing the proportion of registered nurses (RNs) in hospitals could lead to increased patient mortality and readmissions. The research suggests that a 10% decrease in RN staffing could result in 10,947 additional deaths and 5,207 avoidable readmissions annually. 3. An article published in Chief Healthcare Executive reports delayed discharges continue to be a significant issue, with patients staying in hospitals for weeks or even months due to various factors, including staff shortages and lack of post-acute care beds. Skilled Nursing Care 1. Skilled Nursing News reports nursing home staffing shortages are contributing to the hospital discharge crisis. A survey by the American Health Care Association revealed that most skilled nursing facilities are still operating with lower workforce levels compared to pre-pandemic times. About 20% of skilled nursing facility operators have closed at least one wing or unit due to staffing challenges, limiting their ability to admit new patients. Delayed pre-authorizations in Medicare Advantage and other managed care plans are significantly contributing to discharge issues related to skilled nursing facilities. Medicaid 1.?And from the AP, Georgia's Medicaid work requirement program, Pathways to Coverage, is struggling to meet enrollment targets in its first year. Launched with the aim of providing health insurance to around 25,000 low-income individuals, the program has only attracted approximately 4,300 participants.?This falls significantly short of expectations and represents a small fraction of those who could benefit from full Medicaid expansion. The program requires recipients to demonstrate at least 80 hours of work, volunteer work, education, or vocational rehabilitation per month. Critics argue that these stringent requirements, along with complex enrollment processes, are major barriers to participation, especially in rural areas where resources and opportunities may be limited. Links to the articles used in the comments below.?

In this guide, we explore strategies for case managers to integrate palliative care principles early in patient care in resource-constrained settings. This guide offers practical tools and insights to: ? Initiate timely palliative care discussions ? Overcome common barriers in implementation ? Empower caregivers with knowledge and support ? Enhance patient outcomes through creative solutions Whether you're a seasoned case manager or new to the field, this presentation provides valuable perspectives on maximizing quality of life for patients with serious illnesses. Join us to learn how to transform challenges into opportunities for better, more holistic care.#PalliativeCare #CaseManagement #HealthcareInnovation #PatientCare