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:: NAHC Report
NAHC Report: Issue# 2285, 10/1/2013
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Dartmouth Atlas Brief: Cancer Care Near the End of Life
The Companionship Exemption Explained
For Your Information: Chip Bell to Address NAHC’s 2013 Annual Meeting & Exposition on Saturday, November 2nd
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Dartmouth Atlas Brief: Cancer Care Near the End of Life

A recent Dartmouth Atlas of Health Care Brief found that even though most patients with advanced cancer prefer care that minimizes symptoms, many still receive intense treatment and are not admitted into hospice care until their last three days of life.

While utilization of hospice by Medicare patients with advanced cancer is increasing, a growing proportion of patients begin hospice care in the final three days of life. At the same time, these patients are spending fewer days in the last month of life hospitalized, but the number of days they spend in intensive care units (ICUs) has increased. Following are some of the study’s key findings:

  • Between 2003-2007 and 2010, the percentage of Medicare patients with advanced cancer dying in hospitals and the average number of days they spent in the hospital before their deaths declined across most regions, medical centers, and cancer centers.
  • Overall, Medicare patients with cancer were significantly more likely to spend time in the ICU, as the percentage of patients admitted to the ICU during the last month of life increased by nearly 22 percent, from 23.7 percent from 2003-2007 to 28.8 percent in 2010.
  • Medicare patients with advanced cancer were more likely to receive hospice care in 2010, as 61.3 percent of patients were admitted into hospice care during the last month of life, compared to 54.6 percent in 2003-2007.

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Chip Bell to Address NAHC’s 2013 Annual Meeting & Exposition on Saturday, November 2nd
2013 NAHC Annual Meeting & Exposition General Session Speakers Announced

Chip Bell helps companies build cultures that support long-term customer loyalty. As founder of The Chip Bell Group, he works from both Dallas, Texas, and Atlanta, Georgia. Before starting the firm in 1980, he was director of management and organization development for NCNB, now Bank of America. He holds graduate degrees from Vanderbilt University and George Washington University, and brings both academic and real-world experience to his many publications.

Bell is the author or co-author of several best-selling books, including Customer Loyalty Guaranteed, Service Magic, Customers as Partners, Take Their Breath Away: How Imaginative Service Creates Devoted Customers, and his latest The 9 ½ Principles of Innovative Service. 

He is also the author of over 300 articles that have appeared in professional journals, such as Management Review, Quality Digest, Leader to Leader, Journal of Management Consulting, and CARING magazine. 

To register to attend NAHC’s Annual Meeting, and to hear Chip Bell in person, please click here.

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The Companionship Exemption Explained
The following article comes from an upcoming CARING Magazine piece written by CARING’s Managing Editor Lisa Yarkony

A new rule from the Labor Department decrees overtime pay for home care workers, a move that may ruin Jonathan’s life. Jonathan is disabled and depends on a ventilator to breathe. He has three regular caregivers who cover most of his shifts, and two of them work the majority of hours. He has had these trusted caregivers for over 20 years, but he may soon be seeing some strange, new faces in his home. Because they aren’t family and don’t live with him, their hours will be capped at 40 under the rule. This means that Jonathan will need to hire additional caregivers and the earnings for his current caregivers will be cut. Jonathan is worried that he won’t be able to find caregivers who are as skilled when their weekly pay check is less than half of what he’s been paying his current ones. If Jonathan can’t make it work, he knows he will wind up in a nursing home … or worse.

And he isn’t the only one who fears the new rule despite cheers that the “White House is giving 2 million health care workers a raise,” as the Washington Post gleefully declared. The Cato Institute was more inclined to jeer at the rule requiring time-and-a-half overtime pay for home care workers who put in more than 40 hours a week serving the disabled and aged. “This is a terrible move,” the institute sneered in no uncertain terms. “The fear and anger it has stirred is coming not just from commercial employment agencies, as some careless media accounts might leave you to believe, but above all from elderly and disabled persons and their families and loved ones who know that home attendant services are often the only alternative to institutional and nursing home care.”

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