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The Jimmo case involved a 2011 lawsuit against the Centers for Medicare and Medicaid Services (CMS) alleging they illegally used an improvement standard instead of a need standard to make coverage decisions for Medicare home health and other Medicare beneficiaries. In 2013 CMS and the plaintiffs reached a settlement with CMS agreeing to replace the improvement standard with a need standard and conduct an education campaign to ensure its proper implementation. A literature review indicates no studies on the nature, significance, or impacts of the Jimmo case in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 28 home care nurses between January 2019 and May 2019 in the New York City metropolitan area. Results indicate nurses believe they had little to no knowledge of the Jimmo case ; there was limited communication about the case from their agencies; they lacked guidance on the implications of the case on intake and eligibility decisions; they received no guidance on the impact of the case on documentation; and that their lack of knowledge and guidance had adverse impacts on patients. [ABSTRACT FROM AUTHOR]

The article explores the struggle of home health care providers in complying state laws and Medicare rules in the U.S. as demand for their services increase. According to seniors' advocates and home health professionals, rules set by the Centers for Medicare and Medicaid Services (CMS) have created obstacles to getting such services. Congress had added a provision to the Affordable Care Act (ACA) in order to curb fraud and abuse in the home health industry.

Americans generally want to remain in their homes even if they develop chronic health problems or disabilities that qualify them for nursing home care. While family members or friends provide the preponderance of home-based support, millions of Americans use paid personal assistance services (PAS). Inexorable demographic trends are increasing the numbers of people who need paid home-based PAS, with this need rapidly outstripping the capacity of the paid PAS workforce. While many factors contribute to this widening discrepancy, its roots reach back more than eighty years to asynchrony among various policies affecting home-based supports for people with functional impairments and policies affecting home-based PAS workers. Finding solutions to the growing gap between demand for the services and the PAS workforce requires policies that cut across societal sectors and align incentives for consumers, workers, and other key stakeholders. [ABSTRACT FROM AUTHOR]

A 2018 ballot initiative in Maine proposed universal home care and improved work conditions for home care workers.Although ultimately defeated, the innovative proposal received considerable support and laid the groundwork for an upcoming legislative campaign.It offers a framework for increasing access to home care and creating quality jobs for home care aides. This commentary reviews the problems addressed by the Homecare for All initiative, what was proposed, the campaign process and anticipated next steps, and implications for gerontological social workers. [ABSTRACT FROM AUTHOR]

The article examines the implications of the U.S. Supreme Court decision in Janus vs. American Federation of State, County & Municipal Employees (AFSCME) wherein plaintiff Mark Janus objected to union representation because it was too successful in raising pay despite the fiscal crises. Topics covered include the state of Washington as a battleground over union representation and the Janus implications for national home care.

This article addresses the increasing importance within Western welfare states, to adequately deal with the growing need to facilitate alternative relations of home-care and support for its citizens, as well as finding lower cost models. Currently government care budgets seem to demand ever increasing funding, especially in relation to the elderly. In this context the author argues for the option of expanding care-leave facilities, to include not only close family members, but to register also close friends living in the vicinity, who can be granted care-leave to support the citizen concerned. This issue is rapidly gaining importance as the traditionally relatively small nuclear families tend to have few children, while employment requirements often involve substantially larger distances than former generations experienced. Since in the West intergenerational care is seldom included in such schemes, elderly people still largely rely on costly 'Senior Homes' for their old age security. [ABSTRACT FROM AUTHOR]

In this paper, I argue that addressing the medical needs of older persons warrants expanding the array of insured services as described by the Canada Health Act (CHA) to include home care. The growing importance of chronic care supports my call for federally regulated home care services as the nature of disease management has changed significantly in the last decades. In addition, if the values of equity, fairness and solidarity, which are the keystone values of the CHA, are to be upheld within the current social and demographic context, then Canada's health care system should adapt accordingly. I focus my argument on the services provided to older persons for two main reasons. First, the changing nature of disease management is best seen in this population. If it is to be successfully argued that the transformations in medicine warrant an expansion of insured services covered by the CHA, it will be best illustrated by looking at the needs of older persons. Second, with the demographic shift looming large in the policy agenda, an exploration of this issue is not only crucial but timely. [ABSTRACT FROM AUTHOR]

District nurses and their teams often work in isolation during domiciliary visits. As employers, providers of district nursing services have responsibility to ensure that appropriate policies and procedures are in place to keep district nursing teams safe. If the employer fails to do everything that was reasonable in the circumstances to keep the employee safe, the employer can be deemed to have breached their duty of care. Employees also have responsibility for their own health and wellbeing at work, and they are entitled by law to refuse to undertake work that is not safe, without fear of disciplinary action. Staff training in risk management, personal safety, handling aggressive behaviour, using safety devices such as mobile phone trackers, incident reporting and debriefing are essential for district nurses and their teams, as they face a steeply increased demand for their services and a severely compromised skill mix within their teams. [ABSTRACT FROM AUTHOR]

The article focuses on the future of nursing and home health care in the U.S. Topics discussed include enactment of Patient Protection and Affordable Care Act of 2010 and Health Care and Education Reconciliation Act of 2010 for same; background of home health; and switching over from traditional home health and nursing home care to a combination of telehealth and Accountable Care Organizations (ACOs) to lower costs for improving quality of care.

This study investigated both causal factors and consequences of time pressure in hospital-in-the-home (HITH) nurses. These nurses may experience additional stress from the time pressure they encounter while driving to patients' homes, which may result in greater risk taking while driving. From observation in natural settings, data related to the nurses' driving behaviours and emotions were collected and analysed statistically; semi-directed interviews with the nurses were analysed qualitatively. The results suggest that objective time constraints alone do not necessarily elicit subjective time pressure. The challenges and uncertainty associated with healthcare and the driving period contribute to the emergence of this time pressure, which has a negative impact on both the nurses' driving and their emotions. Finally, the study focuses on anticipated and in situ regulations. These findings provide guidelines for organizational and technical solutions allowing the reduction of time pressure among HITH nurses. [ABSTRACT FROM AUTHOR]

Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. [ABSTRACT FROM AUTHOR]

The article focuses on challenges that inhibit the ability of the Medicare home health care program to meet the growing needs of Medicare's beneficiaries and reimbursement cuts to home care providers leading to underutilization of services. It mentions passage of the Affordable Care Act requires a focus on improving the quality of care delivered to patients and increasing access to health care for Americans. It also mentions need to reduce health care costs and technological changes.

The article focuses on home care services for the elderly under the Patient Protection and Affordable Care Act (PPACA). Topics discussed include home and community-based services (HCBS) being provided by Medicaid, limitations to homecare under the Social Security Act, violation of the Americans with Disabilities Act discussed in Olmstead v. L.C ex rel. Zimring., nursing facilities provided by Medicaid, lack of training among home care workers and the need for developing standards for home care.

This exercise is designed to focus students' attention on the challenges of regulatory enforcement. The case example is drawn from Oregon's regulation of in-home care agencies (IHCA). Students are asked to formulate suggestions for enhancing compliance with IHCA regulations in the absence of additional funding. The author includes her own suggestions, which she developed during her fellowship. [ABSTRACT FROM AUTHOR]

The Medicare home health prospective payment system (PPS) has existed for 13 years, yielding significant profits to providers. However, studies indicate many unresolved questions about whether PPS improves patient quality of care, is cost-effective, and reduces patient levels of unmet need. In addition, PPS has undermined the provision of social work home health services. The article presents the views of 29 home health care nurses regarding the impact of PPS on their care decisions for people with Alzheimer's disease and their caregivers. The nurses identify Alzheimer's disease symptom management and psychosocial needs as phantoms, omnipresent below the surface but not attended to by home care clinicians. The interviews support the greater involvement of social workers to more adequately address the psychosocial needs of Medicare home health patients. The article contends that the current failure to simultaneously address the cost, needs, and quality-of-life issues of people with Alzheimer's disease who are cared for at home is analogous to the end-of-life care situation before passage of the Medicare Hospice Benefit. A collaborative demonstration project—social work and nursing—is proposed to determine how PPS might better address quality of life and costs of home-based people with Alzheimer's disease and their caregivers. [ABSTRACT FROM PUBLISHER]

By tracing the transformations of troubling exchanges in paid home care, this article examines how differently positioned individuals strive to build caring relations within potentially restrictive regimes of care. In paid home care in Chicago, older adults and their workers regularly participate in exchanges of money, time, and material goods. These gifts play a crucial role in building good care relationships that sustain participants' moral personhood. Amid widespread concern about vulnerable elders, home care agencies compete in a crowded marketplace by prohibiting these exchanges, even as they depend on them to strengthen relationships. Supervisors thus exercise discretion, sometimes reclassifying gift exchanges as punishable thefts. In this context, the commodification of care did not lead to the actual elimination of gift relations, but rather transformed gift relations into a suspicious and troublesome source of value. [ABSTRACT FROM AUTHOR]

The article focuses on the implementation of Jordan's principle, a child first principle used in Canada named in memory of Jordan River Anderson, a child from Norway House Cree Nation in Manitoba. It highlight factor that contribute to judicial disputes between provincial and federal governments over funding of service for children living on-reserve. It also discusses the court case Pictou Landing Band Council and Maurina Beadle v. Canada, related to violation of Jordan's principle.

President Obama announced his Early Learning Agenda during his Second Inaugural Address. This announcement has galvanized a special focus on early childhood policy and practices, for the prenatal to 5-year-old period, to improve educational outcomes for America's youth. The emergent science of early childhood development places an emphasis on "one science" for health, education, and social well- being and calls for intentional efforts for infants and young children that focus on strengthening the earliest relationships and mitigating effects of toxic stress on life course health and development. Accordingly, innovations in child health reform call for strengthening the pediatric family-centered medical home and for intensive community programs to improve the foundation of health and development. Linking the Affordable Care Act's Maternal, Infant, and Early Childhood Home Visiting programs with the pediatric family-centered medical home provides a unique and breakthrough opportunity for improving child and family outcomes. [ABSTRACT FROM AUTHOR]

The article focuses on the creation of the home care industry in the U.S. and the differences in state policies concerning home care. Topics include the establishment of trade unions for home care workers, the creation of elder home care frameworks, and the worker compensation laws governing home care employees.

What we know already. There are significant changes in the way that health and social care is being understood and delivered in Scotland. Chaplains are already proficient at promoting the spiritual health and wellbeing of individuals however their impact on organisational spirituality and compassionate communities is fragmented. What this paper adds. This article describes three key elements of health and social care; patient centred care; preventative care and an asset based approach and then proceeds to show how healthcare chaplains contribute to this agenda. Why this is important. Greater awareness is required amongst those working in primary health and social care of the potential of spiritual care to support health and well-being within communities. Greater awareness is required within the chaplaincy community of the issues facing those working in primary health and social care, the common challenges and the areas of shared interest How this impacts on Chaplaincy. Chaplains have key learning needs: to be aware of current health and social care policies and to be innovative in promoting the spiritual health and wellbeing of individuals, organisations and communities. [ABSTRACT FROM AUTHOR]

This research seeks to address the home infusion therapy reimbursement gap found within Medicare Part D. In particular, the research explored the reimbursement gap's impact on home health utilization, its contribution to the national health expenditure growth, and the potential fix of the problem by restructuring Medicare Part B to include a home infusion therapy benefit under its coverage. Previous studies found that there is a great cost avoidance opportunity available through home health and home infusion treatment, because such treatment avoids the high costs associated with hospitalization and nursing home and other long-term care facilities. Future implications of this topic are unclear, as the Affordable Health Care for America Act is equipped to cut Medicare services and reimbursements, in spite of current bipartisan legislation in both houses to cover the home infusion reimbursement gap. [ABSTRACT FROM PUBLISHER]

Topic: This article examines significant new opportunities presented by the Affordable Care Act, the health care reform law passed in the spring of 2010, and specifically addresses changes to the Medicaid program that may be of great benefit to individuals with severe psychiatric disabilities, as well as their relevance to the field of psychiatric rehabilitation. Purpose: The authors offer an assessment of the myriad new options created by health reform, with particular emphasis on those that improve and expand services for persons with severe psychiatric disabilities in their homes and communities. Selective information is presented on the expansion of specific state options within Medicaid that, if implemented, may prove most useful for those with serious psychiatric disabilities. Sources Used: Material was drawn from relevant federal statutes and published literature, as well as personal observation. Conclusions and Implications for Practice: While the health care reform law creates many new opportunities for states to fund and provide services for persons with disabilities, the complexity of the law may present implementation challenges for state authorities, providers, advocates, and consumers alike. Those interested in learning more about the options presented in this paper and further implications of health care reform are encouraged to explore additional resources and information. [ABSTRACT FROM AUTHOR]

Copyright of New Solutions: A Journal of Environmental & Occupational Health Policy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a case study involving the hypothetical corporate taxation of a fictional company, Utopia Home Health Inc. (UHH). The company is a combination of two home health care agencies. A list of assets and liabilities that will be contributed by the owners of the company is provided along with a quiz on the tax consequences of corporate formation.

The article discusses how U.S. home care agencies can revise practices, such as obtaining referrals from physicians and medical groups, and establish better strategies for implementing them. Home care legislation is changing, making it more difficult for home care providers to obtain recommendations for care. Topics include how providers can obtain referrals in the face of changing legislation, such as the U.S. government's policy prohibiting gifts and financial incentives in exchange for referrals, why referrals are the industry's mechanism for growth, and the marketing of health care as a relationship business. Also discussed is the need for health care agencies to associate with chronic disease associations and the use of the Web and the media as marketing tools.

The practice implications of the Centers for Medicare & Medicaid Services hospital payment policy change are likely to influence the relationships between home health care agencies and their referring/receiving hospitals. Maintaining infection control measures can be difficult in the home environment, which was not designed for health care provision and where family members, friends, and pets are present. In addition to the hospital payment changes, there have been epidemiologic changes, with increasing recognition of multidrug resistant organisms and increasing virulence. The purpose of this article is to identify the scope of the practice changes that might be expected in response to epidemiologic and policy changes and activities that home health care agencies can undertake in response. Increased calls for transparency, accountability, and high-quality care, along with threats of denied reimbursement, will force changes across the entire continuum of care. [ABSTRACT FROM AUTHOR]

Health economics pretends to assign resources that are short in essence and that may be used for other purposes. Health costs analysis pretends to compare the pros and cons of several options among which an election can be made in order to obtain greater benefits with lower costs. The current legislation on prescription of enteral nutrition entails confusing definitions about the ad ministration route and the requirements of home-based enteral nutrition, without a specific regulation comprising the prescription of oral supplements (OS). From the year 2000 to 2007, the consumption of home- based enteral nutrition in Andalusia increased considerably; the costs generated being multiplied by 37. Although the number of persons that daily consumed supplements was higher than the number of diets through nasogastric tube (DT) during the years evaluated, the costs derived from OS surpassed those of DT from the year 2005 due to the combination of two factors: a progressive increase in the number of persons to whom supplements were prescribed, and on the other hand the incorporation of more expensive specific formulations. The use of oral supplements seems to be cost/effective in hospitalized surgical patients (during the pre- and post-surgical period) and possibly in hospitalized malnourished elderly, especially after performing a hyponutrition screening. Although they may be effective, under other circumstances, such as ambulatory patients, studies with an adequate methodology are necessary in order to adopt clinical decisions based on evidence and cost analysis. [ABSTRACT FROM AUTHOR]

Abstract: Cardiac stimulators and defibrillators dispose of diagnostic capabilities. Home monitoring permits to have information about the cardiac rhythm of the patient and about the function of the pacemaker or the defibrillator. Technical aspects, safety and legal issues of home monitoring are discussed in this article. [Copyright &y& Elsevier]

Government policy for vulnerable people has long been to encourage as many people as possible out of care homes and into supported accommodation. This article seeks to explore some of the unforeseen legal difficulties arising out of this trend. Two have already become very apparent: first, where the question of ordinary residence arises, with regard to which authority is liable for the purchase of the additional domiciliary care, and second, for residents who may be thought to lack capacity to make a contract for the tenancy which underpins the whole arrangement. The article begins by describing two quite different arrangements for providing accommodation and support. [ABSTRACT FROM AUTHOR]

This article evaluates the impact of legal change on non-profit and for-profit organizations providing home care services mandated in the Israeli Long-Term Care Insurance Law, through the lens of neo-institutional and resource dependency theories. The findings of the study, which was conducted over a ten-year period, revealed that the distinctions between organizations in the two sectors are blurring due to coercive, mimetic, and normative isomorphism. Considerable dependence on government funding provided for in the law forces these organizations to adopt behavior that conforms to government policies and standards for service provision. Moreover, the growing tendency toward mimetic behavior and the increasing proportion of professional workers in both sectors causes for-profit and non-profit organizations to adopt similar bureaucratic behavior and organizational structures. [ABSTRACT FROM AUTHOR]

The article discusses the provisions of the German law 80 SGB XI concerning home care and regulating care quality. The author's research data show that applications for the coverage are at a low level, largely owing to survey respondents' unfamiliarity with the legislation. More than 50% were of the opinion that that the quality of care had improved.

Examines conceptual and policy challenges in home care for the elderly in Canada. Comparison of home care system with other countries; Models of home-based care in relation to social interactions, exchanges and identity construction in gender contexts; Inquiries on caring for elderly that frame a typology for home care analyses.

Details several cases which concern the legal action that nurses face when they visit patients at home. Circumstance within which visiting nurses can terminate home care for patients; Factors that can be used by visiting nurses as legal protection; Significance of medical charting for malpractice protection; Qualifications of medical notes as legal evidence; Advice for visiting nurses.

The article discusses exclusive referral agreements for home care. From a legal standpoint, the advent of prospective payment systems places hospitals squarely between two seemingly conflicting forces. On one hand, since the amount of payment under Medicare is now predetermined, the hospital has a clear directive to shorten the length of inpatient stays. On the other hand, legal principles of abandonment apply without regard to a hospital's fiscal constraints. Hence, early discharge of a patient may result in liability for premature termination of the relationship when post-discharge complications or injuries arise.