In The News

Regulators Taking Aim at Hospice PE Backers

Hospice News | By Jim Parker

Private equity firms are pouring investment dollars into hospices at a record pace. Meanwhile, legislators and regulators as far up as the White House are taking aim at those firms.

Despite a cool down in the hospice mergers and acquisitions market during the first quarter of 2022, private equity firms have stayed aggressive on deals. About 30% to 50% of home health and hospice transactions in 2021 involved private equity, according to the M&A advisory firm The Braff Group.

With this growing influence comes renewed scrutiny about their impact on patient care, federal policymakers have indicated. Even President Joe Biden called out PE investors during his State of the Union address this year.

“As Wall Street firms take over more nursing homes, quality in those homes has gone down and costs have gone up. That ends on my watch,” Biden said. “Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and expect.”

Though the president’s remarks focused on nursing homes, investors throughout the health care continuum should take note. A number of agencies and some lawmakers have also started to step up oversight of these firms.

The U.S. Securities and Exchange Commission (SEC) in January proposed amendments to reporting requirements for advisors to large hedge funds and private equity funds.

If made final, the new rules would require these individuals to file reports within one business day of events that could indicate potential harm to investors or signal broader financial risks.

Current SEC rules mandate that these advisors report their private equity assets under management when they meet or exceed $2 billion. The proposal would reduce that threshold to $1.5 billion and would require firms to provide more information used for risk assessment and regulatory enforcement.

Another key finance regulator, the U.S. Federal Trade Commission, is also sharpening its gaze on private equity, based on recent actions and statements from the commission’s leaders.

Stakeholders have raised similar antirust questions about PE firms that invest in health care, as well as perceived lack of oversight.

“Private equity firms operate under the public and regulatory radar. Most private equity acquisitions in health care are not reportable to antitrust or financial regulatory authorities under current law,” a report from the American Antitrust Institute recently stated. “And, even where transactions are reportable, the complex structure of private equity funds obscures the competitive impact of those deals. As a result, private equity companies operate in health care without any effective oversight.”

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COVID-19 Updates

What to Know About the Newest, Most Contagious Omicron Subvariants

It only took about a month for BA.2.12.1, an Omicron subvariant, to cause most of the new COVID-19 cases in the U.S. since scientists first spotted it in the country. But even newer iterations of the Omicron variant are spreading rapidly through the U.S. and are poised to outcompete past versions of the virus, reinfect millions of Americans, and extend the country’s current COVID-19 surge.

Read more @ Time

Omicron Less Likely to Cause Long COVID, Data Suggest

The SARS-CoV-2 Omicron variant may pose less risk for long COVID than the Delta variant, U.K. researchers reported.

About 4.5% of people who became infected with SARS-CoV-2 when Omicron was the dominant strain experienced long COVID symptoms, compared with 10.8% who became infected during the Delta period, reported Claire Steves, PhD, of King's College London in England, and co-authors.

Overall odds of long COVID were about 20% to 50% less during the Omicron era -- defined as December 2021 to February 2022 in this study -- depending on age and time since vaccination, the researchers wrote in a letter to The Lancet.

Read more @ MedPage Today

FDA Panel Unanimously Backs Moderna's COVID Vax for Kids and Teens

A committee of independent vaccine experts recommended that the FDA grant an emergency use authorization (EUA) for the two-dose Moderna COVID-19 vaccine for kids ages 6 to 17 years.

The Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted 22-0, agreeing unanimously that the benefits of vaccination outweigh the risks in two age groups: kids ages 6 to 11 years and teens ages 12 to 17. They recommended two 50-mcg doses for the younger kids and two 100-mcg doses for teens.

Read more @ MedPage Today


Citing a Disastrous Pandemic Response, an Expert Panel Will Call for an Overhaul of the U.S. Public Health System

A bipartisan panel of health experts will call on Tuesday for an overhaul of the American public health system that would greatly expand the role of the federal government, giving Washington the authority to set minimum health standards and coordinate a patchwork of nearly 3,000 state, local and tribal agencies.

The recommendations flow from what the panel, the Commonwealth Fund Commission on a National Public Health System, described as the inadequacies and inequities of the United States’ response to the coronavirus pandemic, which has killed more than one million Americans.

Read more @ NY Times


ATTENTION Hospices! CMS Recruiting Additional Hospices for HOPE Beta Testing

As hospices should already be aware, the Centers for Medicare & Medicaid Services (CMS) and Abt Associates are currently beta testing a draft standardized hospice patient assessment instrument called Hospice Outcomes & Patient Evaluation (HOPE).  Additional hospice providers are needed to complete the testing.

Hospices must be Medicare-certified and training for this round of hospices is anticipated to occur mid-July 2022 with data collection slated to begin in August 2022 and continue through early fall 2022.

CMS is specifically seeking hospice providers with sufficient registered nurse, social worker, and chaplain staffing to conduct at least 1 – 2 joint visits per week. Hospices currently participating in the beta test may be finding this difficult amidst the workforce shortage causing CMS to recruit more hospices.

It appears that CMS is still aiming for completion of the beta testing in early fall of this year.  Should this occur, there may be time for CMS to analyze the results of the testing and formulate a proposal for use of the HOPE by all hospices in the FY2024 proposed rule.  This proposed rule would be posted in Spring 2023 for public review.

Joint visits are typical in beta testing standardized assessment instruments such as the HOPE for inter-rater reliability, but it is not expected that joint visits will be required when a HOPE tool is implemented in hospice. CMS includes the following additional information about the 1-2 joint visits per week that would occur as part of the HOPE testing:  For joint visits, two registered nurses visit one patient at the same time to complete the HOPE nurse assessment. Two social workers visit the patient at the same time to complete the HOPE social work assessment, and two chaplains visit the patient at the same time to complete the HOPE chaplain assessment. One of the two registered nurses, social workers and chaplains may attend their joint visit via video call, such as Zoom. HOPE assessments are completed at hospice admission, for symptom reassessment and at live discharge.

Recruitment will continue until CMS reaches the desired number of participants (number not specified). Those interested in participating should email [email protected] by June 30, 2022.


Support for Family Caregivers

For caregivers, the job doesn’t end at 5pm. You don’t get time off on weekends. Your around-the-clock dedication to your care partner likely means you need support to face the challenges each new day may bring. The Building Better Caregivers® (BBC) six-week online workshop, developed by Stanford University, can help you reset, recharge and discover new information so you can be the best caregiver you can be. When you join a BBC workshop, you’ll connect with a small group of caregivers just like you and support each other in reaching your goals.

“The workshop helped me see different ways to approach my caregiving responsibilities. I tried to learn to re-channel some feelings or rethink my feelings in a more positive way. And I didn’t feel guilty for taking time for me. There were helpful tools & ideas, and also, reading the feedback was helpful & positive for me. With each week it gave me another chance at becoming a better caregiver. Thank you for this workshop!”  - BBC Graduate

Click here to join a BBC workshop and you’ll learn:

  • New ways to approach caregiving
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To participate in BBC, caregivers must be enrolled in one of the Department of Veterans Affairs’ Caregiver Support Program offerings:

If you are a caregiver, reach out to your Caregiver Support Team to learn more about signing up or visit BBC’s website today!

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