In the News

Supreme Court Declines to Hear Case Against Home Health Certificate of Need Laws

Home Health Care News | By Andrew Donlan
 
A home health care company hoping to operate in Louisville, Kentucky has hit a road block in its fight against Certificate of Need (CON) laws.
 
CON laws vary by state. Some have home health CON barriers, while others do not. That results in some states having far more home health agencies than others.
 
Because Kentucky has CON laws in home health care, Dipendra Tiwari and Kishor Sapkota – two Nepalese immigrants – were met with resistance when they tried to open up an agency specifically tailored to the Nepali speaking people of Jefferson County and Louisville.
 
Due to language barriers, Tiwari and Sapkota believed that there was a need for home health care services in the community, and were hoping to keep more Nepali-speaking people out of nursing homes by offering up these services. The agency was to be dubbed Grace Home Care.
 
After a request for a CON was denied by the state of Kentucky, Tiwari and Sapkota filed a lawsuit. The lawsuit was dismissed, however, and eventually, they requested for the U.S. Supreme Court to review their case. They failed to convince the court, however.
 
“In these cases, the challengers often mischaracterize what CON laws do, what they represent and how they actually function,” Matt Wolfe, a shareholder at the law firm Baker Donelson, told HHCN in an email. “Each state’s CON law operates a little differently, but every CON law allows for and encourages public input, involves various stakeholders – including businesses, providers, and patients – and is flexible to adapt its approach to the changing needs of the communities it covers.”
 
CON laws have undergone much legal scrutiny in the past, something that Wolfe does not think will stop just because of this case in Kentucky.
 
Home Health Care News has reported on the pros and cons of certificate of need laws in the past. While some believe that CON laws uphold quality in home health services, others argue that it hurts access and also deters competition. In Tiwari and Sapkota’s case specifically, they were trying – in part – to argue CON laws are unconstitutional.
 
“There is a coordinated and well-funded campaign by ‘free market’ special interest groups to continue to bring these types of legal challenges to the constitutionality of CON laws in federal and state courts,” he said. 
 
And while the cases against CON laws often make intellectual sense, Wolfe does not believe that the evidence has created a good case against them.
 
“CON laws play an important role in ensuring access to quality, affordable care,” he said. “The reality is that health care is not provided in a free market. Repealing or substantially limiting CON laws would do nothing to address access issues. In fact, in states that have repealed CON laws, we have seen a proliferation of providers with no appreciable improvement in access. Instead, home health agencies experience small and unsustainable patient censuses.”

 

New Resource Available: PHQ-2 to 9 Cue Card

CMS is offering a cue card to assist providers in coding the Patient Health Questionnaire (PHQ-2 to 9) as referenced in the coding guidance for D0150. This resource is intended to be utilized during the Patient Mood Interview as a supplemental communication tool that provides a visual reference to assist patient selection of symptom frequency.

The cue card is offered in two sizes which can be viewed or printed and is available in the Downloads section of the HH QRPIRF QRP, and LTCH QRP Training pages.

If you have questions about accessing the resources or feedback regarding the trainings, please email PAC Training. Content-related questions should be submitted to the HH QRP Help DeskIRF QRP Help Desk, or LTCH QRP Help Desk.

 

More than 90% of COVID Deaths Occurring Among Elderly Adults: CDC

ABC News | Mary Kekatos

Older people have always been known to be one of the groups at highest risk of death from COVID-19, but they now make up a larger share than ever before.

As of the week ending Nov. 19, Americans aged 65 and older make up 92% of all deaths from the virus, according to data from the Centers for Disease Control and Prevention.

It's the first time senior citizens have made up more than nine out of 10 deaths since the pandemic began and a drastic increase from the roughly 58% of deaths they made up in summer 2021, an ABC News analysis shows.

An infectious disease expert told ABC News the data showcases the lack of boosters received by the older population and how the impact of the disease is hitting the most vulnerable as protection mounts in the population.

"The bottom line is that age is the most powerful risk factor for COVID deaths and we've known that all along," Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, told ABC News. "At this point in the pandemic, it's not enough to just get a vaccine series. So, what it reflects is the failure of the older age group to get boosters."

As of Nov. 24, just one-third of people aged 65 and older have received the bivalent boosters, CDC data shows.

The updated booster specifically protects against the omicron subvariants BA.4 and BA.5, currently making up about 20% of infections in the U.S.

While this percentage is higher than most other age groups, Chin-Hong said it's still quite low for a group at high risk of severe illness and death.

Read Full Article

 

A Common Treatment for Your Knee Osteoarthritis May be Making it Worse, Studies Say

CNN | By Madeline Holcombe

A common treatment for some arthritis pain might actually be making the condition worse, according to two new studies.

“Knee osteoarthritis is one of the most chronic, degenerative and progressive conditions, with an estimated incidence of 800,000 patients each year in the US alone,” said lead author of one of the studies, Dr. Upasana Bharadwaj.

Osteoarthritis is a common form of arthritis where the cartilage within a joint breaks down over time and the bones around it change, getting worse over time, according to the US Centers for Disease Control and Prevention.

At least 10% of the patients in the study used injections to manage the pain, added Bharadwaj, who is a postdoctoral research fellow in the department of radiology at the University of California San Francisco’s School of Medicine. Two of those pain management injectables are corticosteroids, the more common of the two, and hyaluronic acid.

The studies, which were presented at the annual meeting of the Radiological Society of North America, used either radiograph or MRI images to track the progression of osteoarthritis in the knees of patients. Some of those patients didn’t receive any treatment and others got corticosteroid or hyaluronic acid injections, according to the studies.

Both papers showed a statistically significant increase in progression of degenerative changes in knee cartilage over two years in people that had corticosteroid injections compared with those who had hyaluronic acid or no injections, according to the study authors.

However, just because the images might look worse doesn’t always mean that the people are feeling more pain, said Azad Darbandi, lead author of the other study.

“You might see that the knee looks bad on a radiograph, but the patient might not be having worse symptoms,” added Darbandi, a researcher and medical student at the Chicago Medical School of Rosalind Franklin University of Medicine and Science.

The studies highlight a debate in the osteoarthritis scientific community about the role of changes in the structure of the joint. Currently, pain is the primarily recognized symptom, said Jason Kim, the Arthritis Foundation’s vice president of osteoarthritis research. Kim was not involved in either study.

The takeaway from the studies is that corticosteroids should be administered with caution for osteoarthritis pain.

Read Full Article

 

Latest 'Quarterly Report' Available Electronically Now 

The latest print issue -- Fall 2022 - Vol. 57 No. 4 -- of the APTA Home Health Quarterly Report is on its way to Academy members, however members can read it now on the Academy's Quarterly Report Library page (you must be signed in as a member to view this page). Not a member? Join us!

 
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