0:02

Welcome to TCNt alks . The

0:04

goal of our podcast is to provide

0:07

concise and relevant information

0:09

for busy hospice and palliative

0:11

care leaders and staff . We

0:14

understand your busy schedules and believe

0:16

that brevity signals respect

0:19

. And now here's

0:21

our host , Chris Comeaux

0:23

.

0:24

Hello and welcome to TCNt alks

0:26

. Our guest today is Mark Cohen . This

0:29

is Mark and I's monthly show that I

0:31

really do start to look forward to each month . Mark , it's

0:33

definitely made me up my game in reading

0:35

your actual hospice news today and

0:37

kind of distilling what's coming to us

0:39

. Mark , I want to pivot a little bit differently this

0:41

month as I queue you up . You've shared so many

0:43

great stories about your

0:45

wisdom , your experience . I'm

0:49

a little bit of a not a big

0:51

art connoisseur , but some of the best painters

0:53

are known after they're gone because people

0:55

didn't realize the amazing art they produce while they're

0:57

here . I kind of feel like that's

0:59

you , man . People don't realize the amazing

1:02

piece of art and what you do with those hospice

1:04

news today . But as I've done this with

1:06

you , I realize there's so much wisdom that you have

1:08

, and so I think I'm going to start asking

1:11

you each month Maybe , of course , we're going into

1:13

football season as well . So

1:15

almost that half-time advice , wisdom

1:18

that you would want to pay forward to hospice

1:20

palliative care leaders and your perspective .

1:24

Thanks , Chris . It's always a pleasure

1:26

to be with you , and it's an interesting

1:28

twist on how to start this

1:30

month's podcast . My

1:34

advice , I think , is recognizing

1:37

that hospices

1:39

today don't have the same communications

1:41

resources that they would have had

1:43

10 , 15 , 20 years ago . A

1:46

hospice that had a VP level communicator

1:49

20 years ago today maybe has a

1:51

senior manager doing that job , and

1:54

I see that reflected almost

1:56

daily in the

1:59

news releases that come across

2:02

my screen for hospice news today . And

2:04

I think I'll start

2:06

with the advice , and that is

2:08

if you've got , if all you've

2:10

got is a junior communicator

2:13

, a mid-level communicator in your hospice , because

2:16

that's all you can afford these days , there

2:19

are ways to supplement that . Get

2:21

a writing coach for

2:24

your in-house writer , whether

2:26

that's a volunteer , whether that's somebody

2:29

from a local college , whether

2:32

that's a retired PR person or

2:34

a retired journalist . Kids coming

2:36

out of journalism school today don't have the experience

2:38

, and they don't have the

2:40

same level of education . I

2:42

went to journalism school in the mid to late-70s . It

2:45

was a time when Watergate had

2:47

spurred a significant increase in

2:50

journalism school enrollment

2:52

, although I had actually decided on

2:55

a journalism major when I was in high school a

2:58

year before Watergate broke . Journalism

3:00

school at that time , though , was a very

3:03

different animal than it is today . The

3:05

emphasis was on print journalism , not

3:08

social media or broadcast journalism , and

3:11

therefore good writing and perfective

3:15

storytelling were the keys . It

3:17

was an era when your instructors

3:20

were burnt-out journalists and burnt-out

3:22

editors , and so

3:24

they would do things like throw erasers

3:27

at errant writers , rip

3:29

up your copy in front of the whole class , stand

3:32

in front of the class on the first day and

3:34

say this is tougher than you think it is . Half

3:36

of you will be gone by the end of the semester , and

3:39

they were right . I

3:41

even witnessed a professor pick

3:43

up a manual typewriter from a student's desk and

3:46

dump it in a metal-bent wastebasket

3:48

. Just to make the point , you

3:51

either learned how to write quickly and

3:54

correctly or you were soon

3:56

looking for another major , and so

3:58

it really pains me today to see

4:00

so many orally written news releases come

4:02

across my screen , as

4:04

I put together hospice news today

4:07

. Each day , news

4:09

releases with lead sentences that

4:11

are written in the passive voice have

4:13

to have to release , sometimes as written in the passive

4:15

voice . An example memories

4:18

were shared and tears were shed at

4:20

the 15th-angle butterfly release

4:22

by XYZ hospice . Another

4:25

problem news releases that begin with the least

4:27

important fact , which nine

4:30

out of ten times is the time element

4:32

. Today , memories were shared

4:34

and tears were shed at the 15th-angle

4:37

butterfly release by XYZ

4:39

hospice . Lead

4:41

sentences , like the entire news story

4:43

or news release generally , should be written in

4:46

what we were taught as the pyramid style

4:48

of journalism Most important

4:50

fact first , subsequent

4:52

facts cascading from the most important

4:54

to the least important . Time

4:58

element is almost never the

5:00

most important fact in the news story , but

5:03

it so often leads the news

5:05

releases I see . And

5:07

then there are the words I see in releases that

5:09

simply have no meaning in a press

5:11

release and they have no business

5:14

being in a press release . Words like

5:16

excited , thrilled , proud

5:18

, leased and the like

5:20

, as an editor I simply do

5:23

not care . Feelings

5:26

as a general rule are not

5:28

news and , in a similar

5:30

vein , inexperienced

5:32

writers strain to

5:34

use words to attribute simple

5:37

facts . So they'll say that he

5:39

shared or she expressed

5:41

a simple

5:43

fact and that is just

5:45

simply ridiculous . You know , expressed

5:48

is what a veterinarian does

5:50

to your cats or dogs anal glands

5:52

at a regular checkup . It is not

5:54

a word that is used

5:56

to describe the recitation of

5:59

a generally known fact . So

6:02

why does all this matter except

6:04

to me ? You know it's unprofessional

6:06

and there are still enough old

6:08

time editors out there Ed

6:11

Newspapers and in broadcast centers

6:13

that you ought not to

6:15

risk their wrath with

6:17

a crappy news release . So

6:20

again I go back to how I started

6:22

Find

6:26

the writing codes to help your writers . You

6:29

probably don't have an editor in house

6:31

, but find somebody

6:34

outside the organization who can

6:36

help your writers . It really will pay

6:39

dividends . Here's a final

6:41

hint . You can tell what

6:43

I think of a badly written press

6:45

release in Hospice News today , because

6:47

I will go out of my way to minimize

6:49

the amount of copy that I

6:51

use from a badly written release , because

6:54

I choose not to reward bad

6:56

writing .

6:58

Well , mark , that's priceless . We're

7:00

gonna have to pay that forward to a lot of the different marketing

7:03

departments that we have in communication departments

7:05

throughout our network . You probably

7:07

don't know this , but you've provided coaching to

7:09

me , not maybe overtly , it's just

7:11

who you are . I'm now writing

7:14

my first book and so there's a couple

7:16

of pearls I've gleaned along the way and I just know

7:18

I'm gonna bring my A game with you . My

7:21

mom would probably laugh and go . Chris

7:24

is bringing right grammar and actually

7:26

getting more precise in his writing . Knowing , having

7:28

grown up in South Louisiana , not exactly my strong

7:31

suit . It's more kind of doing what we're

7:33

doing right here in the podcast . So thank you for

7:35

the gift of paying that forward to me . I know it's made me a better

7:37

writer and I think that if a lot of

7:39

folks would go back and listen to what you just said , that's

7:41

like a master's class just now on

7:43

actually good communication and good writing . So

7:45

are you ready to jump in ? So , mark , as I

7:48

was doing my review , I have a perception

7:50

that the volume of articles went up pretty tremendously

7:53

this month . Was that an accurate perception

7:56

?

7:56

I think it was . It was more than just pure

7:58

hospice stories , also news

8:02

subjects on the periphery of hospice

8:04

throughout the post-acute continuum

8:07

. Huge number of stories , beginning

8:09

with long-term care , assisted living

8:12

and senior living , which had a record number of

8:14

articles in hospice news today in August

8:17

74 articles that

8:19

I ran in the past month

8:22

about those topics

8:24

. And you know there's good news , bad news there . The

8:26

good news is that there were 74 articles

8:29

about long-term care , senior

8:31

living , et cetera . The bad news most

8:33

of the articles were

8:35

negative , focus

8:38

on quality issues , labor problems

8:40

. They both gave closures

8:43

and bankruptcies a run for the money in August

8:45

. In terms of the sheer quantity of

8:48

news articles , it is

8:50

worth noting . Among the positive

8:52

reports were

8:55

news reports that said that census is continuing

8:57

to slowly rebuild from

9:00

the depths of the pandemic . But once again

9:02

, not a great month for

9:05

long-term care , assisted living and senior

9:07

living , unless all you're doing is

9:09

counting clips . General

9:12

hospice news with a lot of focus

9:14

on public policy and regulatory issues

9:16

generated 52 articles

9:18

that I ran in hospice news today in

9:21

August . Perhaps the biggest news

9:23

I think even bigger than the Medicare

9:26

payment update was the news that

9:28

CMS is considering quote

9:30

administrative action unquote

9:32

against 400 suspect

9:34

hospices , following

9:36

a lengthy review of each hospice location

9:39

. The media continue to refer

9:41

back to last December's pro-publica

9:43

investigation on fly-by-night

9:46

hospices , with repeated references

9:49

in news coverage of possible

9:51

reforms , and there was an absolutely

9:53

scathing column by Dr Ira

9:55

Bayak in stat news that

9:57

said that the first thing hospice should do

9:59

in terms of reform

10:02

is apologize for the abuses wrought

10:04

by the corporatization of

10:06

the sector . On

10:09

the other hand , news about hospice

10:11

community-based and mission-driven providers

10:14

came in third place last

10:16

month with 43 articles a distant

10:18

third place , but still a large number

10:21

of articles , as in months past

10:23

. Opening , closing and new construction

10:25

of inpatient units was the biggest

10:28

news , although the month ended

10:30

with an article about the 50th anniversary

10:32

plans of Connecticut Hospice

10:35

, the nation's first hospice . For-profit

10:39

providers were right behind , in fourth place

10:41

with 42 articles

10:43

in August . August is

10:45

earning season , so

10:47

stories about the numbers of publicly

10:50

traded hospices dominated

10:52

most of the coverage in August of

10:54

for-profit providers . The month

10:57

ended , however , with a bit of a bang

10:59

as the relatively new encompass

11:01

health spin-off in Habit Home

11:03

Health and Hospice announced it

11:05

was buckling to pressure from an activist

11:08

investor and will begin to examine

11:10

strategic opportunities that

11:12

could lead emphasis on the conditional

11:15

could lead to a sale or merger

11:18

. And right behind

11:20

that in fifth place was labor and

11:22

employment news , with 40 articles in

11:24

the month of August . Most

11:27

of the articles were about strikes , threats

11:29

to strike , labor settlements , votes

11:31

to unionize . The

11:34

most interesting series of

11:36

stories in the post-acute

11:39

sector in terms of labor news

11:41

came from Maine Health Care at Home , which

11:43

fire administration fired a couple

11:45

of nurses , allegedly for disciplinary

11:48

reasons , and that caused the unionized

11:50

nurses at Maine Health Care at Home

11:53

to vote no confidence in management

11:55

and the whole thing played

11:57

out in their local daily

11:59

newspaper in Portland , oregon

12:01

. You begin to see

12:03

a bit of a drop-off . After the top five categories

12:06

, m&a News had 32

12:08

articles in the month of August

12:11

. Hospice got its fair share , mostly

12:14

regarding the Department of Justice asking

12:16

for more information about the pending Optima-Medicis

12:20

merger . Also of note

12:22

if you read between the

12:24

lines , we got the final results of

12:27

the sale of the former not-for-profit

12:29

hospice of Chattanooga and its

12:31

affiliated hospices to

12:34

a for-profit hospice in Virginia , with

12:36

the spin-off foundation created

12:39

by the sale of those not-for-profit

12:41

assets receiving $103

12:44

million . So article didn't say

12:46

so , but I think you can assume that

12:49

all the bills have been paid , all the

12:51

settlements have been settled and

12:56

the folks who ran the hospice who now

12:58

run the foundation have $103

13:01

million with which to play In

13:04

the post-acute structure . In the broader

13:06

post-acute sector , struggling

13:08

Tabula Rasa , the pharmacy provider

13:10

and innovator , announced that it is

13:12

going private after

13:14

several years of bad financial

13:17

news . Seven

13:19

plates was grief and bereavement news . There

13:21

were 30 articles . August is

13:23

a great month for butterfly releases

13:25

and kids' grief camps . They

13:28

certainly dominated the

13:30

coverage of grief and bereavement . There were a couple

13:32

of stories in a column that

13:35

were of note because they were about the

13:37

summer concert tours of

13:40

Bruce Springsteen and Beyonce , both

13:43

of whom are featuring

13:45

original songs that spoke

13:47

to grief and recovery as

13:49

part of their concert sets , and

13:52

they touched a number

13:54

of people out there who

13:57

mentioned it and their local media coverage

13:59

of those concerts . Hospital

14:02

news was in eighth place with

14:04

28 articles . Bankruptcies and

14:06

closures dominated hospital

14:09

coverage again in August . There

14:12

were also several articles that

14:14

focused on the continuing or is

14:17

it the growing threat of

14:19

mass closures among rural hospitals

14:21

and as hospice providers

14:23

, it's always worth remembering that when a hospital

14:25

closes , the local hospices

14:28

can see a significant decline in

14:30

timely referrals . In fact , the entire

14:32

remaining local health provider

14:35

community usually suffers when

14:37

the local hospital closes significantly

14:40

downsizes . Ninth

14:43

place for me in terms of

14:45

sheer quantity were stories about

14:47

end of life care and palliative care . That were

14:49

26 last month . The largest

14:51

number of those articles focused really on

14:53

the cost savings and the efficiencies

14:56

that result from palliative care

14:58

and nice to say if

15:01

you're a not-for-profit . The tenth

15:03

category , with 23 articles

15:05

, was fundraising and development news . The

15:10

usual array of stories

15:12

about fundraising events , foundation

15:14

grants , corporate gifts

15:16

, which stories also

15:18

included a couple of rather sizable grants

15:21

for local hospice providers

15:23

and there were also a couple of articles

15:25

about hospice thrift shops which

15:28

can generate a lot of income for

15:31

the hospice they support and

15:33

which can drive for-profit providers

15:36

crazy because of the branding

15:38

and the market penetration

15:40

and the goodwill that thrift

15:43

stores can generate . We

15:46

are pretty nomead , pretty steep falloff to

15:49

the honorable mention for the

15:51

month of August . The

15:53

next half dozen categories were physician

15:55

and nursing news , home health

15:57

and private duty news , wish and

16:00

dream fulfillment stories , dementia

16:02

care news , which saw 10 articles , which

16:04

was pretty significant Huge

16:07

drop off with physician assisted suicide

16:09

, medical aid and dying only

16:11

nine articles . Legislatures are

16:14

out of session and so

16:16

the article this issue is getting

16:18

a lot less attention . Elder

16:20

news and aging care news

16:23

brought up the rear

16:25

for this half dozen of honorable mentions , with

16:27

nine articles . It's worth noting

16:29

that medical marijuana

16:32

has fallen off the charts again because

16:34

state legislators have

16:38

largely ended their work

16:40

for the year and

16:43

not making the honorable mention

16:45

, but still significant . There were five articles

16:47

in the last month about Jimmy

16:49

Carter's hospice journey and

16:52

they were all compelling , important

16:54

and affirming . So

16:57

that's my take on it from a quantitative

17:00

point of view , chris .

17:03

You know , mark , something occurred to me this month . I've been

17:05

wanting to ask you in your actual hospice

17:08

news today you have

17:10

kind of like a summary of the beginning , like in this

17:12

issue , and then you've got a title

17:14

and then kind of a little bit of a

17:16

paragraph or so explanation . Do

17:18

you choose that title , or is that always generated

17:21

by the actual title of the article ?

17:23

Well , the categories I chose as I

17:25

developed the newsletter , and

17:29

so that is

17:31

that's

17:33

what the articles fall under . But the

17:35

contents listing is just

17:37

a pure top to bottom

17:39

list of the titles of the articles

17:41

.

17:42

Okay , and then the summary is that

17:44

kind of your summary or kind of an extrapolation

17:47

.

17:47

That's an extract from

17:49

the actual articles to give people

17:51

an hint of what's in there , in case

17:54

they want to click on the URL or

17:56

open up the PDF and read more .

18:00

So what struck me this month is just again

18:02

just how masterful you are

18:04

and I think we've lost the art

18:06

of what's the point . Get

18:09

to the point , what is the meat ? And it just

18:11

hit me this month that I

18:13

don't know if most people realize that , but as

18:16

I've now spent so much time in this with you , that

18:18

is the gift and that's also the wonderful

18:21

value that you're providing on what you're doing

18:23

. Because as I go through

18:25

and kind of segment all the different articles

18:27

, it just starts to strike me as number

18:29

one , the title , but then number two , that explanation

18:32

. You get the gist of it . And

18:34

we do live at a time . You've got Blinkist

18:36

and all these other tools , whether they're trying to extract

18:39

the essence of a book , et cetera . You've

18:41

mastered that as far as news

18:43

articles . So I just want to pay that forward to you because it

18:46

just hit me this month that that is part

18:48

of the gift . That is Hospice News today .

18:50

Yeah , the . You know I learned

18:52

that doing news summaries

18:54

for almost 10 years for VITAS

18:57

. I knew that our senior

18:59

staff were too busy

19:01

to read everything , so I tried to come

19:03

up with a system that would let

19:06

them skim the

19:08

news quickly and pay attention

19:11

to that which was of interest

19:13

to them . You know , I would

19:15

tell folks that I don't expect you

19:17

to read everything . You

19:19

don't have to be the smartest person in Hospice

19:21

, you just have to be the smartest

19:23

general manager or medical director

19:25

or sales director or chief

19:27

nursing officer in your particular

19:30

market .

19:32

Thank you to our TCNt alks sponsor

19:34

, Deltacarerx . Deltacarerx

19:37

is also the title sponsor for our May

19:39

and November 2023 leadership

19:42

immersion courses . Deltacarerx

19:44

is primarily known as a national hospice

19:46

, pbm and prescription

19:49

mail order company . Deltacarerx

19:51

is a premier vendor of TCN and

19:53

provides not only pharmaceutical care

19:55

, but also niche software

19:57

innovations that save their customers time

20:00

, stress and money . Thank you , Deltacarerx

20:03

, for all the work you do in end-of-life

20:06

and serious illness care .

20:10

My mentor , mark , I think I've mentioned to you before he

20:12

was actually Stephen Covey's mentor a gentleman

20:14

named Dr Lee Thayer , and he taught a concept

20:16

which we teach now , until he asked we

20:19

model it with our team as the concept of need

20:21

to know , and really that's what need to know is

20:23

is what you've modeled , is what's

20:25

the essence of what you need to know from this , and

20:28

that is a skill

20:30

that , if it's woven into the culture

20:32

of an organization number one , you'll be much more

20:34

efficient , but number two , you

20:36

will be focusing on the things , that which you

20:38

need to focus on , and I think that really gets to the essence

20:41

of why you and I do this each month . So let

20:43

me jump in now , mark , from the perspective of

20:45

I love how you do it quantitatively , mine's

20:48

from the C-suite . Here's the

20:50

things that I hope you did miss this past month

20:52

, and so my top 10 themes . There

20:54

were 73 articles this month . The last

20:56

time I think I had this many articles flagged

20:59

was probably about March or

21:01

so . So I always start with Mark

21:03

. When we do an , our pre-show prep , I'm like , okay , here's

21:05

my perception . Is this kind of jive ? And

21:07

Mark affirmed it did so . The first one that I

21:09

flagged Mark was the present quarter articles . And

21:12

again , you've had the privilege of being on

21:14

his administration . That's where you've honed

21:16

some of these skills . I've been giving you a good shout out

21:18

for this morning . But the fact that

21:20

he's still alive in six months , the gift of

21:23

that , because just who he is a

21:25

former president of the United States and then

21:27

changing the perception that hospice

21:29

does not mean you're dying tomorrow . And

21:32

here he is six months later . So there are several

21:34

articles

21:36

. A fitting final gift from Jimmy Carter

21:38

is one of the ones . I just love the way that was actually framed

21:41

. President Carter reaches

21:43

six months on hospice care . Oldest

21:45

living president redefines hospice

21:48

care . So just some really great articles

21:50

given a shout out . And again I've said before

21:52

, my favorite movies is secondhand lions

21:54

being

21:57

used up in this life . And here's President

21:59

Carter making an impact even at the very

22:01

end of his life . And just major

22:03

kudos to him and just his family and we

22:06

will continue to pray for them and wish them all the best

22:08

. Next category was the hospice

22:10

regulations that you actually called out . There's

22:13

actually a fortune article that I put in that category

22:15

. Does Medicare cover hospice services ? Yes

22:18

, and here's exactly what it pays for . I

22:20

think I theorized and dreamed about days

22:22

that hospice would be covered in fortune when I started

22:24

at the age of 25 and used to

22:26

subscribe to a fortune . So I

22:28

think at some level that's interesting that we've

22:30

kind of been noticed in that way . But

22:33

then lots of articles . Cms threatens to cut hospices

22:36

from Medicare if they can't prove legitimacy . Nearly

22:39

400 hospices are considered for administrative

22:41

action as program integrity efforts . Hospice

22:44

advocacy groups call on CMS to delay

22:46

revised special focus programs . So the

22:48

SFP is probably an acronym

22:51

, c-suite leaders that you're going

22:53

to hear going forward . Hospice

22:55

industry groups CMS must reform the auditing

22:57

processes . Hospice news providers

23:00

to lawmakers Hospice has a huge value

23:02

to Medicare . And

23:04

then NHPCO this was

23:06

a news release , six month update on hospice

23:08

program integrity recommendations . And

23:11

then again Dr Bayak's article

23:13

about the hospice industry needs major

23:16

reforms . It should start with apologies

23:18

, which prompted me , mark , that is going to be our first

23:20

show of 24 . It's going to be with

23:22

Dr Ira Bayak , so that's going to be a pretty

23:24

cool show . The next category

23:27

really had one article , but I just wanted to call

23:29

it out to leaders . Nhpco

23:32

so knock and NHPCO

23:34

inch closer to possible combination . That's

23:36

pretty big for our segment . And

23:40

next one was a hill piece . The price

23:42

of elder care soars as demand

23:44

increases and the baby boomers age

23:46

, so that silver tsunami

23:48

demographic . Hopefully by now everyone

23:50

has that very pithy way of encapsulating that , because

23:53

that is going to change our world over the next 15

23:56

to 20 years as we're shifting from having care

23:58

for the greatest generation to the baby boomers , the

24:01

next category . I kind of grouped several articles

24:03

. I would call it value based care , medicare

24:05

Advantage , alternative Pair Models , and

24:08

so ACO programs have saved Medicare

24:11

$1.8 billion . I think

24:13

we're about ready to get into a season where

24:15

ACO programs are going to be a little bit more

24:17

open to partnership with what

24:20

I call serious illness providers . A

24:22

McKnight's article what exactly is value-based

24:24

care ? Many employers and consumers don't

24:27

know from a study which

24:29

is interesting , considering how many people have

24:31

actually saying that value-based

24:34

care is going to be 100% by 2030

24:36

. Medicare Advantage is another article

24:38

. Medicare Advantage linked to less favorable outcomes

24:41

and also reduced post-acute use

24:43

. Reach ACO

24:45

. So the ACO reach will change in 2024

24:48

. There's some pretty substantial

24:51

but some changes as we go forward with Reach

24:53

ACO , which actually has had some success . And

24:55

then another article about VBIT . Hospices

24:58

operate in a teeter-tottered landscape

25:00

, so that was a really interesting article . Another

25:03

article about cost control . So hospices

25:05

true north in Medicare Advantage , and

25:08

so talking about hospices being carved

25:11

into hospice Medicare Advantage and

25:13

then nursing home . Investors on the sidelines

25:15

admit higher interest rates , less

25:18

stable skilled nursing facilities

25:20

, which kind of leads to kind

25:23

of one of the next categories that I had

25:25

actually , mark , and I think you called

25:27

that out as well . There were several articles

25:29

and kind of storm clouds on the horizon

25:31

. I can remember being

25:34

hospice CEO and wondering at

25:36

some point are we going to encounter some pretty stormy waters

25:39

for skilled nursing facilities ? And

25:41

it sure feels like those are here now . So several

25:43

articles healthcare bankruptcies

25:45

or skyrocketing , but not

25:47

yet in home-based care . But really

25:49

referring to skilled nursing facilities , access

25:54

to care . Number of Medicare-certified home

25:56

health agencies continues to fall An

25:59

aqueous article . Operating

26:01

margins improve but hospitals

26:04

still face high expenses and

26:06

that was kind of quoted from Kaufman Hall . This

26:10

year will not bring a full rebound to

26:12

nonprofit hospitals . So we're

26:14

talking about hospitals and skilled nursing facilities

26:16

. Skilled nursing sector is growing

26:19

or shrinking . Problems get new attention and

26:22

, mark , this is one . Not only was in your hospice news

26:24

today , but you and I had an email exchange with

26:26

a mutual friend in rural America

26:28

. 30% of rural hospitals

26:31

are at risk of closure . That

26:33

is pretty daunting and , as you were saying , just the impact

26:36

if that actually goes , if that happens

26:38

, and the impact on local healthcare landscape

26:40

. Nursing homes , hospices and

26:42

other businesses are sold as

26:44

hospitals are refocused . Mark , you've probably

26:47

seen that throughout your career . I saw it in my career

26:49

kind of post 1995 . Hey

26:51

, let's bulk up , not bad idea , let's

26:53

now go ahead and divest of a whole bunch

26:55

of that . So I think we're going to

26:58

see a lot of that in the next 24 to 36

27:00

months . Again , rural hospitals fill

27:02

the squeeze of Medicare Advantage . Skilled

27:05

nursing news almost half of nonprofit

27:07

provider skilled back , construction on new SNF

27:10

projects . And then Wall

27:12

Street Journal , the upheaval at America's

27:14

disappearing nursing homes in charts

27:16

and there's a pretty fascinating chart in

27:18

that article . So my next category

27:21

was I called mergers and acquisitions

27:23

, lots of movement where people

27:25

maybe in the past who wouldn't have thought kind of moving into

27:28

healthcare . But Best Buy there was an article about Best

27:30

Buy grows in home care presence with assistant

27:32

services . Of course . Cvs

27:34

Health reiterates commitment to driving more

27:37

at home care in the United States . Then

27:39

a couple articles about the whole United Healthcare

27:41

and the Medicis . So the Justice

27:44

Department is providing more scrutiny because

27:46

of growing antitrust concerns . Article

27:49

from the New Orleans advocate how United

27:51

Health Group wooed and medecis and the breaking

27:53

up with option care health . And

27:55

then another interesting article and

27:58

I just really caught my attention because I literally had

28:00

an interaction with a

28:02

premier care practice in another

28:04

state that sold out to

28:06

private equity and he said it was the worst decision

28:09

of his life , destroyed his practice . But the article

28:11

was in time what happens when private

28:13

equity buys your doctor's office . So

28:15

that was kind of the next category . And

28:18

then powder care . There are several good articles

28:20

how powder care generates savings and boosts

28:22

hospice utilization . I can

28:24

remember the days we dream of kind of being the pioneers

28:27

of four seasons where you get some great press

28:29

coverage about powder care , basically

28:31

saving money to the broader healthcare system

28:33

. And now we're getting some good coverage why

28:36

MA plans are investing in powder care as a

28:38

supplemental benefit . That's one that caught my eye

28:40

and this was an interesting one . The US

28:42

prison system is struggling to keep up with the

28:44

growing need for powder care . And

28:47

then kind of rounding out my top 10 staffing

28:50

is always work . We're probably it's

28:52

going to probably never be a month where we don't call it out

28:54

. And this probably was the largest volume of

28:56

articles and I'll try to cite just a few because I think

28:58

I've got like 20 . But senior

29:00

living court approves class action status

29:02

for ALF staffing lawsuit . Us

29:06

women miss out on 627

29:08

billion by not getting paid for caregiving

29:10

. I kind of put that in the staffing category

29:13

why we need more resources for caregivers

29:15

, especially those for immigrant families . Everyday

29:18

people nurse finds new purpose in hospice

29:20

care is a really good article . I thought of kind of

29:22

, hey , this is some very purposeful work . Image

29:26

of nurses as healthcare heroes is daunting

29:28

and inspiring to students . New

29:30

Medicare proposal would cover training for

29:32

family caregivers . Healthcare

29:34

workers at high risk of drug overdose

29:36

I thought that was kind of interesting . Care

29:39

employment rate rises but providers still

29:41

anticipate hiring difficulties . There's

29:44

a modern healthcare article staffing shortages

29:46

may worsen again and here's how hospitals

29:49

are preparing . And then as

29:51

healthcare moves into the home , do we have enough

29:53

workers ? Yeah , definitely not . Hhs

29:57

invests 100 million to bolster the nursing

30:00

workforce , preparing the next

30:02

generation for nurse leaders . Nursing

30:04

shortage is tied to burnout . 50%

30:07

of nurses have a side hustle to earn

30:09

extra income . So just a lot

30:11

of articles in that category and then my

30:13

kind of honorable mention category . There are

30:15

a couple articles about death doulas Mark , you're really

30:18

kind of one of the ones , kind of maybe put

30:20

that on my radar screen . This

30:22

is one that was interesting . Everyone dies . End of life

30:24

dualists can help us process it . And

30:26

there was another one about can a death class make

30:28

life more worth living ? And these students

30:31

think so . It was about death dualists . Couple

30:33

articles about dementia care and maybe I'm just a little

30:35

bit more attuned to that . We're

30:37

going to do a show on dementia as we get towards

30:40

the end of this year . So there are a couple about college

30:42

students change the lives of people with dementia . Cms

30:45

involves a program to improve dementia care and

30:47

ease unpaid caregiver strain . And

30:49

then an article so kind of shifting to another category

30:52

, the average cost of healthcare data breach

30:54

reaches now $11 million . That's

30:56

another theme that we've called out on this show . And

30:59

then the article you mentioned , mark , how Bruce Springsteen

31:02

and 18,000 strangers helped me mourn my

31:05

mom . It was a great article . Another

31:07

interesting article as far as a niche Florida's

31:10

first LGBTQ and centric assisted

31:13

living community actually opens , and

31:16

then a Cumberland couple's hospice care

31:19

has ended but their need for it is not , and

31:21

really kind of bemoaning being

31:23

discharged because the patient's

31:25

not declining . Then an article in

31:27

the USA today about a my doctor so is my mother

31:29

when she got cancer . I realized

31:31

how little that mattered which

31:34

is interesting coming from a doctor to say that but

31:36

it was a very touching article . And

31:38

then one again you put on my radar screen that I

31:40

watch for Senators pushed IRS

31:42

to launch non-profit hospital probe

31:45

. That's when we're going to have to continue to watch . And

31:48

then in New York are the hidden harms

31:50

of CPR . And

31:52

then human composting Mark , I was

31:54

looking at something last night , so the article is turning dead

31:56

bodies into soil . There's a fascinating

31:59

I don't look at social media very often and I almost

32:01

screenshot it but it took like

32:03

in all these futuristic movies and it

32:05

put like what year the futuristic movie

32:08

and where we're pegged right now was Soylent

32:10

Green and I thought I don't think that's a good thing

32:12

and it actually went all the way into

32:14

like 2300 or something like that . And

32:17

then the last one that I had to call out my

32:19

good friend Carol Fisher , who's

32:21

the president of MPHI

32:24

. Carol Fisher hosts Global

32:26

Trending True Crime Podcast

32:29

, the Girlfriends . Carol's been number one in

32:31

the US and the UK , which she's

32:33

such an amazing human being and

32:35

spent the vast majority of her life in hospice and

32:37

power of care , but also calling

32:39

out just domestic abuse

32:42

and just using this podcast as a beautiful

32:44

platform , and so so that's

32:46

mine , mark . Any final comments from you ?

32:50

And the diversity of

32:52

issues that have

32:54

an impact on the C-suite

32:57

really speaks to the need

32:59

for healthcare

33:01

leaders , hospice leaders , to

33:04

get out of their tall , narrow

33:06

silo and look over

33:08

the edges of it and see what is going

33:10

on outside of the four walls

33:12

of their particular

33:14

provider business . And

33:16

this was a great month to make that argument

33:19

. And it makes the argument that if

33:21

you're not doing this on

33:23

your own or subscribing to Hospice News

33:25

today , your competitors who

33:27

are have a significant advantage over you .

33:31

That's well said , mark . In fact , that's probably something

33:34

I would definitely want to highlight . This month , we had a couple

33:36

of people ask and say hey , how can we get a copy

33:38

of the articles that you and Mark actually cite

33:41

? So , in the summary

33:43

that we put out with the podcast , you're going to have my email

33:45

, mark's email email , either one of us . We

33:47

could get you a list of the articles and , most importantly , mark

33:49

can get you actually subscribed to Hospice News today

33:51

. If you're not , I strongly recommend

33:54

it . I don't know how I could do my job

33:56

if I did not , and if I

33:58

was a hospice CEO or any C-suite leader

34:00

, this would be required reading on a day to day basis

34:03

. I do it before I hit my eight o'clock each morning

34:05

. It's kind of one of my last things , as I

34:07

have in my morning ritual Get

34:09

. That gives me a framing for the day and then I'm off

34:11

to all my tasks for the day . So , mark , thank you for

34:14

the service that you continue to provide to

34:16

the Hospice and Power Care segment with the work

34:18

that you do .

34:19

Happy to do it and happy to be on the podcast

34:21

.

34:22

All right . So I'm going to close with this quote , right , this one

34:24

by Mark . And so my daughter loves to Dwayne

34:26

"the rock , johnson . So from the

34:28

rock , when you focus on you , you grow

34:30

. When you focus on shit , shit grows

34:32

. Thanks for listening to TCNt alks

34:35

.