0:01

Welcome to TCN Talks . The

0:04

goal of our podcast is to provide

0:06

concise and relevant information

0:08

for busy hospice and palliative

0:11

care leaders and staff . We

0:13

understand your busy schedules and believe

0:16

that brevity signals respect

0:18

. And now here's

0:20

our host , chris Como

0:23

.

0:23

Hello and welcome to TCN Talks . This

0:25

is my favorite time of the month when Mark

0:27

Cohen and I review the top news stories

0:30

of the month . Welcome back , Mark .

0:32

Hi , chris , glad to be here , as always

0:34

, looking forward to it .

0:35

Me as well . You ready to jump ?

0:36

in Yep , you bet . So

0:40

, chris , I'm going to do something a little different

0:42

with our top news stories for April . I'll

0:45

review the most clicked upon stories from hospice

0:48

and palliative care today . But rather

0:50

than dive deeply into those

0:52

, I'm going to dig a little deeper into the

0:54

numbers and pull out the top stories specifically

0:57

about a hospice provider . I

0:59

thought that would be an interesting change of pace for

1:01

us and it relates a bit to the subject

1:03

of my master class in communications

1:05

at the end of our podcast . So

1:09

there were six articles that ran in hospice

1:11

and palliative care today in April that garnered

1:13

2,000 plus clicks , which

1:15

clearly separated them from the rest of

1:17

the field , as the seventh most

1:19

clicked upon article received about 1,400

1:22

clicks . Here are the top

1:24

six articles With 2,700

1:27

clicks . The most popular

1:29

story last month was a posting on the website

1:31

of the Louisiana Mississippi Hospice

1:34

and Palliative Care Organization which

1:36

was reporting on a visit to the staff

1:38

and volunteers of the pioneering hospice

1:41

program at Louisiana's notorious

1:43

Angola prison . Only

1:46

20 clicks behind that was a report

1:49

in the Oncology Nursing Society

1:51

Voice which was headlined . Quote

1:53

LGBTQ plus individuals

1:56

have higher rates

1:58

of cancer because of disparities

2:01

in modifiable

2:03

risk factors , american Cancer

2:05

Society says . Another

2:08

clinical article the HAP Foundation

2:10

conducts research study on black

2:12

Americans' experience with serious

2:15

illness in Chicago , ranked

2:17

third in CLICS with about 2,600

2:19

. And

2:36

right behind that was a collection of postings that Hospice and Palliative

2:38

Care Today collected from the

2:40

Hospice Foundation of America , nhpco and

2:42

the Convers McKnight's senior living mortality

2:45

hospice use rates differ in

2:47

assisted living communities depending on whether

2:49

memory care is offered received

2:51

about 2,200 clicks . And

2:54

the sixth article in this set , with

2:56

2,024 clicks , was

2:59

another clinical article , this one , a release from

3:01

a consortium of academic medical

3:03

centers , headlined Bereaved

3:05

Parent Support Study Seeking

3:08

Participants . I think it's

3:10

noteworthy , chris , to see the interest

3:12

among readers of hospice and palliative care

3:14

today in articles that focus

3:16

on clinical issues and other

3:18

subjects beyond news about hospice

3:20

providers . But what articles

3:22

specifically about providers , whether

3:25

for-profit or not-for-profit , did

3:27

see the greatest number of clicks ? In

3:29

first place was a roundup

3:32

of executive personnel news from a couple

3:34

of news sources , including announcement

3:36

of a new medical director of Pathways Hospice

3:38

in Fort Collins , colorado

3:40

, and a new chief medical officer at

3:43

Samaritan in Mount Laurel , new Jersey

3:45

. And in second place , a week later

3:47

, was a similar roundup of executive

3:49

personnel news , this time including an

3:52

announcement of a new executive director

3:54

at Hospice of the Foothills in

3:56

Grass Valley , california , and a new

3:58

VP of marketing communications at

4:01

Carolina Caring in Newton , north Carolina

4:03

. The third most viewed provider

4:06

article was actually from England , the BBC

4:08

reported quote hospice boss

4:10

warns of funding challenges . Unquote

4:13

a story that's been percolating for

4:15

several years about the lack

4:17

of direct funding for hospice providers

4:19

from the British National Health Service

4:22

. Next was a

4:24

story that broke last month but continued

4:26

to see coverage in April . The headline Connecticut

4:29

Hospice Says it Can't Provide Home Care

4:31

Under Bill to Protect Healthcare

4:33

Workers , and

4:35

it ran in the online publication Connecticut

4:37

News Junkie . The proposed legislation

4:40

Senate Bill 1 , would require

4:42

organizations that care for people in their

4:44

homes to conduct background checks on

4:46

the clients and anyone in the

4:48

location where care is given . The

4:51

checks would include psychiatric histories

4:53

as well as checks for histories of violence

4:55

, domestic abuse , substance abuse

4:58

and criminal records . The legislation

5:00

and here's a direct quote is

5:02

too broad , too unclear as

5:05

to requirements , not guaranteed to

5:07

achieve its aims , duplicative

5:09

of other procedures required in hospice

5:11

care and contradictory to certain

5:13

regulations of Medicare . Unquote

5:15

, says Connecticut Hospice

5:18

CEO Barbara Pierce . And

5:20

the fifth most viewed provider story

5:23

was certainly a noteworthy one the headline

5:25

Central Oregon Hospice Sues

5:28

Feds Over Challenged Medicare

5:30

Claims . This ran in an

5:32

Oregon health care newsletter , the

5:34

Lund Report . Hospice

5:46

providers , partners and care leaders have successfully defended the vast majority of

5:48

disputed claims but have sued to erase the rest , while challenging

5:50

government methods . The case could

5:52

have quote huge ramifications

5:55

unquote and will be closely

5:57

watched . Finally

5:59

, to round out the top half dozen most viewed

6:01

stories about providers , there's a

6:03

story we certainly would expect to find in a listing

6:05

like this . The headline King

6:07

and Lake Hospice Care Extends Compassionate

6:10

Services to El Cajon

6:12

Community , which was a release from

6:14

the Temecula California hospice

6:16

. In sum , you

6:19

know this is not really the list of top-click

6:22

provider articles you would expect to see

6:24

, chris . I think it speaks to a decline

6:26

in business-as-usual coverage of

6:29

hospice providers , which reflects

6:31

in large part the decline in local coverage

6:33

, largely due to the decimation

6:36

of local daily newspaper newsroom

6:38

staff and the massive closures

6:40

of weekly newspapers all across

6:42

the country . There are , however

6:45

, other news opportunities out there . Many

6:47

local TV stations have increased

6:49

their local coverage in response to

6:52

the decline of local print coverage . There

6:54

are now literally hundreds of not-for-profit

6:57

internet-based newsrooms across

6:59

all 50 states with a

7:01

mission of filling the local or state news

7:03

vacuum , and there are several state

7:06

focused healthcare news sites

7:08

publishing substantive

7:10

content every day . The

7:12

challenge here is that they all require pitching

7:15

, substantive stories , not fluff

7:17

and not business as usual , and

7:19

there's never a guarantee that the article they

7:21

publish will come

7:23

out exactly the way you'd like it to . Still

7:26

, it's vital for hospice providers to remain

7:28

top of mind in the communities they serve

7:30

, so this month's rundown of top

7:32

stories ought to serve as a cautionary

7:35

marker . There's more work that

7:37

needs to be done here , of

7:39

course , keeping an eye on media coverage

7:41

outside of your own market , whether for

7:44

the type of broader stories I mentioned

7:46

in the rundown at the top of the podcast or

7:48

the stories about individual providers

7:51

. The news that

7:53

I just spoke about , the newsletter

7:55

Hospice and Palliative Care Today , is an essential

7:58

daily read for everyone . Hospice

8:00

and Palliative Care Today , as

8:02

you know , operates on a free subscription

8:04

model . Advertising

8:06

makes the free subscription model possible , so

8:08

if you're a hospice vendor listening to this podcast

8:11

, you should check it out as a cost-efficient

8:13

way to reach 1,500 plus daily

8:16

readers . And if you're listening to this podcast

8:18

but not yet subscribed to Hospice and Palliative

8:21

Care Today , you should fix that as

8:23

soon as this podcast is over . Now

8:26

back to you , chris .

8:27

Yeah , that's great . Thank you , Mark

8:30

. I'm just sitting here reflecting , like you know , you

8:32

and I doing this in 2023 and now

8:34

having this data from court and seeing

8:37

, like what people are clicking on , I

8:39

just find it fascinating and then like

8:41

what I'm about ready to share . I mean there are a few

8:43

overlaps , but my

8:46

purview is supposed to be from the C-suite perspective

8:48

. What would I think C-suite

8:51

leaders should be looking at April ?

8:52

and November 2024 leadership immersion

8:54

courses . Deltacarerx is

8:57

primarily known as a national

9:08

hospice , pbm and prescription

9:10

mail order company . Deltacarerx

9:12

is a premier vendor of TCN and

9:15

provides not only pharmaceutical care

9:17

but also niche software

9:19

innovations that save their customers

9:21

time , stress and money . Thank

9:23

you , deltacarerx , for all the great

9:26

work you do in the end-of-life and serious

9:28

illness care .

9:30

And so a lot of mine actually don't dovetail

9:32

with that , so it'd be interesting to see if you have

9:34

any comments at the end , mark . So I've

9:36

now got my categories

9:38

very consistent

9:40

and the great thing is , now I also can

9:43

see the percentage each month . And

9:50

so my first category is mission moments this month that was 5% . Next is reimbursement

9:52

challenges and warning signs and implications this month that was 8%

9:55

. Competition to be aware

9:57

of this month that was 10% . Workforce

10:00

challenges this month that's 30%

10:02

. So that was a big jump . This month there was a lot

10:04

more articles either I picked up

10:06

on or just seemed like there were a lot more this month

10:08

. Next category is patient , family

10:11

and future customer demographics and

10:13

trends this month that was 12

10:15

. So a lot of the shift into workforce

10:17

was out of demographics and trends this month

10:19

. Uh , regulatory and political is my

10:22

next category . That was 12 . Technology and innovations that

10:24

was 13 . And then I , political is my next category . That was 12% . Technology and innovations

10:26

that was 13% . And then

10:28

I'll call this next category speed of change

10:30

, resiliency and culture 1%

10:33

. And then next is the human

10:35

factor 3% . And then just

10:37

kind of my catch-all category , articles

10:39

of interest I want to highlight . This month . That's 4%

10:42

, so I'm going to jump in . So

10:44

my first category is mission

10:47

moment articles and I have flag to highlight this

10:49

month . That's 4% , so I'm going to jump in . So my first . My

10:51

first category is mission moment articles and I have flagged three

10:53

this month . First one I

10:55

love the movie Mr Holland's Opus . Mark , I don't know about you , but it's one

10:57

of my favorite movies with Richard Dreyfuss . Actually you kind of look like him

10:59

a little bit too , mark , but the article

11:02

was about . This was in Ohio

11:04

and basically a student

11:06

of his music teacher . She

11:09

was passing away and the footage that the article

11:11

was kind of talking about shows this hospice

11:13

worker , joshua Woodard , singing

11:16

a heartfelt redemption of how Thou Art to

11:18

his former mentor , mary Redmond , just

11:26

days before her beautiful passing and

11:28

her peaceful passing . And Mary

11:30

was not only a cherished voice and piano

11:33

teacher in her community but also a vibrant

11:35

member of the art scene , starring

11:38

in productions like Hello Dolly and the Music

11:40

man . And then one of those

11:42

lives touched was this young hospice

11:44

worker . So just just a beautiful mission

11:47

moment . And the next mark this one

11:49

wasn't overlap between you and I was the article

11:51

about Louisiana , mississippi , hospice

11:53

and power of care organization announcement . And

11:55

so great COVID . There was so

11:57

much great movement before in

12:00

Louisiana working with Angola and

12:02

that really lost traction during COVID and

12:04

seeing that now getting kind

12:06

of revi- , revibrated , revitalized

12:10

, and so I know there are a lot of people in the country like me

12:12

that are interested in that work . So

12:14

we could replicate that in other parts of the country

12:16

because we know the number of people

12:18

incarcerated in our country and the

12:20

aging of that population

12:22

is very substantial . And

12:24

then the last one in my mission moment category North

12:27

Carolina restaurant fulfills woman's

12:29

dying wish . This woman was

12:31

actually in West Virginia and

12:33

one of her favorite places was a North

12:35

Carolina restaurant and on

12:38

her deathbed Ms Bowers had one last

12:40

wish a pork plate from the Outer Banks

12:42

restaurant , mama Kwan's , and

12:44

she wondered how to make it happen . And even though she

12:46

lives six hours away , folks made it happen

12:49

. So I thought that was a beautiful mission moment . So

12:51

now into the weighty

12:54

matters . And so reimbursement challenges

12:56

is the next , and so had five

12:58

total . The first one

13:00

we kind of do general to hospice . The second section

13:03

is more Medicare Advantage . So

13:05

home care industry slams the finalized

13:07

80-20 rule , warns agency

13:09

closures are coming , and

13:13

this is an interesting thing , it's kind of like MLR

13:15

that they do in the insurance

13:17

MA space . But this 80-20

13:19

provision says that 80%

13:21

of reimbursement must go directly

13:24

to wages , which is interesting

13:26

if you think about it , mark . I mean you definitely

13:28

want to pay your people 80% , but

13:31

typically a business has overhead

13:33

about 20% . So my

13:35

guess is what they're pushing back is there's no room

13:37

for margin . How do you grow your business ? How do you reinvest

13:40

? So it's going to be interesting to see . On one hand

13:42

, you see what they're trying to do We'll see

13:44

some other articles , I'm going to point out , of a

13:47

lot of scrutiny about how profitization

13:49

, private equity coming into healthcare

13:51

, and so now you see kind of some of these macro

13:53

moves to try to Create

13:56

some type of equity and make sure the right thing is

13:58

done , and you see a lot of unionization

14:00

. But the 80-20

14:02

is interesting and so the MLR is 15%

14:05

. So I don't know what kind of drove them to do the

14:07

80-20 . But you see these different

14:10

forces that are kind of confluencing and

14:13

you see what they're trying to make right , but I don't know if

14:15

the 80-20 is the way to go about it . This

14:17

next one says March goes out like a lion

14:20

, and so of course we're in April doing

14:22

April top news stories of the month , but

14:24

this is one I just picked up afterwards says

14:26

that um , what's the old adage

14:29

, mark comes in like a lion and goes out like a lamb

14:31

. But that didn't hold true for the hospice sector . A

14:33

lot of late month flurry activity

14:35

. Um , med packs , suggested

14:37

freeze and hospice rates for 2025

14:40

. Um , it wouldn't see

14:43

proposed . Oh , medpac , that was before , but

14:45

of course we're going to get 2.6% . But

14:47

then the CMS proposed hospice

14:49

rule lays the groundwork for the long anticipated

14:51

hope tool . And of course then

14:53

the announcement also a sunsetting the VBID demonstration

14:56

. All right , the next category under

14:58

payer was my always keep my Medicare advantage

15:00

in there , and so there are three articles

15:03

how MA plans design affects

15:05

the utilization . Specifically around health

15:07

equity , a new study found that enrollees

15:10

with zero premium MA plans

15:12

they're three times as likely

15:14

to be non-white compared to other MA

15:17

enrollees and traditional Medicare

15:19

enrollees , and this was a study published by Harvard

15:21

Medical School . Next is wide

15:24

variation in differences in resource use

15:26

seen across conditions between

15:28

Medicare Advantage and traditional Medicare

15:30

Mark . I think we're going to see a lot more studies

15:32

trying to push in and just make sense

15:34

because Medicare Advantage , while theoretically

15:37

in the beginning it was going to save traditional Medicare money

15:39

. Now it's actually costing more . So now they're

15:41

trying to say well , what's the difference in the patient populations

15:43

? So I found this kind

15:45

of interesting it was actually a health affairs article

15:47

and then the last one in this section

15:49

CMS finalizes the 2025

15:52

Medicare Advantage rates . Cms

15:54

finalized a slight decrease in

15:56

MA benchmark payments for 2025 . The

15:59

final rule was similar

16:01

to the proposed rates that were back in January , but

16:03

basically they're going to get their

16:06

C to

16:08

think about 2.45% decline

16:10

in revenue and , of course , nationally

16:13

Mark . We're seeing a whole lot of say

16:16

layoffs , reduction in forces and a lot

16:18

of these insurance companies . I imagine this in response

16:20

to this next category

16:23

is competition to be aware of , and I flex

16:25

, I flag six articles in

16:27

that section , and so the first are

16:29

kind of general and then the next ones are more kind

16:31

of mergers and acquisitions . First one hospitals

16:34

cash in on private equity back

16:36

trend . It was a really interesting play

16:38

on words . They're really saying is hospitals

16:40

are mimicking what you see in the private equity space

16:42

, which is concierge physician

16:44

care . Nonprofit hospitals create , largely

16:47

serve the poor , adding concierge

16:49

physician practices , charging patients annual

16:52

membership fees of $2,000 or

16:54

more , and you can't blame them , mark

16:56

, because what they're trying to do is create almost like a diversified

16:59

portfolio within their

17:01

health system . But we know I think it was Mayo

17:03

that CEO got a lot of kind of

17:05

scrutiny and bad press about kind

17:07

of catering to larger affluent

17:10

populations . But you

17:12

could see if , as a nonprofit , if you could do

17:14

both , you could probably serve more of

17:16

that need in the nonprofit side . Because

17:18

we know government rates , and

17:20

most particularly in the acute care sector . We know government rates , and most particularly in the acute care sector

17:23

, are not exactly where they make their margins . So

17:26

many interesting things between those

17:28

two different worldviews . If you will , kaiser

17:31

Permanente and Town Hall ventures

17:33

to launch a PACE program called Habitat

17:35

for Health . So Kaiser Permanente

17:38

coming together and they're actually going to be

17:40

launching PACE programs that are going to be dubbed Habitat

17:42

Health , and so Kaiser and Town Hall Ventures

17:45

are coming together to actually

17:47

do that . And the two particular markets

17:49

is in California , sacramento and Los

17:51

Angeles , and so of course PACE is becoming very

17:54

popular throughout the country . It kind of feels

17:56

like that early trajectory of hospice and

17:58

now you're seeing a lot more for-profits

18:00

folks come into that sector as well . Next

18:02

one is the emergent and acquisition section

18:05

. And so , first off , analysts not

18:07

ruling out Cigna Humana merger

18:09

. That'll be an interesting one to watch , especially

18:12

considering the scrutiny that UnitedHealthcare is getting

18:15

about antitrust . This

18:17

next one Kaiser closes Geisinger

18:19

Health Acquisition forming Ryzant Health

18:21

. So they're coming together to create

18:23

a nationwide value-based care

18:26

network . And it's a new nonprofit In

18:29

the senior living space Lutheran

18:31

Senior Services and Daikin

18:33

. I'd never heard of that company before . Daikin

18:35

form one of the largest US

18:37

nonprofit long-term care organizations

18:40

, form one of the largest US nonprofit

18:42

long-term care organizations , so that's really

18:44

interesting . And the next $45 billion worth of physician group

18:46

acquisitions since 2019 . That was an actual Becker's

18:48

article . All right , so that's my competition

18:51

category . My next category is workforce

18:53

challenges , which was about a third of them

18:55

this month , and I always substratify

18:57

those into three categories . The first category

18:59

is these are articles that paint the

19:01

picture of the challenge . We've talked

19:04

about it many times the silver tsunami of

19:06

demand as the baby boomers are aging

19:08

, and then just the sheer number of workforce

19:11

that we have and the pipeline

19:13

of what's producing . It just feels like the

19:15

numbers are going to be really hard to match . Hard

19:22

to match . So this first one why are so many nurses fleeing healthcare and how

19:24

hospitals can address the problem . But when you looked at the article , it was a whole lot more of the problem than it was a solutions

19:26

. But fear not , we have a lot of solution

19:28

articles this month . Next one is

19:30

top factors in nurses

19:33

ending healthcare employment between 2018

19:36

and 2021 . Really

19:38

good article in

19:43

2021 . Really good article . Top contributing factors leaving

19:45

were planned retirement that was about 39% . Burnout 26% . That's

19:47

really that just hurts my heart . Insufficient

19:49

staffing 21%

19:51

. Family obligations 18%

19:54

. And so that was an interesting article . That was in JAMA

19:56

. All right . So my next category

19:58

under workforce is then the implications

20:01

of the issue . Providence

20:03

employees awarded a $98

20:05

million in wage suit . The jury awarded

20:07

more than 98 million in Providence health and service

20:10

employees in a class action lawsuit over claims

20:13

the health system illegally denied

20:15

meal breaks and pay for time worked . Next

20:18

article they work 80 hours

20:20

a week for low pay . Now California's

20:22

early career doctors are joining unions

20:24

. Mark , I know you probably remember

20:27

this because Del Nii is the

20:29

one who taught me this . Where the doctors go

20:31

is where healthcare will go Like . Watch the doctors

20:33

, the influence that they have in healthcare , and

20:36

you know doctors being salaried employed

20:38

has been relatively new

20:40

. Compared to my 30 years You've got more , but

20:43

now seeing some of these even younger

20:45

career physicians joining unions , and

20:47

so that feels new Mark . Have you

20:49

ever seen that ?

20:52

I was at I had just left

20:54

Jackson Memorial in the mid 90s

20:56

when the residents there first

20:59

started to talk about

21:01

unionizing . So it's been

21:03

driven . There have been resident-driven

21:06

efforts going

21:08

back more than 20 years in

21:10

major metro areas and

21:13

you're just seeing more of it now with the corporatization

21:16

of healthcare . But it

21:19

was radical back then because

21:21

that was the first time residents

21:24

had ever done it and now it's

21:27

a little more common and it's

21:29

understandable , given the hours they work , the pay

21:31

they get , the debt load they carry

21:34

and

21:36

the lack

21:38

of resources that teaching

21:41

hospitals have to cushion

21:43

some of those burdens .

21:44

Yeah , absolutely In fact got a good article . That's going to point

21:46

to some of that in just a little bit , so

21:49

can continue . My next one Fraudsters sentenced

21:51

in scheme that distributed seventy six hundred

21:53

phony nursing diplomas

21:55

. Implications , because you could

21:58

almost see the , the

22:00

, the temptation because of the lack

22:02

to createa diploma

22:04

mill , and that was nc

22:07

. This was in providers that end

22:09

up in ohio , new york , massachusetts

22:11

, new jersey and texas , and , mark , I think you

22:13

were the first one to kind of bring that whole thing to my

22:15

attention . That was a mcknight's article . Next

22:18

is major unions , including SEIU

22:20

, maintain momentum following the 2023

22:23

strike upswing , and

22:25

so obviously that's continuing into 2024

22:28

. This is an interesting one . That was

22:30

kind of scratching my head , mark , and I've got a theory about

22:32

this one RNs are moving away from

22:35

home health and hospice . Federal survey reveals

22:37

, though , the number of registered nurses continues to grow , fewer are working in home health and

22:39

hospice . Federal survey reveals through , though , the number of registered nurses continues to

22:41

grow fewer working in home health

22:43

and hospice compared to years past . In

22:46

2018 , there were 179,509

22:49

RNs and now there

22:51

are 173,808 . Here's

22:53

my theory , mark , and this looks like the data

22:56

was from 2022 versus 2018

22:58

, so a four-year . I think

23:00

that you're seeing because of the reimbursement challenges

23:03

. Home health is further down the

23:05

life cycle and so

23:07

they're getting lots and lots of consolidation

23:09

. Ma is not good

23:11

at all for them because they get a per visit basis

23:13

. I wonder if they were able to get the

23:15

data between home health and hospice . I would think

23:17

hospice is growing because there are more and more people getting

23:19

hospice care , but maybe it's more on

23:21

the home health side where that shrinkage was , because

23:24

it's kind of a head scratcher . We know healthcare is moving into

23:26

the home , so it just feels very counterintuitive

23:28

. Do you have an opinion on that one ?

23:31

Well , I think part of it is . I

23:33

guess the question is how are they

23:35

categorizing LPNs , lpn

23:38

I

23:45

, you know ? I'd want to know that answer before I would

23:47

offer an opinion on

23:49

it .

23:50

Yeah , it was actually a McKnight's article , so maybe we'll

23:52

dig into that a little bit later and it

23:54

looks like the actually so HRSA . So

23:57

it was McKnight's article but HRSA was the actual

23:59

data source on that . Because

24:01

, again , that's just counterintuitive to me . To me , there are a lot

24:03

more people going into home , into

24:06

care , into the home as a whole , but then

24:08

I wonder , even if they do hospital at home , would

24:10

they , I guess they put that at

24:12

the hospital , even though that's care in the home

24:14

? So that may kind of interesting . Another

24:16

um thing that may be working during that time as

24:18

well . Um , it shows you the

24:20

time that we live , right , those old little categories get

24:22

really blurry now , whenever you got a hospital

24:25

at home , that's not exactly

24:27

acute care or acute care facility . All

24:29

right , my next category in the workforce is

24:31

the solutions , and this month there were 11

24:34

articles under solutions , which

24:36

is great because that's exactly what we need . First

24:38

one was an AMA article . Five steps

24:40

to cutting the red tape that adds

24:43

to doctor burnout , mark , so you were talking about

24:45

that a couple moments ago . Number one identify

24:47

the regulatory burdens . Do something about that

24:49

. Number two sort and prioritize

24:52

the issues . Number three clarify the confusion

24:54

. Then make the dang changes that

24:56

need to be made and then quantify the impact

24:59

. And so reducing

25:01

burnout is essential to high quality patient

25:03

care and a sustainable health care system , and

25:05

AMA is measuring and responding to physician

25:08

burnout , helping to drive solutions

25:10

and intervention . So that was good , and I think

25:12

I got another one a little bit later . Two

25:14

federal bills look to boost the pipeline

25:16

of healthcare workers . That also is a McKnight's

25:19

article and so welcome

25:21

back to . The Healthcare Workforce Act

25:23

is meant to address the shortage of

25:25

healthcare workers across the country . Specifically

25:28

, the legislation would help intentionally educate healthcare

25:30

workers to overcome barriers . Specifically , the legislation would help intentionally educate healthcare workers to overcome barriers to

25:32

working in the United States . And there's

25:34

no doubt that smart

25:38

. What's

25:42

the word I'm looking for ? It's

25:44

not navigation , what do you call that ? Where people come to

25:46

our country , come to work , immigration

25:48

. Immigration Immigration I kept wanting

25:50

to say migration . I knew that wasn't the word . That's

25:53

going to have to be part of the equation and when you

25:55

look at just a birth rate in the United States

25:57

, the numbers just

25:59

don't work and so we're

26:01

going to have to address that . And I remember

26:03

when I brought it up at a national meeting and I remember

26:06

getting some really weird looks at

26:09

a national meeting and I remember getting some really weird looks , but now you're starting

26:11

to see it on like presentations and a lot of the national conferences

26:13

and helping healthcare organizations know how

26:15

to navigate that .

26:17

It's a . I mean , as long as

26:19

the current quotas

26:21

exist on worker visas

26:24

for foreign workers , we're never

26:26

going to get out of that mess because there just

26:28

are not enough slots

26:30

. And no matter what

26:32

health care as a whole

26:35

does to

26:37

try and get its share of the available visas

26:39

, it's still not going to be enough . And

26:42

half of Washington is

26:44

against expanding those

26:47

worker visa programs .

26:49

Well , just like you and I's great conversation , like market

26:52

, I think I've told you before I don't know what . I don't

26:54

know what my politics are anymore because I'm more of a

26:56

solutions based person . And so

26:58

when we talked about , was it the Hill Burton act

27:00

? That was the act right for the critical access

27:02

hospitals . We'll come back to that at the

27:04

end . There's an interesting article talking

27:07

about critical access hospitals , but what a great

27:09

example of making investments in communities

27:11

that the tale was probably 50

27:14

years and so

27:16

people that are commonsensical

27:18

. I was talking to Judy Lundperson

27:20

we had her on our podcast and we were talking

27:22

about the political environment when hospice

27:25

became a benefit and you know Tip

27:27

O'Neill and Bob Dole and Ronald

27:29

Reagan and just you know they at

27:31

the end of the day they came together to get solutions

27:33

done , as opposed to the political kind of . I know

27:36

politics is always somewhat of a blood

27:38

sport , but it seems like

27:40

it's just become more about it's almost like the MMA

27:42

fighting ring and that's the entertainment , as opposed

27:44

to getting stuff done . But

27:47

we digress Next

27:49

up physician coaching by professional trained

27:52

peers for burnout and wellbeing , and it's

27:54

actually a randomized clinical trial . It's a

27:56

JAMA article . In this randomized clinical

27:58

trial there was 138 physicians . They

28:01

received three months of coaching by professionally

28:03

trained physician peers . Those

28:05

folks that were that were coached in that way had

28:07

a significant reduction

28:10

in their interpersonal

28:14

disengagement and burnout and

28:16

they improved in their professional fulfillment

28:18

and work engagement . So , like when you

28:20

were talking about physicians earlier

28:22

, Mark , and just the challenges of why you see them unionizing

28:25

, You're seeing a couple of people actually work on

28:27

the , on the core of the problem , which

28:31

is great . And then here's an interesting article how

28:33

to become a nurse later in life

28:35

. Embarking on a career in the nursing field

28:38

later in life is an inspiring journey that many

28:40

individuals choose to undertake , whether

28:42

it's a personal passion or a long held dream , and just

28:44

really great article . And

28:46

then Court had some editor notes there about

28:48

just challenging hospice and palliative care folks Do

28:51

. They partner with their community

28:53

and university and maybe really being a little bit

28:55

more proactive in this area , which I think is very

28:57

innovative thinking . Next

28:59

was ladders and lattices provide

29:02

career opportunities for CNAs , which

29:04

is brilliant , especially as we think about

29:06

more diversity in our workforce

29:09

and so creating career ladders for

29:11

those at the CNA level to work

29:13

through to maybe become an LPN and RN

29:15

, potentially an administrator , or

29:17

even later a nurse practitioner , PA

29:20

, even maybe a physician going to medical school

29:22

, and so that was a great article in McKnight's . A

29:24

couple more improved onboarding processes

29:27

could boost worker retention . And

29:29

just talking about that better onboarding process

29:31

In fact we had Quint Studer

29:33

on our Anatomy of Leadership podcast and

29:35

Quint had some great little

29:38

examples in there of things

29:40

tactics to do in the upfront . First

29:43

, interactions of staff and the orientation program

29:45

, et cetera . Next is

29:47

frontline burnout in healthcare

29:49

. A growing crisis demands action

29:51

and , of course , the reason

29:54

why I pointed this one out is they had solutions investing

29:56

in leadership , elevating employees' voices

29:58

, investing in team members , empowering

30:01

frontline leaders , enabling

30:03

meaningful engagement , elevating the employee's

30:06

voice , listening , but also taking

30:08

action . Investing in team

30:10

members and then investing in our healthcare workforce

30:12

and see a couple more Optimizing

30:15

RN responsibilities is more essential

30:17

than staffing hours , In other words , enabling

30:20

RNs to practice at the very top of their

30:22

license and taking tasks off of them

30:24

that create friction , mindless

30:26

work , etc . This is where technology

30:29

should be part of the solution and not part of the problem

30:31

Fostering respect and appreciation

30:33

seen as keys to retaining direct care workers

30:36

. And then the operational

30:38

advantages of hiring seniors to provide

30:40

home care . And then one last

30:42

one in this section the workforce management

30:45

playbook how Mercy is empowering

30:47

nurses , saving premium labor costs

30:49

. Plus they're improving care . So

30:51

it's great to see 11 articles

30:53

on the solution side this month . Next

30:56

category is patient , family , future , customer

30:58

demographics and trends . Uh

31:00

, this was uh . At first I thought it was a mistake

31:02

, like that one time mark of you . You picked up an

31:04

older article but

31:07

apparently court did this one on purpose . It

31:09

was jama , 1924 . Editors

31:12

note yes , this article's original day is 1924

31:14

, 100 years ago , shortly

31:16

after the spanish flu pandemic . Modern

31:19

hygiene has been described as the reaction

31:21

against the old fatalistic creed that deaths

31:24

and inevitably occurred . A constant rate

31:26

study of vital statistics shows

31:28

there's no iron law of mortality . The

31:31

New York report states that the increase in the expectation

31:33

of life has been almost entirely

31:36

confined to the ages . Hold

31:38

your seats for this before the age of 35

31:41

. In the future , the health

31:43

officer must of necessity consider

31:46

steps to be taken to minimize the mortality

31:48

among those of middle and advanced

31:51

life , and there's much to encourage man

31:53

today to seek to secure a normal

31:55

lifetime . I thought that was kind of fascinating

31:57

. Next is

31:59

change in long-term care . Nursing

32:01

homes across the US are closing . According

32:03

to an American Healthcare Association

32:06

website , more than 1,000 nursing homes

32:08

1,000 , have

32:10

closed since 2015 . So

32:13

pretty concerning trend there . Next , $1

32:16

billion class action settlement would trigger

32:18

transition of 2,400

32:20

nursing home residents to other settings

32:23

. That was really

32:25

concerning . It was a class action lawsuit . So

32:27

imagine 2,400 nursing home residents . That's kind of the implications of that class action lawsuit . So imagine 2,400

32:29

nursing home residents . That's kind of the implications of

32:31

that class action lawsuit . This

32:34

is interesting . Home care sees the largest

32:36

price jump in history because

32:38

of inflation . The cost of home care rose

32:40

faster than ever in the last

32:43

year for outpacing inflation across

32:45

every other healthcare spending sector

32:47

. And I've got a theory about

32:50

that one Mark , because home care is one of

32:52

the few where they actually can control the prices

32:54

, Whereas the rest of us , within

32:56

healthcare , we've got inflation and

32:58

the government gives us a 2.6%

33:00

increase . Really hard to stay in business

33:03

when that's the case . The next is

33:05

healthcare on the brink , Navigating the challenges

33:07

of an aging society in the United States

33:09

. We've talked about that many times , but just the

33:11

challenge of the silver tsunami . This

33:14

one is America's population ages

33:16

. Women are more shouldering the

33:18

burden as primary caregivers . One

33:21

in six Americans is older than 65

33:23

and numbers projected to rise to one to

33:25

four by 2050 . But

33:27

the key is that most of that caregiving burden

33:29

is falling on women , and

33:33

it speaks that they really like the

33:35

unseen cost of caregiving throughout

33:37

the country , because family members are stepping up

33:39

, either pulling them out of the workplace , et

33:41

cetera . And then this last one

33:43

it's a global medical

33:46

tourism report 2024 . Medical

33:48

tourism has been touted as the next big thing for many

33:51

years . It refers to the practice of individuals

33:53

traveling across borders to receive medical

33:55

treatment and healthcare services . This global

33:57

phenomenon has gained significant traction

33:59

in recent years due to various factors such

34:01

as cost savings , high

34:04

quality healthcare facilities and

34:06

accessibility to advanced medical

34:08

treatments . All right . Next category

34:10

is regulatory and political . I have about seven articles

34:13

in this category . Breaking news

34:15

Labor Department announces final overtime

34:17

rule . If you don't know what this is about , you really need

34:19

to check it out . They're now moving

34:21

the threshold of what can actually be a

34:24

salaried employee versus an hourly employee . There's

34:26

a lot that came out related to who

34:28

you call a contractor , and so

34:31

more than we have time to cover today , but

34:33

something you definitely want to miss . Next

34:35

, on the regulatory examining how

34:37

improper payments cost taxpayers

34:39

billions and weaken Medicare

34:42

and Medicaid . And this is a

34:44

HHS inspector testifies for

34:46

US House Committee talking

34:49

about how OIGs work to address improper

34:51

payments in Medicare and Medicaid . Next

34:54

, private equity proposed Health Over

34:56

Wealth Act . What this means there

34:58

was an actual hearing and talking about bill

35:01

would require PE backed or other

35:03

for profit owned providers , such

35:06

as hospitals , hospice , nursing homes , certain facilities

35:08

, to annually report to HHS

35:10

on all manner of things , including

35:12

, but not limited to , and then the article actually

35:15

goes through that . So certainly a lot more scrutiny

35:17

about kind of that for-profit private

35:19

equity kind of play in healthcare . This

35:22

next one navigating new requirements in the 2025

35:24

proposed hospice rule whole lot

35:26

in that new rule that just came out , which

35:29

would probably be finalized around August-ish

35:31

. It's past time for an upgrade

35:33

to the Medicare hospice benefit . This was a

35:35

Health Affairs article and

35:38

Quirt , as

35:40

the editor had a good note at the end and said many hospices

35:42

have used Jimmy Carter's one-year anniversary as

35:45

a marketing tool . That hospice is not really

35:47

for those on the brink of death .

36:41

Many , if not most , of those articles were not transparent

36:44

, identifying any type of recertification , decertification or

36:46

the revocation processes that make it was a great example of how horribly

36:49

human being to people that I mentor on writing

36:51

as to why everybody needs

36:53

a good editor and just because you have

36:55

an advanced degree in healthcare

36:57

or law doesn't make you a great

37:00

writer . I mean , some of the worst writing I've

37:02

ever seen has been in medical journals

37:04

and in legal briefs , and

37:07

there's a reason for that . But for

37:09

those people who flagged that article , take a look

37:11

at it and read it , not

37:14

as a hospice professional or a practicing

37:17

clinician , but read it as a human

37:19

being absorbing

37:23

the words and see if you can actually follow

37:25

the thing . It's

37:27

really bad . Sounds like a

37:29

good master class , great content

37:31

. You just can't get . You know , it's just a challenge

37:34

to work through it .

37:35

Yeah , that's really good , mark , sounds like a future master

37:37

class for you . Yeah , All right , so

37:39

just round out , this section proposed hospice rule

37:41

offers key quality improvement changes

37:43

experts offer , and

37:45

so this is all related to the 2025

37:48

hospice payment update . And then , last

37:50

again , mark was the original one to

37:52

bring this to my attention Hospital charity

37:54

care falls short of nonprofit

37:57

tax breaks and this was actually a modern healthcare

37:59

article . Next category

38:01

technology and innovations . And so

38:03

I think I had eight articles here . 30

38:05

systems sign on to the new effort to advance

38:08

age-friendly care . This actually

38:10

was like

38:12

a nationwide collaborative , basically , and

38:15

figuring out how to . This new collaborative through

38:17

the Institute for IHI , so Institute

38:19

for Healthcare Improvement , aims to accelerate

38:22

the adoption of age-friendly care

38:24

for older adults . Next article

38:26

VR off a smartphone Tech

38:29

breakthrough could allow seniors to do away with

38:31

clunky headsets . And just talking

38:33

about how VR and the application and

38:35

utilization by seniors and what that could actually

38:37

bring , there's a

38:39

friend of mine who's about ready to publish , or

38:41

has just published , a book about

38:43

the utilization of VR

38:46

in lieu of pain drugs and

38:48

actually have some really good data behind that . Next

38:50

, modern ultrasound tech . Benefits

38:52

extend from Alzheimer's to palliative care

38:55

. This is something that hit my radar screen almost

38:57

maybe eight years ago , but

38:59

putting an ultrasound in the hands

39:02

of a clinician in the field and

39:04

what that does , as opposed to just the old stethoscope

39:06

, you literally could look inside folks and

39:08

then how you could utilize that

39:11

. So that's a really great article . We're going to see a lot

39:13

more of that , I predict , in the future , and

39:15

then hopefully we could keep people out of the hospitals and

39:18

also in very , very high costs , you know

39:20

, bringing them in for cat scans and mris

39:22

etc . Telehealth , effective

39:25

in supporting rural caregivers , and

39:27

so you're all talking about better utilization

39:30

of telehealth . The USDA rural

39:32

development accepting application for grants

39:34

to fund high-speed internet and digital

39:36

equipment for rural and tribal

39:38

communities . If we

39:40

don't do that , there are a lot of the rural where you have so

39:42

many healthcare deserts , pharmacy

39:45

deserts , etc . And so getting that is going to allow

39:47

people to get high quality healthcare anywhere pharmacy deserts

39:49

, et cetera and so getting that is going to allow people to get high quality healthcare anywhere

39:51

. This is a good one , mark . The iconic stethoscope is getting a 21st

39:53

century makeover , and

39:56

really that's where the ultrasound , which to me

39:58

is brilliant marketing Like the stethoscope

40:01

is getting redesigned Effectively . It's

40:03

this ultrasound that they're putting in the hands of folks

40:05

. The FDA approves an AI

40:07

tool that could detect sepsis . Just

40:10

had a family member went through a situation

40:12

and so utilizing AI to detect

40:14

sepsis sooner and then last

40:16

in this section , palliative care could be a game

40:18

changer for public health . All right , my

40:21

next sections are much briefer . The speed

40:23

of change and resilience in reculture is

40:25

the section , and

40:27

then LensX , a

40:30

practical approach to taking care of your people

40:32

. This was in the Journal of Character and Leadership

40:34

Development . Kudos to Court and

40:37

David Levy , who Court is introducing

40:39

me to . I'm looking forward to going to have a conversation with him

40:41

. Good chance we're going to have him on the Anatomy of Leadership

40:44

podcast later this year . He's a professor

40:46

of management leadership at the US Air Force Academy

40:48

, and so talking about leadership

40:51

is about taking care of your people and

40:54

what that means in practice . It's

40:56

a really great article about leadership . Next

40:58

category , the human factor . I had

41:00

about three Longevity , why

41:03

we're all so focused on living longer

41:05

instead of living better . So

41:08

quality of life is what's being called out in that

41:10

one . This next one living to 100

41:12

, making Maryland a blue zone , and

41:15

so article about Marylanders and

41:17

how they're focused on some more blue zone communities

41:19

. And then last one in this section

41:21

, non-healthcare nuances

41:24

that defy simple criticisms

41:26

. Those who work in healthcare should be proud

41:28

of the distinct role we play in our communities and society

41:30

. Beyond all the numbers and details

41:32

, it's important to understand that healthcare is deeply human

41:35

and personal . We're all potential patients

41:37

and many of us have already been . And then

41:39

the article goes on for Dowling's

41:41

nine differences and distinctions , specifically

41:44

for nonprofit healthcare . All

41:47

right . And then my last one is just more of Chris's

41:49

catch-all . Just had two here . Home

41:51

healthcare market is projected by

41:53

2028 to be worth $383

41:56

billion . So obviously

41:58

care in the home is talking about

42:01

skill care , rehab therapy , hospice

42:03

powder care , respiratory therapy , infusion

42:05

therapy , in other words , all of those healthcare

42:07

services shifting into the home . And

42:10

then the last one . I alluded

42:12

to this earlier a popular healthcare

42:14

myth debunked . This

42:20

is paradoxical . This is Becker's article , mark it's . Many in the healthcare

42:22

industry assume rural hospitals are inherently worse off financially than

42:24

urban hospitals , but a Kaufman report refutes the financial

42:26

divide between rural and urban hospitals . This

42:29

is where it's interesting , right ? You just go with the headline

42:31

and actually have to read the article because

42:33

I'm like what ? This doesn't . Even this doesn't compute

42:35

. And so the firm found no

42:37

statistically

42:40

significant difference in average operating margin

42:42

and just basically goes on . But

42:44

yeah , if I've got a margin off

42:46

of $5 billion versus

42:49

300 , well , probably

42:52

more like 100 million or even 20 million

42:54

.

42:55

That's a big difference .

42:56

Whereas the cost of a hospital , well yeah

42:58

, maybe it might cost a lot more in metropolitan area

43:00

, but that's not the same ratio . So

43:04

I guess you're almost kind of saying , well , cutesy

43:07

, isn't this interesting , the margins are the same . I guess

43:09

you're almost kind of saying , well , cutesy , isn't this interesting , the margins are the

43:11

same . But this one really reminded me of what you pointed out about

43:13

the Hill-Burton and just what that meant

43:15

for communities . And when you've got margins on

43:18

such a smaller pool of dollars and you

43:20

can't reinvest in that physical plant , it really

43:22

makes it hard for those hospitals to stay in business

43:24

.

43:25

And it also matters whether the state has expanded

43:27

Medicaid .

43:28

Yes , quite a bit which . Yeah , all

43:31

right , mark . Well , that's it .

43:32

And it matters whether it happens

43:34

to be a rural area that has

43:37

commercial

43:39

industry , which means paying

43:42

patients with commercial insurance versus

43:44

being totally dependent on Medicaid

43:46

, if Medicaid's been expanded and Medicare

43:49

in a market . So there's a lot of variables there

43:52

. So , you're right , it

43:54

can make for a sexy headline , but you

43:56

know how much there is really there . So

44:12

I was . You know , I believe that the best hospice marketing

44:14

is storytelling , and so I was disappointed when you said that your mission moment

44:17

stories comprise 5% of the articles that you tabbed for this month . We really need

44:19

to do a better job on that , all

44:21

across the sector , for-profit

44:23

, not-for-profit , multi-site , sole site

44:26

, multi-site

44:33

, soul site , um , it's really we . We're in danger of losing the uh , that which makes hospice different , uh

44:35

, by failing to tell those stories , like the story about the woman in virginia

44:37

who craved , uh , the barbecue

44:39

from um , from north carolina

44:42

, um and I was very

44:44

well said yeah , and

44:46

I I did want to . The

44:48

the late career switchers article was

44:50

really interesting . Before I got into

44:52

health care I was in Miami . I was working in banking

44:55

. That was when both Pan Am and

44:57

Eastern Airlines went down and

45:00

Miami was the headquarters for both

45:02

and it had a huge economic

45:04

impact and there was some combination

45:06

of city , county , state and

45:08

federal funding that went into retraining

45:11

as many of those laid off

45:13

employees as was

45:15

possible . And several years later

45:17

I find myself at Jackson Memorial Hospital

45:20

and I'm working with the media

45:22

on a story regarding

45:24

a pediatric patient in the

45:26

pediatric ICU and

45:28

there was a husband and wife team of

45:31

middle-aged nurses working

45:33

the PICU at Jackson Memorial and

45:36

they were both former airline

45:38

flight attendants . One

45:40

was at Pan Am , one was at Eastern . They

45:42

figured that would keep the

45:45

family income safe and they both ended up

45:47

getting laid off , losing

45:49

their jobs and their employers within the space

45:51

of about 18 months and they both went

45:54

to retraining . They both decided that

45:56

it would be a natural , fit middle-aged

45:58

to go from a flight attendant

46:01

to nurse and they were both highly regarded

46:03

and highly respected nurses

46:06

in that unit and PICU is obviously

46:08

not the easiest nursing job

46:11

to do , both

46:13

in terms of the medical

46:15

challenges as well as the challenges

46:18

in supporting the patient and supporting

46:20

the family . So those programs

46:22

do exist . They've been proven to work

46:25

for 40 years and

46:27

I think in a lot of areas we've

46:29

probably taken our eye off the ball of some of that

46:31

. But healthcare all of

46:33

healthcare could probably do a better job

46:35

of advocating that

46:38

, when there are significant

46:40

industrial shifts , that healthcare

46:42

ought to be a welcoming next

46:46

stop for people in their career ladder .

46:49

Those are two incredible points , mark , I'm going

46:51

to with the interest of time . I want you to get to

46:53

your master's class , but those are two like

46:55

if I would , if I do a like

46:58

highlight exclamation point . Those last two points

47:00

are incredible . You want to take us to our master's

47:02

class ?

47:03

It's a little brief this month . Our

47:05

master class in the last couple of

47:07

months is focused on marketing , so

47:09

I thought it'd be good to pivot back to public and media

47:12

relations this month , chris , and

47:14

rather than do a deep dive on a single aspect

47:16

of hospice public and media relations , I'm

47:18

going to cover a couple of quick hits Tips

47:20

that used to be part of the standard public

47:23

relations playbook a generation

47:25

ago , when nearly every mid-size

47:27

and large-size hospice provider had

47:30

an experienced public relations staff

47:32

on board . But these things

47:34

have gotten somewhat lost as hospices

47:36

have had to downsize their communication

47:38

staffs , often collapsing public

47:40

relations under marketing development or

47:43

even human resources . As

47:45

local media in many markets have

47:47

decreased , often significantly , their

47:50

health care coverage , I find many hospices

47:52

have taken their eye off the ball . But

47:54

you never know when a reporter perhaps

47:56

a reporter from outside your immediate market

47:59

may come a calling . It could

48:01

be good news a roundup of every four

48:03

and five star provider in a state

48:05

, or every provider with an

48:07

inpatient care center or

48:10

a provider with a home-based palliative

48:12

care program . Or it could be bad news

48:14

a roundup of one and two star providers

48:16

in your state , or a lawsuit out

48:19

of left field from a whistleblower or

48:21

disgruntled employee . In

48:23

such an event , reporters

48:25

not familiar with your hospice need to know

48:27

how to quickly reach someone with

48:29

responsibility for media relations . So

48:32

take a look at your website and ask

48:34

and answer the following questions

48:36

Do you have a newsroom

48:39

tab on your website ? Is

48:41

it buried three layers down , or

48:44

does it have its own button or menu item

48:46

on your home page ? If it takes

48:48

a reporter more than one click to discover

48:50

how to contact someone when that

48:52

reporter has a question or is requesting a comment

48:56

, you're starting off on the wrong foot

48:58

with that reporter . Does

49:00

your newsroom page have up-to-date contact

49:03

information for whoever has frontline

49:05

responsibility for media relations

49:08

? And finally , is the about

49:10

us information on your website up to

49:12

date , because the reporter is going to scoop

49:14

that up and throw that in the story

49:16

if the reporter needs background . Even

49:19

those hospices with limited media relations

49:21

operations are still interested

49:23

to some degree in hospice coverage . That's

49:26

why they're listening to us every month , chris

49:28

. Hospice and palliative care today , of course , is the preeminent resource for all hospice coverage . That's why they're listening to us every month , chris . Hospice and palliative care today

49:30

, of course , is the preeminent resource

49:32

for all hospice decision

49:34

makers , thought leaders and the staff

49:36

who support them and the online

49:38

trade publications like Hospice News , home

49:40

Health Care News and McKnight's Home

49:42

Care Daily are both useful and

49:44

timely for media monitoring and

49:47

free . But many media

49:49

relations staff and even hospice leaders

49:51

do go above and beyond that . For

49:53

many , it's setting up a few news alerts

49:55

on a search engine like Google . When

49:57

I was producing hospice news today , I

50:00

had about 80 active searches on Google

50:02

that were executed throughout the day . Others

50:06

with a budget for news monitoring may have

50:08

the opportunity to engage a paid media

50:10

and web monitoring service like Session

50:13

, nexus , meltwater , talkwalker

50:16

and a handful of others . I

50:18

myself enjoyed Nexus access

50:20

for more than 30 years in my

50:22

career in healthcare public relations . But

50:24

regardless of how much or how little effort

50:27

one puts into media monitoring but

50:37

regardless of how much or how little effort one puts into media monitoring

50:40

you'll get much better results if you employ a tactic called Boolean logic searching instead

50:42

of using simple words and phrases . Boolean searching it's

50:45

spelled B , as in boy , o-o-l-e-a

50:48

, n as in Nancy . Boolean

50:51

allows you to dig deeper and receive much more focused results . It may sound scary , especially

50:53

with that word logic attached , but

50:55

you can master the basics . Really in about

50:57

15 to 30 minutes you can

50:59

do a search for something like quote

51:01

how to use Boolean logic , search unquote

51:04

on Google and find tons of

51:06

help online . Or you can ask

51:08

a librarian or someone with a library

51:10

sciences degree to lend you

51:13

a brief hand . It's well worth

51:15

the effort and will pay dividends

51:17

, with more productive results at

51:19

a fraction of the time required to sift

51:21

through the results that you get . That's

51:24

our master class for April , chris . Some

51:26

of the work I do as a communications consultant

51:28

involves mentoring and assisting

51:31

one person , hospice , public relations

51:33

and media relations staff . Anyone

51:35

looking for that kind of help is always welcome

51:37

to give me a call . I'd love to hear from

51:39

them .

51:40

Perfect , mark . Well , thank you , and I'd never even heard

51:42

of Boolean Logic Searches until you

51:45

and I did an extended play . It was probably well over

51:47

a year ago , it was probably a year and a half

51:49

ago , and then , lo and behold , one

51:51

of our incredible docs we worked with a long time

51:53

. His daughter had a library

51:55

science degree and we actually brought her into our team

51:58

and she actually did a training on Boolean logic

52:00

searches . So , thank you . We now have her

52:02

available as a contractor via

52:04

Telia . So if you need a class in that , reach out

52:06

to us and we now have a great resource . That's

52:09

great . Always a pleasure , mark , thank you

52:11

, and I love this quote because it really does

52:13

kind of show just the work that Mark and I are doing together

52:16

and we really appreciate the work that Court

52:18

and his team are doing now at Hospice and Palliative Care

52:20

today . And so to end our talk

52:22

, this is a George Elliott quote Great

52:25

things are not done by impulse , but they're

52:27

done by a series of small things

52:29

brought together . Thanks for listening

52:31

to TCN Talks .