In The News

Draft OASIS E-1 Manual and Instruments

The draft Guidance Manual for the OASIS-E1 version of the OASIS data set, effective January 1, 2025, is available in the Downloads section of the OASIS User Manuals | CMS page, www.cms.gov/medicare/quality/home-health/.... The draft OASIS-E1 Instruments (All Items and Time Points versions) are available in a zip file in the Downloads section of the OASIS Data Sets | CMS page. 

 

Why is Cancer Called Cancer? We Need to go Back to Greco-Roman Times for the Answer

The Conversation / By Konstantine Panegyres

One of the earliest descriptions of someone with cancer comes from the fourth century BC. Satyrus, tyrant of the city of Heracleia on the Black Sea, developed a cancer between his groin and scrotum. As the cancer spread, Satyrus had ever greater pains. He was unable to sleep and had convulsions.

Advanced cancers in that part of the body were regarded as inoperable, and there were no drugs strong enough to alleviate the agony. So doctors could do nothing. Eventually, the cancer took Satyrus' life at the age of 65.

Cancer was already well known in this period. A text written in the late fifth or early fourth century BC, called Diseases of Women, described how breast cancer develops:

"Hard growths form […] out of them hidden cancers develop […] pains shoot up from the patients' breasts to their throats, and around their shoulder blades […] such patients become thin through their whole body […] breathing decreases, the sense of smell is lost […]"

Other medical works of this period describe different sorts of cancers. A woman from the Greek city of Abdera died from a cancer of the chest; a man with throat cancer survived after his doctor burned away the tumor.

Where does the word 'cancer' come from?

The word cancer comes from the same era. In the late fifth and early fourth century BC, doctors were using the word karkinos—the ancient Greek word for crab—to describe malignant tumors. Later, when Latin-speaking doctors described the same disease, they used the Latin word for crab: cancer. So, the name stuck.

Even in ancient times, people wondered why doctors named the disease after an animal. One explanation was the crab is an aggressive animal, just as cancer can be an aggressive disease; another explanation was the crab can grip one part of a person's body with its claws and be difficult to remove, just as cancer can be difficult to remove once it has developed. Others thought it was because of the appearance of the tumor.

The physician Galen (129–216 AD) described breast cancer in his work A Method of Medicine to Glaucon, and compared the form of the tumor to the form of a crab:

"We have often seen in the breasts a tumor exactly like a crab. Just as that animal has feet on either side of its body, so too in this disease the veins of the unnatural swelling are stretched out on either side, creating a form similar to a crab."…

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‘This Battle Is Far From Over’: Federal Court Dismisses NAHC’s Lawsuit Against CMS

Home Health Care News / By Joyce Famakinwa 
 
Last summer, the National Association for Home Care & Hospice (NAHC) made waves when it filed a lawsuit against the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) over Medicare home health payment calculations.
 
Last week, a federal court in Washington D.C., dismissed NAHC’s lawsuit against CMS and HHS.
 
The lawsuit claimed that CMS and HHS utilized an “invalid” methodology to decide payment, and that recent home health payment cuts were unlawful. 
 
“The primary claim in our lawsuit is that the methodology violated the plain language of the Medicare law,” NAHC wrote in its latest report.
 
CMS implemented a 3.925% rate reduction for 2023, and a 2.89% one for 2024. 
 
On April 26, the U.S. District Court for the District of Columbia ruled that NAHC skipped an agency review process prior to suing. 
 
“The Court ruling addresses a combination of the NAHC arguments and the defenses presented by the U.S. Department of Justice on behalf of CMS,” NAHC wrote. “DOJ argued that the Court did not have the power to hear any challenges to the PDGM budget neutrality adjustment methodology, that NAHC failed to exhaust all administrative appeal steps, and that the challenged methodology was in compliance with the law.” 
 
Still, NAHC noted that the Court ruled in its favor on something it considers a crucial element of the case. 
 
“[The court rejected] DOJ’s argument that all judicial review was precluded on anything related to the PDGM system,” NAHC wrote. “The Court specifically held that NAHC could challenge the budget neutrality adjustment methodology once administrative remedies are exhausted. Of further note, the Court did not rule on or evaluate the merits of the NAHC claim that the methodology violated Medicare law.” 
 
Last year, the Biden administration asked a federal judge to throw out NAHC’s lawsuit against CMS and HHS. 
 
Looking ahead, NAHC is considering its next move. One of the things the organization is thinking about is appealing the court’s ruling on exhaustion of administrative appeals. 
Pursuing a request for expedited judicial review with CMS is also on the table. If a judicial review is expedited, NAHC plans to refine its lawsuit.
 
“The Court did not rule on the merits of NAHC’s claims that it had violated Medicare laws,” NAHC wrote. “As such, a lawsuit can be pursued once the administrative steps are completed.” 
 
Ultimately, NAHC President William A. Dombi believes that the lawsuit dismissal is a stumbling block, but one that the organization will prevail over. 
 
“We are disappointed with the court’s ruling. However, it is a minor setback that we can readily overcome,” Dombi said in the report. “Often justice delayed is justice denied. Here, we will have our day in court. This battle is far from over.”
 
In addition to his role as president, Dombi also served as legal counsel to NAHC.

 

Investigation Finds Home Care Agency Failed to Protect Visiting Nurse Who Died in Willimantic

NBC Connecticut / By Angela Fortuna

A federal investigation following the death of a Connecticut visiting nurse found that the home care agency she worked for did not provide enough safeguards to protect her.

The Department of Labor's Occupational Safety and Health Administration found that Elara Caring, one of the nation's largest home-based care providers, failed to protect Joyce Grayson, who was killed on Oct. 28, 2023.

Michael Reese, the man accused of killing Grayson, has been charged with murder. Grayson, a visiting nurse, had an appointment with Reese at his residence, a halfway house for sex offenders in Willimantic.

Around 2 p.m., Willimantic police received a call asking them to check on Grayson after she missed several patient appointments. The caller said Reese was Grayson’s first appointment of the day and there had been no contact with her since early that morning.

Police eventually found Grayson's body in the padlocked basement of the Chapman Street home, and they found her cell phone in a bucket of liquid in the bathtub, according to the arrest warrant.

Grayson died of compression of the neck and her death was ruled a homicide, according to authorities.

Federal OSHA officials found that on the day of Grayson's death, and at times prior, Elara Caring "exposed home healthcare employees to workplace violence from patients who exhibited aggressive behavior and were known to pose a risk to others."

Jordan Health Care Inc. and New England Home Care Inc., who both did business as Elara Caring, have been cited for willful violation under the agency's general duty clause, officials said.

Feds cited the home care agency for "not developing and implementing adequate measures to protect employees from the ongoing serious hazard of workplace violence." Elara Caring was also cited for not providing work-related injury and illness records to OSHA within four business hours, as required by law.

The home care agency will have to pay over $163,000 in proposed penalties…

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EEOC Releases Final Guidance on Workplace Harassment

SESCO Management

The U.S. Equal Employment Opportunity Commission (“EEOC”) has released its Enforcement Guidance on Harassment in the Workplace (the “Final Guidance”).

Guidance Clarifies the Scope of Sex Discrimination and Harassment.

The Final Guidance:

  • Clarifies that Title VII’s protections extend to LGBTQ employees. Specifically, it clarifies that workplace harassment includes “misgendering” employees or denying access to bathroom facilities that align with their gender identity.
  • Reminds employers that discrimination and harassment based on “sex” includes harassment based on pregnancy, childbirth, and “related medical conditions,” which include employees’ decisions related to contraception and abortion.

Guidance Addresses Harassment in a Remote Work Environment.

The Final Guidance:

  • Clarifies that conduct in a virtual work environment, including electronic communications using private phones, computers, or social media accounts can contribute to a hostile work environment if they impact the workplace. The EEOC states that, for example, an employee who is the subject of ethnic epithets posted on a coworker’s personal social media page could be subjected to a hostile work environment if the employee is directly exposed to the post or other coworkers see the post and discuss it at work.
  • Clarifies that conduct occurring outside the workplace, including on social media, which does not target the employer or its employees and is not brought into the workplace generally will not contribute to a hostile work environment.

Guidance Updates Anti-Harassment Policy Requirements.

The Final Guidance states that a harassment and discrimination policy should be widely disseminated, comprehensible to workers, and include:

  • A definition of the prohibited conduct;
  • A requirement that supervisors report harassment;
  • Multiple avenues for reporting harassment;
  • A statement that clearly identifies accessible points of contact for reporting purposes, including contact information; and
  • An explanation of the complaint process, including adequate anti-retaliation and confidentiality protections, and prompt and effective investigations and corrective action.

The Final Guidance also includes a “non-exhaustive” list of the elements of an effective training: an overview of the employer’s anti-harassment policy and complaint process; examples of prohibited harassment; information on rights for those who witness, experience, or report harassment; and clear instructions for supervisors and managers on how to prevent, identify, stop, report, and correct harassment.

If you are not a retainer client, [of SESCO Management] contact us to learn about our services by calling 423-764-4127 or click here.

 
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