In the News

Public Health Emergency Resource Update

On January 30, 2023, the Biden-Harris Administration announced its intent to end the national emergency and public health emergency (PHE) declarations related to the COVID-19 pandemic on May 11, 2023. The Centers for Medicare & Medicaid Services has resources available to help you prepare for the end of the PHE, some of which have been updated based on recent action by Congress.

On December 29, 2022, H.R. 2716, the Consolidated Appropriations Act (CAA) for Fiscal Year 2023 was signed into law. This legislation included an extension of the major telehealth waivers and the Acute Hospital Care at Home (AHCaH) individual waiver that were initiated during the PHE.

We will continue to execute the process of a smooth operational wind down of the flexibilities enabled by the COVID-19 emergency declarations. The following materials reflect recent changes and are currently available on the CMS Emergencies Page:

Updates will continue to be provided as we approach the end of the PHE. We encourage you to regularly visit the CMS Emergencies Page for the most up to date information.


Study: Most Patients are Getting Small Doses of Rehab Therapy After Stroke

News Medical Life Sciences | By Emily Henderson, B.Sc.

Many patients don't receive much rehabilitation therapy following a stroke, despite strong evidence that higher amounts can reduce long-term disability, according to a new UCLA-led study that tracked over 500 patients across 28 acute care hospitals in their first year following a stroke.

The new research, published in the peer-reviewed journal Stroke, is the first U.S.-wide study to find that patients who had more severe strokes received higher amounts of rehabilitation therapy, a welcome finding. "But in the bigger picture, the findings reinforce that too many patients are missing out on a golden opportunity to maximize recovery during a critical period following a stroke," said the study's lead author, Steven Cramer, MD. Stroke is a leading cause of long-term disability in the United State and can affect speech, memory, and mobility, among other impairments.

Among the study's key findings:

  • Many patients tracked in this study did not receive any rehabilitation therapy after their stroke. After three months, about one-third of patients had not received physical therapy, almost half had not received occupational therapy, and over 6 in 10 did not receive speech therapy.
  • Those who did receive rehabilitation therapy typically had six to eight sessions by three months after their stroke – and between 0 and 1.5 sessions the rest of the year.
  • Where patients were sent following hospitalization also mattered. Those who were discharged home had the lowest levels of rehabilitation therapy, regardless of the severity of their stroke.
  • Hispanic patients received disproportionately lower amounts of physical therapy and occupational therapy.

Cramer said it is important for future research to examine the feasibility of providing higher therapy doses to stroke patients.


Video Games Might be Better for Balance Rehab than Conventional Physical Therapy

MedicalXpress | By Cody Mello-Klein, Northeastern University

Don't throw away that Wii Fit Balance Board––it might be more valuable than you think. New research from a team at Northeastern University found that active video games––like Wii Fit and Dance Dance Revolution––are more effective for improving balance than conventional forms of physical therapy.

Led by Amy Lu, associate professor of communication studies at Northeastern, the team of researchers conducted a comprehensive review and meta analysis of thousands of studies focused on active video games. After narrowing their focus to a few hundred, they grouped the studies into different categories based on what they were measuring, from  to cognitive outcomes. The research on balance is just one of a series of papers the team has written based on their work.

"Personally speaking, I don't think active video games themselves can replace outdoor physical activities like soccer or basketball," Lu says. "It's a good alternative, however, in [this research], we have basically found that compared to those conventional treatments, active games actually work better."

Dagmar Sternad, university distinguished professor of biology at Northeastern who Lu recruited based on her expertise in balance, says, even looking conservatively, the findings indicate that "this automatized and supposedly more motivating and fun way of play and practice is at least as good as conventional training."

The findings are significant, especially in a field that can have lifesaving implications. Sternad says postural balance and falling are, even in healthy people, some of the "main risk factors that lead to immobility and then eventually mortality."

"Even for a 60-year-old woman falling with weak bones, if there is a fracture, the fracture confines her to be less mobile for three months," Sternad says. "Reduced mobility has an effect on overall health, and it's a downward slope."

In studies conducted so far, researchers found that active video games mainly benefit healthy people without . Lu says it's indicative of how much more difficult balance work is for people with neurological conditions like multiple sclerosis, Parkinson's disease or cerebral palsy.

In looking at more than 100 studies, Lu and her team also found that active video game treatment had the greatest effect on children, followed by . Lu hopes these findings can send a signal to the games industry, which has historically not marketed or designed to older adults.

"They really liked it and could benefit a lot from it, so just imagine if we actually are going to be able to switch some of the focus of the population to older adults," Lu says. "Probably we're going to see a lot more public health benefits for this population."

As for why active video games are so effective, Lu says they are, by design, more engaging and motivating than conventional forms of physical therapy. The Wii Fit Balance Board is not too different from traditional balance boards that are used in physical therapy. But the way Nintendo has designed the experience to gamify physical activity––a physical action leads to feedback in the game that helps you achieve a goal both in the game and in real life––can make it more engaging.

"It's really giving you this kind of immediate pleasurable feedback in real time based on your input," Lu says. "Gamification and game companies have done a lot of research on how to make this reward feel very satisfactory. Then, on top of that, I also feel that in terms of the design of the devices, over the years from Wii to [Microsoft] Kinect to VR, one of the things I feel the companies have been dedicating themselves to is to make this interactive process very effortless and smooth."

Sternad says the implications of these findings go beyond the games industry. She says the wider medical field could benefit from using active video games as another tool in the toolkit for physical therapy. In a field that is starting to explore physical distanced forms physical therapy, video games could be a boon for patients.

"Yes, you can provide [patients] with , you can provide people with physical therapy, but all of that has huge downsides," Sternad says. "Physical therapy is expensive. How do people get to the physical  office, if you think of more rural populations? You need a caregiver, a partner who drives you there."

"The opportunity such  [provide] to have some kind of fun way to practice at home, self-guided, is huge," she adds. "If doctors feel there is scientific support to tell them to do this––maybe even insurance paying for such platforms––that would be a step in a good direction."

The research is published in the journal Archives of Physical Medicine and Rehabilitation.


Biden Gives Nod to Home Care in State of the Union Address

McKnight’s Home Care / By Liza Berger

Providers and aging services advocates praised President Biden for expressing support for home care and family caregivers in his State of the Union address on Tuesday night.
“The president was right to support the workforce needed to care for older adults who choose to remain in their homes as they age, and to highlight the need to provide relief for millions of family caregivers,” Terry Fulmer, PhD, RN, president of the The John A. Hartford Foundation, said in a statement Wednesday.
In his address delivered before Congress, Biden mentioned the need to grow home- and community-based services and give relief to family caregivers.
“Let’s get seniors who want to stay in their homes the care they need to do so,” Biden said. “Give more breathing room to millions of family caregivers looking after their loved ones. Pass my plan so we get seniors and people with disabilities the services they need.” 
With the end of the public health emergency approaching, the government must ensure that older adults, their families and professional caregivers receive the support they need, Katie Smith Sloan, president and CEO of LeadingAge, commented in a statement directly after the speech.
Read Full Article


2023 Home-Based Care Outlook Survey

Home Health Care News

Challenges persist, but participants of the Home-Based Care Outlook 2023 survey are largely optimistic about the future of the industry despite staffing and payment hurdles ahead.

HHCN is pleased to share the results of our Home-Based Care Outlook 2023 survey revealing how providers are:

  • Overcoming staffing challenges
  • Approaching growth
  • Investing in technology
  • Navigating the final payment rule for CY 2023
  • And more!

See Attached Report

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