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St. Louis was the only Missouri city on a list of 25 growth markets, ranking No. 11.

Some of Missouri’s animals’ last moments are spent in a gas chamber, suffocating in carbon dioxide – but a bill by Rep. Adam Schwadron, R-St. Charles, would bar shelters from using this type of euthanasia. “Humanely treating our animals in our shelters is something that’s very important for us in the state,” Schwadron said. “And […]

The post Missouri lawmaker works with Humane Society to stop use of gas to kill shelter animals appeared first on Missouri Independent.

A man convicted of murdering the son of a retired Saint Louis police officer was released this morning when the circuit attorney's office dismissed charges against him.

When corporate owners ditched New Orleans's bike share, the community stepped up to rebuild it with a focus on equity.

Newly translated into English and soon to be a Netflix film, "Stolen" is a powerful novel that explores an Indigenous community threatened by climate change, racism, and violence.

Matt LaMartina has fond memories of growing up, riding in the plumbing truck with his father, Tony LaMartina. “There were the smells and the sound it made as it’s going down the road, full of parts and equipment,” Matt LaMartina recalled. LaMartina said his father often would tell him: “This business is going to die with me.” That appeared to be the case for a decade or more, until Matt LaMartina pursued his Master of Business Administration degree at Washington University and decided…

At about 3:30 a.m. this morning, authorities discovered a single-car crash on Winnebago Street near South Grand.

How a little-known federal grant requirement could hinder climate resilience work.

Late Queen frontman Freddie Mercury would be turning 77 this fall if he were still alive, and a big party is planned in his honor.  The Official 77th Freddie Mercury Birthday Party 2023 is going…

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The local staffing industry is thriving. Revenue grew 24% from 2021 to 2022, driven by a national labor shortage. We sat down with recruiting and staffing experts to find out how your firm can best recruit and retain talent.

On the second day of camp in the Ozarks at Wah-Kon-Dah, all of us, all 8 years old, were marched off to the infirmary. We all lined up to be weighed. I was last.

Enjoy a mix of urban and natural landscapes while traveling via railway, an affordable and eco-friendly option for getting around.

A source told 5 On Your Side two kids had gotten hold of their grandfather's firearm and were playing with it when one accidentally shot the other.

The department has yet to implement a rule requiring its contractors to obey labor laws.

The ‘moderates’ who want a debt default: a case study in journalistic destruction of the meaning of words

by Ava Kofman

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

Last week, the four largest hospice trade associations jointly sent a detailed memo of policy proposals to the Centers for Medicare and Medicaid Services, which regulates the end-of-life care benefit. Their 34 recommendations, which span eight pages, directly address the alarming business practices outlined by a recent ProPublica-New Yorker investigation.

“The New Yorker-ProPublica investigation shook the industry to its foundation,” said Dr. Diane Meier, a geriatrician at New York’s Mount Sinai hospital and a leading authority on palliative care. “You have four major industry groups coming together, as they don’t always do, on a series of significant policy and regulatory changes for hospice. This suggests — contrary to public messages about this being just a few bad actors — that it’s not just a few bad actors. There are systemic problems with the lack of oversight and the profit motive.”

Industry leaders are not the only bloc pressuring CMS for greater hospice oversight. Senators and government watchdog agencies are also pushing the agency for concrete changes. Last week, the Government Accountability Office released a report asking that hospices be required to report observations of abuse and neglect, regardless of whether the alleged perpetrator works at the hospice. MedPAC, the congressional advisory panel on Medicare spending, has again endorsed modifying the hospice payment structure to reduce part of the financial incentive for enrolling ineligible patients. And in late December, the inspector general’s office at the Department of Health and Human Services announced that curbing the abuse of hospice patients was among its top unimplemented recommendations.

Drawing on state licensing records and federal data, our story highlighted how networks of entrepreneurs are propping up an alarming number of for-profit hospices in Nevada, Texas, Arizona and California. As part of their recommendations, the trade groups flag several specific ways that CMS could use its power to curb the “inappropriate” proliferation of hospice licenses, such as increasing the number of inspections for new providers, limiting Medicare hospice certifications in high-growth areas and cutting off funding to high-risk operators. ProPublica found that some of these new hospices improbably share staff, owners and addresses. These suspicious business practices, the trade organizations note, could be treated as red flags that would trigger prepayment scrutiny or billing audits.

“Providers don’t like surveys” — inspections — “and are usually not the ones to ask for more of them,” said Dr. Joan Teno, an expert on the industry and adjunct professor at the Brown University School of Public Health. “You’ll hear various entities paying lip service to reform, but what they’re saying here is that they want to fix the problem and offering specific recommendations for how to do so. It’s unusual and impressive.”

Among its proposals, the memo discusses the need to rein in predatory marketing schemes. ProPublica’s reporting found that profit-seeking providers can take advantage of the fact that many people don’t know what hospice is to recruit new patients who are not dying. Some hospice marketers — known in the industry as “community liaisons” or “community educators” — aggressively solicit new patients with promises of free housekeeping and trips to the beach and casino. Others treat physicians to cash bounties and bottle service at Las Vegas nightclubs to gin up referrals. The groups ask that CMS update its regulations to require hospices to develop policies on “ethical marketing practices.” (Such policies, they note, must prohibit kickbacks, disclose bonuses to marketers and mandate that hospices clearly explain the benefit to patients.)

ProPublica’s investigation pointed out that practically anyone can open a hospice. I came across hospices owned by vacation-rental superhosts, a man convicted of drug distribution and a criminal-defense attorney (who once represented a hospice employee convicted of fraud and was later investigated for hospice fraud himself). The trade associations have asked CMS to prohibit individuals with convictions for certain crimes from operating hospices and to require training and background checks for hospice administrators, noting that “unqualified or risky hospice leadership” could lead to fraud or poor quality of care.

It’s hard to require that hospice owners have appropriate qualifications, however, if the identity of those owners remains unknown. As private equity firms acquire an ever-greater share of the hospice market, many families have no way of untangling who actually operates their provider. This lack of transparency, the trade groups write, “makes accountability for poor performance difficult and makes it harder for patients and families to choose quality providers.” At the moment, it’s easier to research a hotel for your honeymoon than it is to research the hospice that will care for your loved one. But it doesn’t have to be this way: CMS could make hospices disclose their owners and major investors, the groups say. It could also revamp its Care Compare website — a sort of TripAdvisor for end-of-life care consumers — to prioritize quality metrics and make its data more accessible. In response to questions from a groundswell of readers in the wake of its reporting, ProPublica published a guide to help families research their provider and spot common signs of fraud. The trade groups propose that similar information be incorporated into the official Medicare handbook for hospice consumers.

Throughout the memo, the trade groups emphasize that CMS already has the authority to implement many of their suggested reforms. The next step, they say, is making sure the agency has the funding to actually carry out its essential oversight role. “Part of our plan is to offer support in advocating for the agency to have the resources it needs, and that’s part of our goal in sharing this with Congress,” said Mollie Gurian, a vice president at LeadingAge, an association of nonprofit eldercare providers, which co-authored the memo. Gurian and her peers in the field are in the process of scheduling a meeting with CMS, which did not respond to ProPublica’s request for comment. “We didn’t all come into these discussions with the same list, but we are all committed for hospice to be the special benefit that it is and we all agree that it is under threat,” Gurian said.

S.M. Wilson, Leadership Council promote; Kwame hires; Eberhard named CEO of Kids in the Middle; Atwell elected principal at Danna McKitrick

Among the compelling experiences of the Vietnam War, few St. Louis stories can compare to the intriguing tale of Howard Mechanic and his journey from activist to fugitive and from prison to freedom. It began nearly 53 years ago, reached a pinnacle 22 years ago today, and has a legacy that continues to resonate. An …

Continue reading "Activist to Fugitive: The Story of Howard Mechanic, Part 1"

Seth Daniels of Alton, IL joined the Real Rock Army today

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