GeriPal Live! at NPCRC Foley Retreat: Dio Kavalieratos, Prasanna Ananth, Alexi Wright
GeriPal podcast; by Eric Widera, Alex Smith, Dio Kavalieratos, Prasanna Ananth, Alexi Wright; 10/16/25
Today we join you from beautiful Banff, Alberta, Canada at the National Palliative Care Research Center (NPCRC) annual Kathleen Foley retreat... On today’s podcast, we invited Dio Kavalieratos, Prasanna Ananth, and Alexi Wright to join us to talk about three articles that spoke to them. Prasanna chose an article by Abby Rosenberg about being fired in palliative care... Dio chose an article about the economic benefits of palliative care internationally, a call to action... Alexi chose an article about cancer care in prison.

[England] Ambulance team uses advanced ultrasound to help frail patients avoid hospital trips 
Emergency Services Times; by James Devonshire; 10/16/25 
The East of England Ambulance Service (EEAST) is using cutting-edge medical technology to help elderly and end-of-life care patients receive treatment in their own homes, reducing the need for hospital admissions. The service’s advanced practice (urgent care) team has introduced point of care ultrasound (POCUS)—a portable diagnostic tool previously reserved for critically ill patients—to assess bladder and urinary conditions safely and effectively in community settings. Using the handheld Butterfly ultrasound device, paramedics can perform scans and interpret results via software on iPads, allowing for faster and more accurate diagnoses.

National Hospice Locator – Sixth quality score update
Hospice Analytics blog; by Cordt T. Kassner; 10/14/25
Based on feedback from hospice leaders nationwide, the sixth update of the hospice quality score calculation was uploaded on October 14, 2025. Launched in 2012, the National Hospice Locator helps individuals find hospice providers in their area and now averages 15,000+ monthly visits and searches. Beginning in 2023, the default sort order changed to prioritize quality scores, offering a more meaningful measure of excellence. This marks the first (and only) publicly available national ranking of all hospices by quality. Notably, nine hospices achieved a perfect score of 100 in this update. Congratulations:

1. Avow Hospice, FL
2. Hospice of Central Ohio, OH
3. Brite Health Services, TX
4. Alpha Omega Hospice, TX
5. Frontier Hospice, OK
6. Angels Grace Hospice, IL
7. Hospice of Lenawee, MI
8. Hospice of Miami County, OH
9. AseraCare Hospice, NE

Hospice quality matters - and the time is now.

Traumatic brain injury in late life tied to elevated dementia risk 
Medscape; by Liz Scherer; 10/13/25 
Traumatic brain injury (TBI) in late life is associated with a significant increase in the risk for new-onset dementia. The risk is especially elevated (by as much as 69%) within the first 5 years following the injury, according to newly published study findings. Though TBI, which results from direct impact or indirect force to the head, has long been recognized as a midlife risk factor for dementia, the risk that TBI poses in adults aged 65 years or older has been unclear.
Editor's Notes: Pair this with the article we recently posted, "Why are more older people dying after falls?"

GeriPal Live! at CAPC: Karen Bullock, Kim Curseen, Matt Gonzales
GeriPal podcast; by Eric Widera, Alex Smith, Karen Bullock, Kim Curseen, Matt Gonzales; 10/9/25
Eric and I had the pleasure of doing a GeriPal Live! Podcast as the closing keynote for the recent Center to Advance Palliative Care (CAPC) National Assembly in Philadelphia PA. For this podcast, we invited 3 guests to each select an article of interest to them, and engage in a discussion about the article, including questions from the CAPC attendees in the audience. Matt Gonzales used AI to select an article by Ravi Parikh on algorithm based nudges to default patients with advanced cancer into a palliative care consult... Kim Curseen selected an article by Harry Han in JPSM that surveyed palliative care fellowships... Karen Bullock selected a letter she first authored in response to Ira Byock’s white paper on a path forward in hospice and palliative care.

How Optum’s Amedisys deal could shake up the hospice market
Hospice News; by Jim Parker; 10/21/25
The acquisition of the home health and hospice provider Amedisys by the insurance mammoth UnitedHealth Group (NYSE: UNH) has far-reaching implications for the hospice community. The UnitedHealth Group subsidiary Optum, in June 2023 inked its agreement to acquire Amedisys in an all-cash transaction of $101 per share, or about $3.3 billion. After leaping a series of regulatory hurdles, including a U.S. Justice Department lawsuit, the deal closed in mid-August... The merger likely makes UnitedHealth Group one of the largest hospice providers in the United States.

Driving sales and admissions success in hospice care
Transcend Strategy Group; 10/13/25
Behind every referral, every admission and every family supported by hospice care is a story. It is the story of providers working against the clock, of families making overwhelming choices, and of staff navigating the delicate balance between operational realities and the urgent need for compassionate care. Hospice admissions and sales are not merely about numbers or processes – they represent moments when trust, urgency and compassion converge.

From mom-care to action: Identifying the crises in eldercare 
Minnesota Women's Press; by Amy Gage; 10/15/25 
“I didn’t set out to write a book,” author Judy Karofsky said. ... “My mom was my inspiration.” ... DisElderly Conduct: The Flawed Business of Assisted Living and Hospice (New Village Press, 2025) ... began as a notebook of jokes and one-liners that her mom would toss off during their time together. A one-time amateur comedienne, Lillian Deutsch “was an amazing personality,” Karofsky says. DisElderly Conduct walks readers through Karofsky’s journey through six assisted living facilities and eventual hospice care before her mother’s death in 2018. Several themes emerge in the well-researched book:

• Unlike nursing homes, assisted living facilities lack federal regulation.
• Facilities are marketed to downsizing retirees — and desperate, grieving family members — as more homelike, active environments than they have the staff or resources to be.

Hospice, as compassionate as the concept sounds, “is a business, with a bottom line,” Karofsky says. Its strict requirements for Medicare coverage include the expectation that a patient will die within six months.

Survey update during government shutdown - REVISED Guidance, 10/21/2025
CHAP blog; 10/21/25
CMS posted and update to the memo, Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown (QSO- 26-01-ALL-Revised) on 10/21/2025 that provides updates to state survey activity during the ongoing federal government shutdown. The revised guidance appears in red text. CMS has instructed CHAP that our survey activity is unaffected, and we will conduct our survey accreditation business as usual.

[UK] Use of HidraWear in a malignant fungating wound at end of life: A case study
Wounds UK; by Alison Schofield; 9/25
Malignant wounds are a devastating complication associated with cancer, which are challenging to manage and can be distressing for patients, family members and healthcare professionals (HCPs). Management of malignant wounds can differ significantly from that of any other wound type, particularly as they often occur at end of life. Increased awareness and communication around this difficult wound type is needed, including case studies and sharing of HCPs’ experiences. This case study describes the treatment of an end-of-life patient in a hospice setting, with a challenging malignant fungating wound (MFW). This case highlights the importance of palliative symptom management and the benefits of using HidraWear in practice.

10 health systems most cited by AI
Becker's Health IT; by Giles Bruce; 10/9/25 
AI chatbots are increasingly citing health system websites in their answers to healthcare-related questions. But which organizations show up the most in these AI-generated responses? Marketing agency Outcomes Rocket analyzed 5,472 unique citations in August generated by ChatGPT, Google Gemini, Claude and Perplexity. Here is where U.S. health systems ranked among the most popular sources, according to the September report and data shared with Becker’s:

2. Cleveland Clinic
3. Mayo Clinic (Rochester, Minn.)
7. Johns Hopkins Medicine (Baltimore)
28. Nemours Children’s Health (Jacksonville, Fla.)
57. Mount Sinai Health System (New York City)

Size of the financial incentives in Medicare’s Skilled Nursing Facility Value-Based Purchasing Program
JAMA Network Open; by Robert E. Burke, Franya Hutchins, Jonathan Heintz, Syama R. Patel, Scott Appel, Julie Norman, Atul Gupta, Liam Rose, Rachel M. Werner; 9/25
The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program seeks to reduce all-cause 30-day readmissions from SNF for traditional Medicare beneficiaries recently discharged from the hospital. Under SNF VBP, most SNFs receive a financial bonus or penalty up to 2% of their total traditional Medicare revenues each year, on the basis of their performance on 30-day readmission rates compared with other SNFs, or their own improvement in readmission rates over time. In this cohort study, we found that the size of the financial incentives at the SNF level are relatively small in terms of dollars and as a proportion of net operating income, and that most SNFs experienced substantial variability from year to year in their incentive payments. These 2 factors may have contributed to the relative lack of effectiveness of the SNF VBP program. First, if the level of the penalty is not sufficient to hire additional staff, purchase equipment (such as an x-ray machine or laboratory testing), or invest in new care processes, then SNFs will not be able to improve their ability to manage changes in patient condition. 

"How lucky we are," said Pooh, "to have friends who make goodbyes so very hard. For it means our time together has been something worth keeping."