Health care system adaptation and resilience during the wildfire crisis
JAMA Network; by Attila J. Hertelendy, PhD, Jeremy Maggin, MD, MS, and Gregory Ciottone, MD; 3/19/25 
... Within a span of hours, the Palisades and Eaton fires, propelled by record-breaking Santa Ana winds reaching 150 miles per hour, consumed more than 37,000 acres, destroyed more than 16,000 structures, and claimed 29 lives. All told, greater than 186,000 residents were placed under evacuation orders. ... The experience in Los Angeles County demonstrates the value of maintaining dual-purpose resources: facilities and personnel who can transition between routine operations and emergency response functions. This approach is exemplified by Kaiser Permanente’s successful deployment of mobile health vehicles and the use of clinically trained administrative leaders in direct patient care roles during crisis events. Key elements of successful resource mobilization include:

• Maintenance of readily convertible clinical resources;
• Integration of clinical professionals in leadership positions;
• Development of preestablished staff redistribution protocols; and
• Implementation of comprehensive employee support programs.

Editor's note: Click here for the full article. Examine and share this all-important guidance with your leadership teams. To evaluate your own Emergency Disaster Plan, click here for the CMS.gov Emergency Preparedness Rule. Click here for Wisconsin's CMS Emergency Preparedness Rule Toolkit: Hospices.

Hospice community responds to proposed DEA telehealth prescribing rule 
Hospice News; by Jim Parker; 3/20/25 
A proposed rule by the U.S. Drug Enforcement Administration (DEA) could impede timely access to medications for hospice and palliative care patients, according to members of the hospice community. ... If finalized, this proposed rule would require prescribers to register with the DEA before they are allowed to prescribe schedule II-V controlled substances, along with some monitoring and other requirements.  ... Implementation of the proposed rule would have adverse consequences for hospice and palliative care patients, according to the National Alliance for Care at Home. ... The Alliance made several recommendations to the DEA regarding the proposal: 

• Clarify that hospice physicians, nurse practitioners (NPs), and physician assistants (PAs) (collectively, hospice practitioners) are not subject to in-person medical evaluation requirements under the Ryan Haight Act when prescribing controlled substances to hospice patients.
• To avoid any ambiguity, the DEA should exempt hospice practitioners from in-person medical evaluation requirements under the Ryan Haight Act.
• [Click here for eight more recommendations.]

Editor's note: Additionally, pair this with the other side of the coin--opioid drug diversion--for which home hospice care is especially susceptible. Both access and restrictions have purposes for safe, compassionate outcomes. Both access and restrictions have high risks for tragic outcomes. Examine The Alliance's recommendations. Related, click here for my Editor's note about hospice drug disposal and/or diversion: Policies and Procedures, staff education and accountability, and more.

If you’re known for these 5 habits, your leadership skills are off the charts 
Inc.; by Marcel Schwantes; 3/19/25 
In an era of constant disruption, every leader should aspire to have these skills and habits. Business is more unpredictable than ever, and it’s hitting leaders hard. More than half (57 percent) of executives say their companies faced serious disruption last year—way up from the year before. Employees are also checking out—engagement is at a 10-year low. The old way of leading, where authority and expertise ruled, isn’t cutting it anymore. The best leaders today aren’t just the smartest or most experienced—they’re the ones who know how to build trust, bring people together, and lead with confidence and compassion. ... Five power skills of essential leadership: ...

1. Suspend self-interest ...
2. Master curiosity and context ...
3. Build psychological safety ...
4. Stay emotionally agile ...
5. Make excellence a habit ...

10 things hospice doesn’t tell you, shared by a Cleveland Clinic doctor 
The Healthy; by Patricia Varacallo, DO (author) with Laura Hoeksema, MD, MPH, FAAHPM (medical director for Cleveland Clinic Hospice); 3/19/25 
... Dr. Hoeksema shares key insights about hospice care and reminds patients and families that the hospice team is always available to answer questions and provide support when things feel uncertain.
What hospice does not tell you, but you should know:

1. Hospice isn’t just for people who are actively dying ...
2. Families receive support, too ...
3. Hospice care can happen in different settings ...
4. Hospice may offer more than just medical care ...
5. Hospice nurses may not be there 24/7 ...
6. Additional costs involved ...
7. Certain treatments and tests may be limited ...
8. Hospice care doesn’t speed up death ...
9. You can leave hospice if you change your mind ...
10. Hospice care may not be available everywhere ...

‘Dying people are incredible teachers’: Hospice nurse leans on personal loss experience to speak about end of life, write children’s books 
Dayton Daily News, Dayton, OH; by Beth Anspach; 3/20/25 
Kim Vesey has experienced more than her share of loss. Her husband, Les, passed away in 2006 of colon cancer. “He died at home with Hospice care,” Vesey said. “Having worked in this area and experiencing it myself, this took it all to a much deeper level and changed my understanding of the process of grief.” ... She was hired for her first Hospice job in 1985. “It’s taught me a lot about life and living and what is important,” she said. “Dying people are incredible teachers.” ... After losing her husband, Vesey continued her work in Hospice care. Then in 2017, her daughter Sarah, who had struggled with severe asthma her entire life, passed away after going into cardiac arrest. She was just 29 years old and left behind a 4-year-old son, Warren. She was also pregnant with her second child. “My experience of losing my daughter shined a light on the struggle for children who are grieving,” Vesey said.“ ... Today, Vesey has published four children's books with two additional scheduled to be published this year, including a book about losing a beloved pet. ...

How our partnership with LovEvolve fosters the message of compassionate care 
Carolina Caring, Newton, NC; 3/20/25 
... Founded and designed by professional artist Sunny Goode, LovEvolve is a mission-driven organization producing scarves, blankets, and swaddles which hold creative attention to color theory and the message of love. ... LovEvolve has distributed their products across thirteen hospitals nationwide, allowing over 61,000 newborns to be wrapped in love. ... Cardinal Kids [Carolina Caring's pediatric palliative medicine and hospice program] began distributing LovEvolve blankets and swaddles to our hospice patients in December 2024. Though these items are a recent addition to our story, families have already shared that these gifts bring lasting meaning to their hospice experience. These blankets are memory makers, reminding families of the impact that their child has had on this world. Sometimes, parents use the blankets whenever they spend the night with their children at the hospice house. The blankets have also been regifted to siblings as a tangible reminder of their brother or sister. The visual cue of love has been a source of peace for many of our Pediatric nurses, as well.

‘Early discussions on what to expect can lessen the strain’ 
Nursing Times; by Kylie Chaffin; 3/19/25 
The article explains the pros and cons of nutrition and hydration at end of life and the several types of artificial nutrition and hydration that can be used, written in a way patients and families can understand. Resources and educational articles, like this one, can also be a great way to introduce new or even more effective ways nurses and care team members can support patients and families when pursuing a palliative approach to their health and wellbeing. My question for readers is, “Should the conversation of end-of-life, hospice and palliative care, and nutritional changes, be initiated sooner rather than later in patients with a terminal diagnosis?”
Editor's note: Click here for a family education video, "Small Words - Big Meanings: EAT," from the caregiver/family video library Family Support Through Serious Illness by Composing Life Out of Loss (newsletter sponsor).

RFK Jr. continues Opioid Crisis PHE into its eighth year 
Inside Health Policy; by Dorothy Mills-Gregg; 3/19/25 
HHS Secretary Robert F. Kennedy Jr. recently renewed the department’s longest ongoing public health emergency (PHE) first declared under the first Trump administration: the opioid abuse crisis. While the Centers for Disease Control and Prevention found a 25.5% decrease in overdose deaths in 2024 compared to the previous year, HHS says the opioid PHE needs to be renewed for another 90 days so federal coordination efforts can continue and key flexibilities for HHS will be preserved.
Editor's note: How recently have you reviewed your Policies & Procedures for destroying drugs in the patient's home, upon death--in accordance with your state laws? For staff education and accountability about medication reconciliation, drug diversion, and disposal? For communicating these with families? For assessing possible drug diversion of opioids, with appropriate follow-up actions? Additionally, numerous hospice bereavement programs have been flooded with grief needs of community bereaved family members from opioid deaths. Click here for the U.S. Department of Justice's Drug Enforcement Administration - Diversion Control Division; more focused, scroll down to their "Home Disposal Methods."

Delaware House passes end-of-life option bill for terminally ill adults 
ABC Action News 6, Dover, DE; by 6abc Digital Staff; 3/20/25 
Currently, medical aid for euthanasia is legal in 10 U.S. states and the District of Columbia. Delaware's House of Representatives has passed a bill giving some terminally ill residents the right to take their life. The bill allows mentally capable adult residents, who have been given a prognosis of six months or less to live, the option to request and obtain life-ending medication. The bill now heads to the Senate. ... Now, for the 10th time, Delaware lawmakers are trying once again to get the bill passed. ... Governor Matt Meyer has signaled his support if the bill passes the Senate,  ...

Hosparus Health hosts senior resource fair for community 
NBC WNKY News 40, Bowling Green, KY; by Noah Faerber; 3/18/25 
Hosparus Health invited partners from the community to WKU’s Medical Science Complex for a senior resource summit. It offered seniors a chance to speak with different organizations that can help them prepare for their future. From Bowling Green Parks & Rec’s fitness department to different healthcare groups, staff were excited to have so many groups out to help look toward what’s next.

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe 
GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe 
Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

[Australia] Advance care planning has brought 'comfort and peace' to Annaliese Holland 
ABC News; by Eva Blandis and Daniel Keane; 3/19/25
Young South Australian woman Annaliese Holland, who is preparing for major high-risk surgery, has spoken about the importance of advance care planning. The 25-year-old was diagnosed with a rare autoimmune disease and terminal illness several years ago. Ms. Holland wants young people to have more open conversations about death and end-of-life care. ... "I say my life is like walking on a field of landmines, not knowing when it will go off,"  she said. While it is a harrowing statement, she is harnessing her situation to help others — Ms. Holland is a strong supporter of advance care planning.

Executive Personnel Changes - 3/21/25

• Dartmouth Health's Visiting Nurse and Hospice for Vermont announced Tammy L. Tarsa as their new interim CEO and President. She is replacing Johanna Beliveau, who served as VNH's CEO since June 2018.
• Providence has appointed Dherodeep Goswami as its new Chief Information Officer, effective May 12.

Social Media Watch 3/21/25

• National Alliance for Care at Home: Watch Empath Health CEO Jonathan Fleece on 3/11/25, testify before the House Ways and Means Health Subcommittee hearing.
• Tracy Romanello: Palliative care is widely underutilized in nursing homes.
• Meg Pekarske: There has been a lot of buzz around psychedelics, and particularly their potential usefulness in treating existential suffering at the end of life.
• Jennifer Kennedy: Great blog from Elizabeth Hogue - OIG's revised nursing facility complicance guidance: Takeaways for hospices.
• Illinois Hospice & Palliative Care Organization: Ellen Byrne, IL-HPCO’s Director of Policy and Government Affairs with State Rep Nicolle Grasse at the Illinois State Capital today. Ellen gave testimony in support of 2 of IL-HPCO priority bills – HB1712 and HB2877...
• Jane Moore reposted Jennifer Kennedy: It's all things survey deficiencies. Kim Skehan and I discuss CHAP's 2024 top 10 survey deficiencies for hospice and home health in these two special CHAPcast episodes.

I hope your decisions in life turn out better than your March Madness bracket! ~ Unknown
Download and print the NCAA Men's Bracket and the NCAAW Women's Bracket.