Literature Review

Walgreens sells to private equity firm Sycamore Partners Healthcare Brew - Pharma; by Nicole Ortiz; 3/11/25 Since December, rumors have floated around that Walgreens was going to be acquired by private equity (PE) firm Sycamore Partners. And while analysts told Healthcare Brew at the time that it was unlikely to happen, the tides appear to have turned in the PE company’s favor. On March 6, Walgreens Boots Alliance announced in a press release that it had signed a definitive purchase agreement with Sycamore for up to $23.7 billion. However, when Walgreens’s debts and assets to be potentially divested are taken out, the total sale price is actually closer to around $10 billion, per the ll Street Journal, turning the retailer into a private entity after nearly a century as a public company.

748 hospitals at risk of closure, state by state Becker's Hospital CFO Report; by Molly Gamble; 3/6/25 Nearly 750 rural U.S. hospitals are at risk of closure due to financial problems, with nearly half of those hospitals at immediate risk of closure. The count of 748 at-risk rural hospitals comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS' most recent hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with 11 states having a majority of their rural hospitals in jeopardy. [Click on the title's link for the list.]Editor's note: On July 5, 2024, we posted from the same source (Becker's Hospital CFO Report) that "Since January 2005, 192 rural hospitals have closed or converted ... Of those hospitals, 105 have completely closed, and 87 have converted, meaning the facilities no longer provide inpatient services, but continue to provide some services, such as primary care, skilled nursing care or long-term care. Since 2020, 36 hospitals have closed or converted. Find the list here. This jump in number since July 2024 is both dramatic and traumatic for our rural communities.

Alliance Member, Jonathan Fleece, testifies before Congress on the value of care at home National Alliance for Care at Home, Washington, DC and Alexandria, VA; Press Release; 3/11/25 The National Alliance for Care at Home (the Alliance) released the following statement at the conclusion of a hearing conducted by the House Ways & Means Subcommittee on Health on After the Hospital: Ensuring Access to Quality Post-Acute Care:"The Alliance thanks Chairman Vern Buchanan (R-FL), Ranking Member Lloyd Doggett (D-TX), and all members of the Health Subcommittee for convening this important discussion on post-acute care,” said Dr. Steve Landers, CEO of the Alliance. “This hearing provided an opportunity to amplify the voices of home health and hospice providers and reinforce the essential role they play in delivering high-quality, patient-centered care in the setting people prefer—at home. “We are especially grateful to Jonathan Fleece, CEO of Empath Health, for sharing his expertise and for his service on behalf of patients and families. ... As our nation’s population rapidly ages, it is more critical than ever to get these policies right and ensure that home health and hospice remain accessible and protected from harmful cuts and unnecessary administrative burdens. ..." [Click on the link's title for more, including the full committee hearing testimony.]

My wrinkles show I laughed,My gray hair shows I cared,My scars show I lived, andMy belly shows I really like snacks.

[Canada] Use of feeding tubes among hospitalized older adults with dementiaJAMA Network Open; Anne-Marie Hartford, MSc; Wenshan Li, PhD; Danial Qureshi, MSc; Robert Talarico, MSc; Stephen G. Fung, MPH; Shirley H. Bush, MBBS; Genevieve Casey, MSc, MBBS; Sarina R. Isenberg, MA, PhD; Colleen Webber, PhD; Peter Tanuseputro, MHSc, MD; 2/25In this cohort study of hospitalized individuals with dementia, feeding tube insertion was not associated with improved survival or postdischarge outcomes. Being male or younger and having swallowing problems and greater functional impairments were associated with increased odds of feeding tube use, while having a do-not-resuscitate directive and living in rural settings were associated with reduced odds. Factors that were (or were not) associated with feeding tube placement were sometimes misaligned with best practice guidelines. Goals of care conversations, alternative intervention options, and improved clinical protocols are recommended. 

[UK] Exploring the challenges experienced by patients and families using palliative and end-of-life care services: A qualitative focus group studyPalliative and Supportive Care; Gina Kallis, Gary Hodge, Hannah Wheat, Tomasina M Oh, Susie Pearce; 3/25In the UK, access to dignified and compassionate palliative care is increasingly being reported as inadequate. A range of challenges were identified at different stages of the patient and family carer journey near the end-of-life. These included issues related to the delivery of care, such as communication challenges, a lack of out of hours care, and also a lack of personalized care. Patients and families also experienced everyday challenges due to the impact of living with a life-shortening condition and altered family dynamics as family members became carers. There were also some traumatic experiences of death and a sense of abandonment when care could not be accessed. 

Understanding and addressing the US hospital bed shortage—Build, Baby, BuildJAMA Network Open; Alexander T. Janke, MD, MHS, MSc; Arjun K. Venkatesh, MD, MBA, MHS; 2/25In the study by Leuchter et al, they provide simple yet provocative projections for the future of hospital care. They project that national hospital occupancy will exceed 85% by 2032, a critical threshold where basic hospital operations can become dysfunctional and even unsafe. Leuchter et al begin to quantify the story already felt at the bedside in hospitals across the nation—namely, a trajectory toward inadequate supply of hospital care for the anticipated demand of the coming decade. US residents are older and more medically complex than ever. Technologically sophisticated surgical interventions and medical therapies have transformed the long-term survival rates for serious conditions, such as end-stage kidney disease, heart failure, and chronic obstructive lung disease. The US needs greater hospital bed capacity, particularly for critical care and complex care services.

Palliative care nurse specialists' perspectives on spiritual care at end of life-A scoping reviewJournal of Hospice and Palliative Nursing; Bronagh Dunning, Michael Connolly, Fiona Timmins; 3/25The research demonstrates that specialist palliative care nurses perceive spiritual care as an important element of holistic care at end of life; however, these nurses also agree that spiritual care is lacking. This deficiency results from a lack of education in spirituality; experience of the nurse; the nurses' own spiritual and religious beliefs and values, fears, and difficulties in communication; and the nurse-patient relationship. The findings demonstrate the necessity to increase the level of spiritual care education in nurse programs, educating nurses on the provision of spiritual care, and how to deal with conflicts in spiritual and religious beliefs.

Wealth disparities in end-of-life symptom burden among older adultsJAMA Network Open; Irena Cenzer, Kenneth E Covinsky, Sarah H Cross, Claire K Ankuda, Lauren J Hunt, Melissa D Aldridge, Krista L Harrison; 3/25This cohort study found that lower wealth was associated with a higher symptom burden at the end of life, mediated in part by higher rates of multimorbidity, functional impairment, and dementia. These findings highlight the need for policies and programs to support patients with lower financial resources to improve end-of-life experiences and mitigate wealth disparities. 

The analysis of hospice trends in the United States in 2020 among Medicare beneficiariesAmerican Journal of Hospice and Palliative Medicine; Noor Chughtai, BS; Cortland Brown, MS; Jordan Shelestak, MS; Jared Nichols, DO; 3/25 While hospice care has many benefits, there is variability among the service throughout the United States. Public hospice care data from data.cms.gov were analyzed to explore these trends. Findings indicate that Medicare beneficiaries in the South and West regions of the U.S. experience longer hospice stays, and in contrast, those in the Northeast and Midwest (including Alaska) reflected reduction from this average. Notably, states with shorter hospice durations showed a higher proportion of neoplastic disorders as the primary diagnosis, while those with longer stays showed an inverse relationship with greater prevalence of circulatory system disorders and lower incidence of neoplastic diagnoses. Additionally, the analysis reveals a consistent decline in average hospice length with increasing age among patients aged 80-85 across all U.S. regions, as expected.

Hospice care quality: Latest CMS data Becker's Hospital Review; by Elizabeth Gregerson; 3/12/25 CMS has analyzed data from more than 5,000 hospice agencies for its latest update to Care Compare. Care Compare, a consumer search tool for home health, hospice and other Medicare-reimbursed healthcare services, provides patients with information to make informed decisions about healthcare. National hospice care quality data from April 1, 2023, and March 31, 2024, was published by the agency Feb. 19. ... The proportion of hospice patients who received each care measure:

Malpractice lawsuits are rising — here’s how physicians can protect themselves Becker's ASC Review; by Patsy Newitt; 3/11/25 Medical malpractice insurance is essential for protecting physicians from financial and legal risks, particularly amid the rise in malpractice lawsuits, according to a March 5 article on Physicians Thrive’s website.  In 2023, malpractice verdicts hit a record high. There were 57 medical malpractice verdicts of $10 million or more, with more than half of those verdicts hitting $25 million.  Here are nine things to know from the Physician’s Thrive article. 

Hospice worker accused of exploiting patient, steals $7K CBS12 News, Tampa, FL; by Skyler Shepard; 3/12/25 A hospice worker is accused of financially exploiting a hospice patient under her care. The Hillsborough County Sheriff's Office (HCSO) said deputies responded to a delayed fraud report on March 4 on Clubhouse Circle, where the victim, receiving hospice care, reported being defrauded by a home health assistant. The sheriff's office said the fraudulent activity reportedly began on January 28. The suspect, identified as Shawn Livingston, allegedly persuaded the victim to use Zelle for service payments and manipulated the transactions to transfer money to her accounts, pay her creditors, and make payments to Carnival Cruises, stealing more than $7,000. On March 7, deputies arrested the 57-year-old woman, who now faces exploitation of an elderly person, fraudulent use of personal information, grand theft, fraudulent use of a credit card, and uttering a forged instrument.