Literature Review

Congress offers new plan for Medicaid cuts, raising fresh concerns among HCBS advocates McKnights Home Care; by Adam Healy; 5/13/25 House Republicans on Sunday [5/11] introduced a new budget reconciliation that outlines exactly how Medicaid cuts could take shape. Home- and community-based services advocates quickly spoke out in opposition to the bill. [Various leaders responded.]

Downside risk, upside payment highlight new CMS innovation agendaModern Healthcare; by Bridget Early; 5/13/25The Centers for Medicare and Medicaid Services is rolling out a broad new agenda for its innovation center that could lead to requirements that participants in value-based care programs to take on downside risk, the agency announced ... The Center for Medicare and Medicaid Innovation plan prioritizes shared risk and prospective payments, streamlined quality measurement, artificial intelligence and other technologies, and Medicare Advantage payment models, Director Abe Sutton said in an interview Friday [5/9]. Notably, CMS is walking away from a goal set four years ago to have all fee-for-service Medicare beneficiaries under accountable care arrangements by 2030, Sutton said. CMS provided Modern Healthcare an advance look at the new innovation center platform. ... Designing models that require providers to accept at least some downside risk could be the most consequential action stemming from the plan. Subjecting participants to potential financial losses, not just potential benefits, is key to driving cost savings and quality improvement, Sutton said.

[United Kingdom] Wife to walk across island for late husband BBC News; 5/11/25 The wife of a gardener who died of cancer is preparing to walk across the Isle of Wight in his memory. Debs Goodenough will be taking part in the Walk the Wight challenge in aid of the Mountbatten Hospice. She said it was an opportunity to honour her husband Simon, while also supporting the hospice which cared for her and her family. ... Mr. Goodenough was a gardener known for his work on Ventnor Botanical Gardens, but he also created a garden for the hospice. ... Mrs. Goodenough will be walking 26.5miles (42.6km) across the island with her sons Rory and Jake. ... The annual Walk the Wight challenge has been running for 35 years and supports the hospice by raising money for patients and the families it cares for. More than 6,500 people are expected to take part, and Mrs. Goodenough has spent the past three months training for the event. ... "The day Simon died, we had a little walk and it was two miles, and I promised Simon I would support the hospice, and my sons said 'If you want to Walk the Wight we'll do it with you'."

End-of-life care behind bars: A periodic literature search - May 2025Personal communication; 5/8/25Regular reviews of articles and reports on key issues in prison hospice and palliative care.

A daughter’s cautionary elder care tale The Progressive Magazine - Book Review; by Bill Lueders; 5/12/25 The call that woke Judy Karofsky in the middle of the night on May 18, 2015, was from a hospice nurse, who got right to the point: “I’m calling to tell you that your mother has died.” Karofsky, deeply shaken by the unexpected news, managed to ask, “Did she struggle?” Karofsky’s important new book, DisElderly Conduct: The Flawed Business of Assisted Living and Hospice, does not mention the hospice nurse’s response to this question. But it does note that she called back a moment later to say: “I’m so sorry . . . . I called the wrong number. I’m at a different facility and I had the wrong file.” Karofsky’s mother, Lillian Deutsch, had not died at all. It was someone else’s mother. Apologies were made. This is just one of many stories Karofsky shares throughout the book about the final years of her mother’s life in Wisconsin. This particular anecdote strikes me as noteworthy not just as an example of the sort of awful things that can happen when facilities are understaffed and staff members are overworked, but also because Karofsky’s first reaction was to wonder whether she struggled.Editor's note: Though printed news typically lifts up the good, compassionate moments of hospice care, most all of us have experienced negative accounts--professionally and/or personally. While this book is sure to give significant insights, perhaps the most important lessons are waiting to be validated from your own family caregivers, employees, and volunteers. What stories are behind your lower-than-you-want CAHPS Hospice scores? Dig deeper. May we all listen, learn, and improve care.

National Alliance: Medicaid cuts would adversely impact home-, community-based services Hospice News; by Jim Parker; 5/12/25 A tax bill currently before Congress could lead to Medicaid cuts that would inhibit access to home- and community-based services (HCBS). The bill, which promises sweeping tax and spending cuts, currently is undergoing a reconciliation process. The amount of tax cuts could reach $4.5 trillion, with spending cuts in the area of $4.5 billion, with a significant portion coming from Medicaid. However, the bill remains a work in progress for now with some resistance to the proposed cuts from both Democrats and a contingent of Republicans. The National Alliance for Care at Home released a statement Monday opposing the Medicaid reductions.

Celebrating National Nurses Month with 62 years of nursing excellence: Meet Alma Flowers, hospice nurse Jacksonville News - JAXChamber, Jacksonville, FL; 4/30/25 This month, we are proud to spotlight Ms. Alma Flowers, a dedicated Registered Nurse at Community Hospice & Palliative Care, whose remarkable career spans an impressive 62 years. Alma's journey began at the Brewster Duval School of Nursing in Jacksonville in 1959, marking the start of a lifelong commitment to compassionate care and professional excellence. Alma's career has been a testament to the evolution of nursing, encompassing diverse roles from acute psychiatric units to the compassionate realm of hospice care. Throughout her journey, Alma has adapted to and contributed to advancements in healthcare practices and policies. ... As we celebrate National Nurses Month, we are reminded of nurses' profound impact on patient care, healthcare innovation, and community well-being. Alma Flowers' journey is a testament to the enduring spirit of nursing excellence at Community Hospice & Palliative Care.Editor's note: What a beautiful tribute to Alma, especially when describing her journey as a "testament to the evolution of nursing." Imagine changes ahead for today's student nurses: 62 years from now will be the year 2087. While we struggle to keep up with the current barrage of nursing workforce challenges, we can draw inspiration from Alma's life-long commitments, flexibility, and immeasurable contributions.

Be ready for updated Special Focus Program, hospice experts sayMcKnight's Home Care; by Adam Healy; 5/9/25A revised hospice Special Focus Program is coming, and providers should make sure they have plans and procedures in place to be successful under this strict oversight program, Linda Woodle, director of accreditation at Community Health Accreditation Partner (CHAP), and Patricia D’Arena, vice president of clinical excellence at Enhabit Home Health and Hospice, said... When that program will be reinstated is anyone’s guess... The Centers for Medicare & Medicaid Services has indicated that assessments will place a high emphasis on four specific Conditions of Participation: patient’s rights; initial and comprehensive assessment of the patient; interdisciplinary group, care planning and coordination of care; and quality assessment and performance improvement. So providers should ensure they meet all of these conditions’ requirements.

Building an ethical culture: Leadership’s role in corporate integrity The Wall Street Journal; by Lori Pressler, Michael Rossen and Miira Velia; 5/7/25 Built from the top down, a strong ethical culture can help mitigate risk by weaving ethics into decision-making at every level. Much of the time, a single moment or lapse in judgment does not precipitate a crisis. Instead, corporate scandals tend to spring from systemic failures in corporate culture, specifically around ethics. However, within many organizations, ethics are often discussed in theoretical terms—lofty yet nebulous aspirations or nice-to-haves. ... Given its potential for harm, organizations may not be giving ethical risk the attention it deserves, particularly from the top down. 

Decoding the 2026 Proposed Hospice RuleCHAPcast podcast;by Jennifer Kennedy, Kim Skehan; 5/6/25Join CHAP’s Jennifer Kennedy and Kim Skehan as they break down the fiscal year 2026 proposed hospice rule.

Frederick Health Hospice hires new director Longview News-Journal, Frederick, MD; by Frederick Health; 5/7/25 Frederick Health Hospice is excited to announce that Korey Cobb has joined the nonprofit organization as its new Director, only the third director since the hospice was founded in 1980. Frederick Health Hospice has served the Frederick community as a non-profit agency for more than four decades. The organization was one of the earliest hospices formed in the U.S. and has been providing compassionate care for patients since before the Medicare Hospice Benefit was made permanent by Congress in 1986. Heather Kirby, Vice President of Integrated Care Delivery & Chief Population Health Officer at Frederick Health, helped lead the search committee ... [and described,] "Korey prides himself on creating a positive team culture, a strong sense of community involvement, and volunteerism. ..."

[New Zealand] Nelson Airport Trees of Remembrance returns with new sponsorship tiers to support Nelson Tasman Hospice Nelson Tasman Hospice, Nelson, New Zealand; Press Release; 5/9/25 The much-loved Nelson Airport Trees of Remembrance activation is returning this holiday season, offering businesses a unique opportunity to give back to the community while boosting their brand visibility during the busiest travel period of the year. This year’s campaign introduces an exciting new structure with three sponsorship tiers—Gold, Silver, and Bronze—allowing even more businesses to take part in this heartwarming tradition that supports Nelson Tasman Hospice. The Trees of Remembrance campaign has been a cherished part of the Nelson Tasman community for over 30 years, offering individuals and businesses a meaningful way to honour loved ones while contributing to free hospice services. Sponsored Christmas trees will once again illuminate Nelson Airport from December 2025 through January 2026, spreading festive cheer to the thousands of locals and travellers passing through during the holiday season.Editor's note: Fall/Winter fund raising plans are surely underway for nonprofit hospices and foundations. What ideas does this article generate? What might you adapt for your community?