Literature Review

CMS issues guidance to implement new limits on federal Medicaid and CHIP funding for certain noncitizens CMS Newsroom; Press Release; 4/8/26 CMS is preparing states for an upcoming change that will limit the ability to claim federal matching funds for Medicaid and the Children’s Health Insurance Program (CHIP) for individuals who are not U.S. citizens or U.S. nationals, or who fall into specific noncitizen categories identified in statute. New guidance issued today will ensure states understand their responsibility in implementing this statutory change beginning October 1, 2026. ... To view the State Health Official (SHO) letter, visit: https://www.medicaid.gov/federal-policy-guidance/downloads/sho26001.pdf.

Stakeholders fear ‘chilling effect’ of heightened hospice scrutiny McKnights Home Care; by Liza Berger; 4/9/26 Advocates and experts, by and large, are supportive of the federal government’s intense efforts to root out fraudulent hospice providers. But they are also concerned that the laserlike focus on fraud could have unintended consequences for high-quality providers. “We’re certainly hearing from members that they want to know whether policymakers and lawmakers truly see the value of hospice and that, yes, there are bad things going on in California and it’s getting a lot of publicity, but people are concerned that this could have a chilling effect,” Scott Levy, chief government affairs officer for the National Alliance for Care at Home, told McKnight’s Home Care Daily Pulse. “Hospices around the country at large are good people doing incredible work for meaningful periods of time for meaningful periods in their beneficiaries’ lives. And we want to make sure that that doesn’t go backwards.”

Reminder: National Healthcare Decisions Day, April 16, 2026 Compilation by Hospice & Palliative Care Today; 4/10/26 National Healthcare Decisions Day (April 16, 2026) is a nationwide initiative that encourages individuals to reflect on and communicate their healthcare preferences—especially for times when they may not be able to speak for themselves. It promotes meaningful conversations, advance care planning, and the completion of documents like advance directives to ensure care aligns with what matters most. Multiple resources are below:

Avow expands hospice services into Glades, Hendry and Lee countiesLake Okeechobee News, Naples, FL; 4/13/26On Monday, April 13 , Avow, a leading nonprofit health care provider based in Southwest Florida, announced its expansion into Glades, Hendry and Lee counties. This expansion extends Avow’s high-quality hospice and comprehensive bereavement support, increasing access and impact for families across the region. ... Over the past year, Avow has expanded its reach and deepened its impact, caring for more than 2,900 hospice patients annually and providing more than 4,000 palliative care visits through its Naples clinic and satellite locations. 

New measure likely to relax antipsychotic prescribing for certain hospice patients McKnights Home Care; by John Roszkowski; 4/8/26 Appropriate prescribing of antipsychotic medications to hospice patients no longer will negatively affect skilled nursing facilities’ quality ratings under a new federal rule change, potentially opening the door for SNFs to accept more hospice patients. The Centers for Medicare and Medicaid Services recently revised its Long-Stay Antipsychotic Quality measure to exclude residents receiving hospice services from the measure denominator for quality reporting. As a result, antipsychotic use for hospice residents will not influence a SNF’s Five-Star Quality Measure score.

I Googled my symptoms and turns out I just need to sit by a fire in the middle of the mountains... ~Unknown

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Engaging bereaved parent educators in pediatric end-of-life workshops: A trauma-informed onboardingJournal of Pain & Symptom Management; by Kayla Solstad, Dannell Shu, Kelly McManimon, Stacy Remke, Susan O'Conner-Von, Anne Woll, Joseph M Miller, Miriam C Shapiro, Johannah M Scheurer; 3/26Recognizing that pediatric end-of-life (EOL) scenarios occur infrequently and are distressing for trainees and other healthcare team members, our group created pediatric end-of-life care skills (PECS) simulation-based workshops to improve trainee competence for these skills. We  ... provide interprofessional workshops, including trainees from the pediatric residency program, graduate school of nursing, and graduate school of social work. Since creation of the workshops, the group and curricula have benefited immensely from including the expertise of bereaved parent educators (BPEs), who have experienced the death of their own infant or child and have been integral team members ... from workshop creation through facilitation. Research shows that families who have experienced the death of a child appreciate an interdisciplinary approach to their care and communication at the EOL. When parents of pediatric patients were asked about priorities in EOL care, they highlighted the importance of communication, emotional expression and support by staff, and ready access to multi-disciplinary staff.

Introducing palliative care: Family caregivers’ knowledge, exposure, and preferred messagingAmerican Journal of Hospice & Palliative Medicine; by Elaine Wittenberg, Joy V. Goldsmith, Sierra Forrest, Hanna G. Lee, Eva YN Yuen; 3/26Most family caregivers have never heard of palliative care, making it challenging for clinicians to introduce the subspecialty. Semi-structured phone interviews with family caregivers of patients eligible to receive palliative care were conducted. Knowledge of palliative care was significantly associated with having heard about and being offered palliative care. Caregiver exposure to palliative care was associated with age and race, with older, White caregivers significantly more likely to have heard about palliative care compared to Hispanic caregivers. Caregivers positively endorsed all message strategies designed for introducing palliative care.