Literature Review

Poverty level affects end-of-life care in adolescent and young adult cancer patients  Cancer Therapy Advisor; by Liam Andrew DAvenport, MA; 7/24/26 Adolescent and young adult (AYA) cancer patients from high-poverty neighborhoods face disparities in end-of-life (EoL) care, according to research published in the Journal of the National Comprehensive Cancer Network. AYA patients from high-poverty neighborhoods have more emergency department visits and hospitalizations, and less hospice use, than their low-poverty counterparts, study researchers reported. ... Eligible patients had been diagnosed with cancer and died between 12 and 39 years of age, and were enrolled in one of the participant health systems for more than 90 days prior to their death. 

Pierce County woman says scammers stole $117K as husband enters hospice care Fox 13, Seattle, WA; by David Rose; 7/23/26 A Pierce County woman says she lost about $117,000 to an elaborate phone scam while caring for her husband in hospice, leaving her uncertain how she will pay her bills after the man she has cared for through years of declining health dies. Charlotte Tripp said the scam unfolded at what she describes as the worst possible time in her life. Her husband of 17 years, who has dementia, recently entered hospice care after suffering a rapid decline following hip surgery and a urinary tract infection. ... "Basically, he can go any day now," Tripp said. "I'm trying to concentrate more on my husband to give him the time he needs." Instead, she said she has spent hours dealing with banks, law enforcement and mounting financial problems after scammers convinced her to drain her accounts.

The business case for supporting the growing population of caregiver-employees — and how to do it McKnights Senior Living; by Kimberly Bonvissuto; 7/22/26 Caregiving no longer is just a personal or family issue — it’s increasingly a workforce, financial and health issue — but employers occupy a unique position in their ability to make a meaningful difference in the lives of their employees, according to two new reports. New research from the Employee Benefit Research Institute and Greenwald Research finds that unpaid family caregivers face greater financial strain, lower retirement confidence and more concern about future retirement risks than Americans who are not unpaid caregivers. Care.com also has released new research focusing on the challenges of caregivers in the sandwich generation, who face simultaneous challenges of caring for aging parents while also raising children. 

This global healthcare lesson could change America | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Mark Stoltenberg; 7/22/26 Some of the most innovative solutions to America's healthcare challenges aren't being developed in the world's wealthiest hospitals—they're emerging from communities with the fewest resources. What can American healthcare learn from global healthcare?  In our latest episode, Dr. Mark Stoltenberg, Harvard Medical School professor and Massachusetts General Hospital physician, joins Chris Comeaux to explore global healthcare, palliative care, hospice leadership, healthcare innovation, and the future of serious illness care in America. ... Drawing from his work leading global palliative care programs throughout Latin America, the Caribbean, Africa, and other underserved regions, he shares how resource-limited healthcare systems are pioneering solutions that can improve American healthcare, strengthen the healthcare workforce, and restore compassionate, person-centered care.

Reporting Face-to-Face encounter conducted by a hospice physician or hospice nurse  practitioner for recertification via telecommunications technology on hospice claims, effective January 1, 2027 U.S. Department of Health & Human Services |CMS; CMS Manual System, Change Request 14495; 7/10/26 Effective January 1,2027, face-to-face encounters using telecommunications must be reported using a modifier or G code on the hospice claim. Guidance was released on July 10, 2026 and can be found in CR 14495 and MM14495. 

This global healthcare lesson could change America | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Mark Stoltenberg; 7/22/26 Some of the most innovative solutions to America's healthcare challenges aren't being developed in the world's wealthiest hospitals—they're emerging from communities with the fewest resources. What can American healthcare learn from global healthcare?  In our latest episode, Dr. Mark Stoltenberg, Harvard Medical School professor and Massachusetts General Hospital physician, joins Chris Comeaux to explore global healthcare, palliative care, hospice leadership, healthcare innovation, and the future of serious illness care in America. ... Drawing from his work leading global palliative care programs throughout Latin America, the Caribbean, Africa, and other underserved regions, he shares how resource-limited healthcare systems are pioneering solutions that can improve American healthcare, strengthen the healthcare workforce, and restore compassionate, person-centered care.

Crushing and flexing: CMS proposes to expand its discretion to deny and revoke Medicare enrollment The National Law Review; by Karen S. Lovitch, Jane Haviland, Mintz; 7/14/26 ... Currently, CMS’s revocation authority allows it to revoke enrollment prospectively following notice to the Provider. Following revocation, the Provider is no longer allowed to bill Medicare. CMS’s proposal would not only make the revocation date retroactive to the date of alleged noncompliance (or other triggering event) but would also allow CMS to claw back payments to the retroactive revocation date. CMS estimates approximately $82 million in annual savings from this proposal, clearly indicating that CMS views it as a high-impact program integrity measure. CMS’s proposal is also notable because, if finalized, it would give CMS greater flexibility to address suspected fraud without considering criteria that might otherwise constrain its actions. For example: ...

Restarting medications after deprescribing in adults discharged from hospital to skilled nursingJAMA Network Open; by Thomas J. Reese, Sandra F. Simmons, Eduard E. Vasilevskis, Emily K. Hollingsworth, Matthew S. Shotwell, Amanda S. Mixon; 6/26Question: Among older adults discharged to skilled nursing facilities (SNFs) after hospital-initiated deprescribing, what is the frequency and timing of medication restarts ...? In this cohort study analyzing data from 2 randomized trials with a total of 598 participants, 15.9% of deprescribed medications were restarted. Higher health literacy and longer intervention exposure were associated with fewer restarts, whereas more prescribers, higher number of baseline medications, and fewer pharmacies were associated with medication restarts; restart during the SNF stay was associated with greater 90-day hospital readmissions. Conclusions: In this cohort study, approximately 1 in 6 deprescribed medications were restarted within 90 days, with nearly half occurring soon after SNF discharge. Patient factors and markers of care fragmentation were associated with restart, suggesting that enhancing transitional care and postdischarge support may improve the durability of hospital-initiated deprescribing.

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When technology meets its limits: Integrating Medical Aid in Dying with withdrawal of a left ventricular assist deviceCureus; by Yvette Vieira, Paola Reveco; 6/26As outcomes improve and patients [with advanced heart failure] live longer with [surgically implanted left ventricular assist devices], ... clinicians across disciplines are increasingly confronted with the complex clinical, ethical, and practical challenges that arise when life-sustaining therapy is dependent on implanted technology, particularly in the context of end-of-life decision-making. We present a case report of a 76-year-old man with advanced heart failure supported by an implanted cardiac pump [who wanted to pursue] ... medical aid in dying ... [in his own home] ... Deactivating a cardiac assist pump typically occurs in a hospital with intravenous sedation for the abrupt heart failure symptoms that can occur when the pump is turned off. An end-of-life care navigator and a carefully assembled interdisciplinary team providing medical aid in dying in conjunction with pump deactivation achieved the patient’s home death at his selected date. Coordinating implanted cardiac device withdrawal with medical aid in dying is clinically achievable, ethically defensible, and legally sound. Healthcare systems must develop written protocols, train hospice providers, provide anticipatory counseling, fund necessary infrastructure, and support this end-of-life care.

Implementing the PAR scale in a pediatric concurrent care setting: A quality improvement projectJournal of Hospice & Palliative Nursing; by Taylor Ronne, Andrea Cahill, Kassidy Horst, Leeza Struwe, Kelly Gonzales; 6/26Pediatric patients in concurrent hospice and palliative care often face fragmented communication regarding family goals of care during acute hospitalizations. This quality improvement project evaluated clinician and care coordinator experiences with the implementation of the Preference for Acute Rehospitalization Scale at Children's Nebraska. A pre- and postimplementation survey design ...  assessed awareness of family goals, confidence in decision-making, and perceptions of the tool among an interdisciplinary team. While clinicians expressed general openness to standardized communication tools, results showed no statistically significant differences in survey items, highlighting that successful adoption in complex pediatric settings requires sustained education, seamless workflow integration, and robust interdisciplinary engagement to ensure treatment remains aligned with family preferences.

The effect of palliative care involvement in vascular patients at the end-of-lifeJournal of Vascular Surgery; by Angela McCarthy, Kristy Wrana, Emma Triantafyllou, Ya-Huei Li, Carol Strycharz, Lindsay Lynch, Edward D Gifford; 6/26Vascular surgeons frequently manage critically ill patients and support complex end-of-life decision-making. Despite well-documented benefits of palliative care in serious illness, prior studies report that only 25% of vascular patients near the end of life received such support. Those without a palliative consult were more likely to undergo a code (18.0% vs. 6.6% ... ). After palliative consultation, the proportion of patients with a code status of do-not-resuscitate increased from 50.0% to 77.4%, and the proportion with a full code designation decreased from 50% to 22.6%  ... Patients with the goal of care to allow natural death increased to more than half of the patients from 18.4% after the palliative consultation ... These findings highlight an opportunity for vascular surgeons to proactively integrate palliative care, improving alignment between clinical interventions and patient preferences.