Literature Review

Hospice leaders: palliative care through home health a limited prospect Hospice News; by Jim Parker; 8/6/26 Structuring palliative care payment through the home health benefit is the wrong approach, according to some hospice leaders. The U.S Centers for Medicare & Medicaid Services (CMS) in its proposed 2027 home health rule included language specifying that Medicare would cover community-based palliative care through the Medicare home health benefit. ... CMS indicated in a statement, “Therefore, in this proposed rule, CMS states that skilled palliative care services can be furnished and billed under existing Medicare home health benefits for eligible patients with serious illnesses.” ... But the home health chassis is not built to support the full range of interdisciplinary palliative care, some hospice leaders contend. The benefit also imposes certain limitations. For example, patients would need to be homebound. ...

National Alliance for Care at Home responds to FY 2027 Hospice Final RuleNational Alliance for Care at Home, Alexandria, VA; Press Release; 7/30/26The National Alliance for Care at Home (the Alliance) today responded to the Centers for Medicare & Medicaid Services (CMS) fiscal year (FY) 2027 Hospice Wage Index and Payment Rate Update final rule, which finalizes payment and regulatory changes under the Medicare hospice benefit.CMS finalized a 2.3% payment update to the Medicare hospice benefit, which continues to fall short of the rising labor and supply costs required to deliver high-quality hospice care. As demand for hospice services continues to grow, payment updates must more accurately reflect providers’ costs so that access to these essential services does not decline. “CMS’s 2.3% payment update does not reflect the true cost of delivering hospice care and adds further strain to providers who are already stretched thin,” said Jennifer Sheets, CEO of the Alliance. “Compounding that pressure is a Service and Spending Variation Index built on a fundamentally flawed methodology that penalizes legitimate providers for non-hospice claims they have no visibility into nor control over, with no process to review or correct the data before it is made public. This is not a sound approach to program integrity. An inadequate payment update combined with an unreliable oversight tool creates a serious and growing burden for legitimate providers working to serve their communities.”

NY’s MAiD law: updates that medical providers and facilities should know JD Supra; by Rivkin Radler, LLD - Attorneys at Law; 7/31/26As discussed in our prior publication, Medical Aid in Dying Is Now Legal in NY, Gov. Kathy Hochul signed New York’s Medical Aid in Dying Act (MAID) on February 6, 2026. Since then, the New York State Department of Health (DOH) has issued a form (DOH-5847) for patients to request MAID, frequently asked questions (FAQs), educational materials, guidance, and proposed reporting regulations. Together, these materials provide important directions for providers and facilities as they prepare for the law’s August 5, 2026, effective date.

One clinician, every conversation: Palliative care delivery by solo APRN hospitalists in Critical Access HospitalsJournal of Hospice & Palliative Nursing; by Melissa Skoff; 7/26Advanced practice registered nurses (APRN) who practice as solo hospitalists in critical access hospitals are often underrecognized in their role in providing palliative and end-of-life care. This article describes the full scope of the solo APRN hospitalist in a critical access hospital setting with close attention to how complex patient demands contribute to the challenges in providing high-quality end-of-life communications. This article examines clinical, educational, and ethical dimensions of this work, and presents a case example that illustrates how these pressures present during a shift. Strategies to strengthen rural palliative care capacity are discussed, including tele-palliative care, remote ethics support, and APRN-centered education. As rural workforce shortages persist and continue to rise, alongside rising patient acuity, naming and addressing these structural gaps is essential in improving quality of care and protecting the well-being of a solo APRN hospitalist.

In the near future, AI is gonna tell a woman that she is wrong and to calm down... And that, my friends, will be the end of AI!

CMS Website: SSVI Index; FY 2027 Final SSVI Overview; FY 2027 Final Hospice Wage IndexCMS website; compiled by Judi Lund Person; retrieved from the Internet 8/3/26 Downloads on CMS website that provide additional information for the final rule; zip files [standard delivery format]

"Ask us anything": A framework for understanding bereaved children's questions about illness, dying, and griefPalliative Care & Social Practice; by Ceilidh Eaton Russell, Liana Bailey, Ashwini Pugazhendhi, Karleigh Sutton, Sandra Twiner Ross, Joanna Humphreys; 7/26Grieving children may wonder about questions of illness, dying, and death as they navigate the death of, or grief for, someone who matters to them. Parents and caregivers, as well as health and psychosocial clinicians frequently report feeling uncertain and unprepared to engage in these conversations even if they are aware of their helpfulness. Interested in examining the questions bereaved children wonder about, this study analyzed 710 anonymous questions submitted by children aged 5-17 during Ask Us Anything sessions at a bereavement camp in Ontario, Canada between 2009 and 2024. Question focuses (i.e., what it says about the core topic) spanned across: Body, Condition, Dying and Death, Grief, while question functions (i.e., what it says about what the person seeks to understand about the topic) spanned: How it Works, Catch, Cause, Cure, Care, Connect. Children's questions can be helpful windows into what their grief experiences are like and what their emotional, existential, and/or informational needs are within this experience.

Aging and end-of-life care planning among transgender and nonbinary individuals: A systematic reviewLGBT Health; by Ginger H Kwak, G Nic Rider, Emily A Paine, Walter O Bockting, Steven A John; 7/26The objective of this review was to identify perceptions of end-of-life (EOL) care needs among transgender and nonbinary (TNB) individuals. We identified five major themes during thematic analysis: fear of discrimination in long-term care facilities, fear of loss of independence, maintaining social circles with aging, obstacles to EOL logistics, and what defines successful aging. Additional subthemes included fear about loss of identity, preference for euthanasia versus loss of identity, participation in EOL planning, and advance care plan/will completion. Psychosocial aspects were the most substantial barriers to successful EOL planning.

When I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping.”  ~Fred Rogers