Literature Review
Medicaid coverage policy variations for chronic pain and opioid use disorder treatment
10/04/25 at 03:20 AMMedicaid coverage policy variations for chronic pain and opioid use disorder treatmentJAMA Network Open; by Meredith C. B. Adams, Seth M. Eller, Cara McDonnell, Sarjona Sritharan, Rishika Chikoti, Amaar Alwani, Elaine L. Hill, Robert W. Hurley, ; 8/25Co-occurring chronic pain and opioid use disorder (OUD) are associated with a high disease burden for the patient, requiring comprehensive treatment approaches, yet Medicaid benefit structures for evidence-based therapies vary substantially across states. Our systematic economic evaluation reveals both promising developments and persistent challenges in Medicaid coverage for treatment of co-occurring OUD and chronic pain. Universal coverage of fundamental medications and basic interventional procedures provides a foundation for care, but varying implementation approaches create a complex landscape requiring further investigation.
Not everything is delirium at the end of life: A case report
10/04/25 at 03:15 AMNot everything is delirium at the end of life: A case reportAnnals of Palliative Medicine; by Daniel Gilbey, Eduardo Bruera, Patricia S Bramati; 9/25In this report, we highlight the challenges faced by clinical teams diagnosing and managing delirium, in particular when a language barrier is present. Case description: A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation. He appeared to become delirious and agitated, trying to remove the face mask, wriggling in bed, and tapping the bedrails. Haloperidol and lorazepam were required when non pharmacological interventions failed to calm him down. The following morning, the patient was able to explain that the positive-pressure facemask was suffocating him and that he could not breathe. So, he was transitioned to high-flow oxygen via nasal cannula, and within a few hours, his respiratory distress significantly improved, and he regained his previous self.
Emergency Department care coordination program for assisted living residents with dementia-A qualitative study
10/04/25 at 03:10 AMEmergency Department care coordination program for assisted living residents with dementia-A qualitative studyJAMA Network Open; Grace F. Wittenberg, Peter T. Serina, Nichole E. Stetten, Ann Reddy, Ellen McCreedy; 8/25Care transitions to the emergency department (ED) from assisted living centers (ALCs) for residents may include incomplete or inaccurate information during transfer. These transitions can be especially difficult for vulnerable populations, including persons living with dementia (PLWD). In this qualitative study of a care coordination intervention, CCMs [complex care managers] advocated for their patients remotely by filling information gaps, particularly for PLWD and patients in hospice, and perceived that the intervention was associated with improved patient care. CCMs also identified key areas for improvement, such as to increase ED staff awareness of the program and to expand program hours.
Emergency physicians and hospice & palliative medicine: A growing trend in fellowship training
10/04/25 at 03:05 AMEmergency physicians and hospice & palliative medicine: A growing trend in fellowship trainingJournal of Pain and Symptom Management; by Alexander Zirulnik, Caroline Meehan, Daniel Markwalter, Jennifer Gabbard, Alyssa Tilly, Paul Zimmerman, Jensy Stafford, Justin Brooten; 9/25Emergency Medicine (EM) has played a foundational role in Hospice and Palliative Medicine (HPM) since the subspecialty's formal recognition. EM is one of the fastest-growing sources of applicants to HPM fellowships, reflecting rising recognition of palliative care's value in acute care. This trend has important implications for workforce planning, specialty integration, and the future of dual-trained EM-HPM clinicians.
[UK] From living well to dying well with dementia: The significance of an expanded understanding of loss for end-of-life care
10/04/25 at 03:05 AM[UK] From living well to dying well with dementia: The significance of an expanded understanding of loss for end-of-life carePalliative Care and Social Practice; by Joseph M Sawyer, Paul Higgs; 9/25As rates of dementia increase, the need for care is clear. Understanding what this looks like and how people might orientate the narratives and practices of care against a universally relatable version of success is less clear cut yet seems crucial if we are to progress towards an ideal of care that allows for a 'good' or 'dignified' death with palliative care. With this as a central focus, the paper examines the orientating principles that govern the current approach to dementia care. We map the evolution in academic theory from deficit-based models of care that identify impairments as a means to building resources to counter them, towards capacity-oriented approaches that focus on accommodating the new experiences that dementia brings. Where conventionally dementia has been viewed through the reductionist lens of being either a biological or social challenge to which there should be a matching solution, it is perhaps more useful to look at it from the inside out, to learn the lessons that dementia and its associated vulnerabilities may hold for humanity.
Communication surrounding treatment preferences for older adults with dementia during emergency medical services response
10/04/25 at 03:00 AMCommunication surrounding treatment preferences for older adults with dementia during emergency medical services responseJournal of the American Geriatrics Society; by Lauren R. Pollack, Danae G. Dotolo, Anna L. Condella, Whitney A. Kiker, Jamie T. Nomitch, Elizabeth Dzeng, Nicholas J. Johnson, Thomas D. Rea, May J. Reed, Michael R. Sayre, Erin K. Kross; 9/25Emergency Medical Services (EMS) providers, capable of rapidly delivering life-prolonging interventions, are often first to respond to acute health concerns for older adults in the United States. Prior work has shown a preference among many people with dementia for comfort-focused care near end-of-life. EMS providers treating critically ill older adults with dementia face challenges that may hinder their ability to elicit treatment preferences, in particular when responding to calls from professional caregivers. Direct communication with surrogate decision-makers may facilitate goal-concordant care.Assistant Editor's note: Being an RN for over 40 years, I have seen many changes in health care, especially in what is expected now of patients/families. I remember the day when nurses were not permitted to share with the patient his/her own BP reading; instead, we were to tell patients to "ask the doctor". Back then the doctor controlled almost all aspects of the patient's care, as well as the sharing of information with the patient about his/her own medical condition. I am glad those days are gone. Now, patients are expected to engage in ongoing discussions regarding advance care planning, execute written advance directives, and are expected to share their care preferences with health providers and loved ones and/or caregivers. It would be an ideal world where health care providers were continuously aware of evolving patient preferences and could always deliver goal concordant care. I believe we need to keep working toward this goal, but I also understand that this expectation can add burden to patients who are already extremely burdened with the many difficult aspects of serious illness. I believe that, as health care providers, we need to appreciate that some people simply cannot or will not share their preferences; it is simply too scary, too foreign, too difficult to do so.
[Spain] Mapping palliative care for people living with advanced cancer in phase 1 clinical trials: A scoping review
10/04/25 at 03:00 AM[Spain] Mapping palliative care for people living with advanced cancer in phase 1 clinical trials: A scoping reviewPalliative Medicine; by Diego Candelmi, Alazne Belar, Carla Zapata Del Mar, Ana Landa-Magdalena, Anna Vilalta-Lacarra, Mariano Ponz-Sarvisé, Carlos Centeno; 9/25This review highlights the unique needs of patients and caregivers in Phase 1 Cancer Clinical Trials and the complexities of integrating palliative care. Key results revealed patients' limited life expectancy, high symptom burden, distress and unmet spiritual needs [and]... patients were reluctant to seek prognostic information or engage in end-of-life discussions, complicating advance care planning. End-of-life care involved frequent unscheduled hospital admissions, hospital deaths and late hospice-care referrals. Caregivers experienced significant distress, while healthcare professionals faced barriers to integrating palliative care. Palliative care interventions varied widely in approaches, settings and outcomes.Assistant Editor's note: This article discusses how palliative care could benefit patients that are enrolled in phase 1 clinical trials for cancer. Traditionally, it has not been common practice for palliative care programs to serve these kinds of patients and their loved ones. This represents an opportunity for the expansion of much needed palliative care services.
Welcome to fall top news stories September 2025
10/03/25 at 03:00 AMWelcome to fall top news stories September 2025 Teleios News Stories (TCN); pod/videocast hosted by Chris Comeaux with Cordt Kassner; 10/1/25As the seasons shift, so do the conversations shaping Hospice and Palliative Care. In this week’s episode, host Chris Comeaux and Hospice data expert and co-host Cordt Kassner explore the latest headlines, challenges, and innovations impacting Hospice and Palliative Care. ... Covering a range of topics, including the impact of AI on Hospice Care, the importance of end-of-life visits, and the challenges of Hospice utilization trends. Also highlights significant events and stories from the Hospice community, such as the launch of a new nursing scholarship program and the impact of Hurricane Helene one year later.
Sought-after physician specialty roles are taking longer to fill
10/03/25 at 03:00 AMSought-after physician specialty roles are taking longer to fill Modern Healthcare; by Tim Broderick; 9/24/25 The time it took to fill open positions for the most sought-after physician specialties increased to almost five months in 2024, according to new research. The nonprofit Association for Advancing Physician and Provider Recruitment, with research firm Industry Insights, examined 2024 data from more than 15,000 searches of the association’s site, 61% of which were related to physician searches. ... The analysis found the estimated median days to fill the selected jobs increased by 11.5%, to 145 days in 2024 from 130 days in 2023. Oncology positions were the hardest to fill, at an estimated median of 332 days. Cardiology positions followed with an estimated median of 248 days to fill. [Access to the full article might be limited per a paywall.] Editor's Note: Oncology and cardiology are now the two hardest physician specialties to fill. This matters for hospice care because, according to NHPCO’s Facts and Figures 2024, cancer and circulatory diseases join Alzheimer’s and other nervous system disorders as the top three hospice diagnoses—together representing nearly three-fourths of all admissions. Delays in recruiting oncologists and cardiologists risk postponing timely palliative and hospice referrals. Newly hired specialists in these fields also need focused training—and intentional relationship-building with hospice teams—to ensure patients and families receive seamless, compassionate care.
Awards and recognitions: September 2025
10/03/25 at 03:00 AMAwards and Recognitions: September 2025
Landmark verdict awards over $510 million to Saint Mary’s Health Network
10/03/25 at 03:00 AMLandmark verdict awards over $510 million to Saint Mary’s Health Network Business Wire, Reno, NV; by Noel True and Mark Reece; 10/2/25 In a historic decision with national implications for healthcare, a Washoe County jury awarded Saint Mary’s Health Network, affiliate of Prime Healthcare, over $510 million in damages, including punitive damages, after finding Universal Health Services of Delaware, Inc. (UHS) and affiliated defendants liable for fraud, malice, and oppression in a coordinated scheme against Saint Mary’s Health Network during the height of the COVID-19 pandemic. ... “This verdict delivers a resounding message for all of healthcare: integrity and compassion must guide every decision we make,” said Sunny Bhatia, M.D., President of Prime Healthcare.
By working faithfully eight hours a day, you may eventually get to be ...
10/03/25 at 03:00 AMBy working faithfully eight hours a day, you may eventually get to be boss and work 12 hours a day. ~ Robert Frost
Chico nurses at Enloe Health to hold rally to protest closure of home health and hospice units
10/03/25 at 03:00 AMChico nurses at Enloe Health to hold rally to protest closure of home health and hospice units National Nurses United; Press Release by the California Nurses Association/National Nurses United; 10/1/25 ... Nurses are calling on the hospital to protect the health of some of Chico’s most vulnerable patients and maintain the essential services and end-of-life care provided by these units. “For years, Enloe hospice stood alone in providing care for underserved Medi-Cal patients and for our youngest, most fragile patients—children at the end of life,” said Ruby Khoury, registered nurse in the hospice unit. “A vital, compassionate service is being taken away, and a hospital that once led with dignity and inclusivity in hospice care now faces a painful void. We nurses demand that the home health and hospice units remain open. Otherwise, the most vulnerable will suffer first: children, Medi-Cal patients, families without resources.”
Shutdown places brakes on hospital-at-home, sending hundreds back to strained hospitals
10/03/25 at 03:00 AMShutdown places brakes on hospital-at-home, sending hundreds back to strained hospitals McKnights Home Care; by Adam Healy and Liza Berger; 10/1/25The shutdown of the federal government Wednesday has brought the hospital-at-home program to a screeching halt, resulting in hundreds of patients being discharged from the program or sent to hospitals for continuation of care, stressing an already-taxed healthcare system, providers disclosed to McKnight’s Home Care Daily Pulse. ... Several weeks ago, the Centers for Medicare & Medicaid Services instructed hospital-at-home programs to discharge or return patients to the hospital as of Tuesday. CMS also said it no longer would accept waiver requests for participation in the AHCaH initiative after Sept. 1, 2025. Late Wednesday, CMS announced that it will allow up to 60 days of noncompliance with the AHCaH waiver.
Pennant Group completes strategic acquisition of operations
10/03/25 at 03:00 AMPennant Group completes strategic acquisition of operations Investors Hangout; by Ryan Hughes; 10/2/25 ... Pennant Group is set to integrate operational assets worth approximately $146.5 million, encompassing various home health, hospice, and personal care services primarily situated in the Southeast. This acquisition includes 54 locations across multiple states, primarily focusing on the healthcare needs of communities in the region. ... An important aspect to highlight is that about two-thirds of the total revenue is associated with home health services, while the remaining third is linked to hospice care.
Grieving someone who’s still here
10/03/25 at 03:00 AMGrieving someone who’s still here Psychology Today; by Bob Uslander, MD; 10/2/25 Grief does not always begin after death. For many families facing dementia, terminal illness, or a slow decline, it arrives before the final goodbye—quietly, persistently, and often without recognition. This is known as anticipatory grief: the emotional process of mourning a loved one who is still alive. As a palliative care physician, I see this every day. Spouses tell me they feel like they have already lost their partner. Adult children struggle with the reversal of roles, becoming the caregiver to the parent who once cared for them. Caregivers often oscillate between love, exhaustion, guilt, and detachment. None of this means they are doing it wrong. It means they are grieving.
Visiting Nurse Association rejects Cape Cod Healthcare's latest contract proposal
10/03/25 at 03:00 AMVisiting Nurse Association rejects Cape Cod Healthcare's latest contract proposal Cape Cod Times, Hyannis, MA; by Desiree Nikfardjam; 10/2/25 Visiting Nurse Association of Cape Cod registered nurses have voted "overwhelmingly" to reject Cape Cod Healthcare's contract offer that was proposed on Sept. 11, according to a press release. The offer was the "last, best, and final" from Cape Cod Healthcare, according to the statement. The nurse association members are represented by the Massachusetts Nurses Association. ... The Visiting Nurse Association's nurses provide essential home health and hospice care to patients across Cape Cod and the Islands and had previously voted 96% in favor of authorizing a three-day strike if progress at the bargaining table was not made.
The CMS activities that will, won’t continue during the shutdown
10/03/25 at 02:00 AMThe CMS activities that will, won’t continue during the shutdown Becker's Hospital Review; by Andrew Cass; 10/2/25 CMS has outlined the activities that will and won’t continue during the federal government shutdown. The federal government shut down at 12:01 a.m. Oct. 1 after lawmakers failed to reach a spending deal. CMS is retaining 53% of its staff, 3,311 employees, during the shutdown. Here is what the agency said will and won’t continue during a lapse in appropriations: ... Editor's Note: While this article is for the broader healthcare community, we posted extensive hospice-specific information for you in yesterday's issue, Government shutdown impact on telehealth for hospice and palliative care providers, by Judi Lund Person. Click here to download her complete PDF report.
CMS issues memo with contingency plans for state survey & certification activities in the event of federal government shutdown
10/02/25 at 03:10 AMCMS issues memo with contingency plans for state survey & certification activities in the event of federal government shutdown CMS - Center for Clinical Standards and Quality; by CMS Directors, Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG); 10/1/25 On October 1, 2025, CMS issued QSO-26-01-ALL identifying State Survey and Certification functions that (a) are not affected by a Federal shutdown, (b) excepted functions that are to be continued in the event of a shutdown (also referred to as “essential functions”), and (c) other activities that are directly affected and therefore should not be operational during a Federal shutdown. CMS also clarified that Hospice Surveys funded through the Consolidated Appropriations Act (CAA) of 2021are considered mandatory and are not impacted by the Federal Government shutdown. Work funded under these sources should continue.
Home health industry welcomes CMS’ repeal of nursing home staffing mandate
10/02/25 at 03:00 AMHome health industry welcomes CMS’ repeal of nursing home staffing mandate Home Health Care News; by Joyce Famakinwa; 9/20/25 Earlier this month, the Centers for Medicare & Medicaid Services (CMS) drafted a rule that would repeal the federal staffing mandate for nursing homes – a move that would send ripple effects through the home health industry. The rule was controversial among nursing home operators, but it also received pushback from home health providers who were concerned that the mandate would lead to further staffing scarcity. “The repeal is positive for home health agencies,” Katy Barnett, director of home care and hospice operations and policy at LeadingAge, told HHCN in an email.
Hospice: A vital safety net for sepsis survivors
10/02/25 at 03:00 AMHospice: A vital safety net for sepsis survivors South Florida Hospital News and Healthcare Report; by Lauren Loftis, MD, VITAS regional medical director; 10/1/25Sepsis remains one of the most complex and deadly medical conditions treated in hospitals today. ... For patients with advanced illness or multiple comorbidities, the post-sepsis period is often marked by functional decline, emotional distress, and a high risk of rehospitalization or death. ...For sepsis survivors with advanced illness, hospice offers a bridge between high-intensity hospital care and the realities of life at home. It provides interdisciplinary support—including a physician, nurse, hospice aide, social worker, chaplain, volunteer, and bereavement specialist—tailored to the patient’s evolving needs.
Strengthening mental health literacy enhances job well-being in palliative care
10/02/25 at 03:00 AMStrengthening mental health literacy enhances job well-being in palliative care Oncology Nures Advisor; by Megan Garlapow, PhD; 10/1/25 Positive mental health literacy (PMeHL) significantly improved job well-being among palliative care nurses, with job crafting acting as a partial mediator in this relationship, according to a study published in BMC Psychology. These results highlight the importance of psychological resources and proactive role adjustments for supporting nurses working in high-stress palliative care settings.Editor's Note: "Job crafting" is the process by which employees actively shape and redefine their roles to enhance job satisfaction, engagement, and meaning in their work.