Literature Review

Outcomes for hospitalized patients with comfort measures only ordersJournal of Palliative Medicine; by Gina Piscitello, Donna Durant, Tami Minnier, Marika Haranis, Robert M Arnold, Jane Schell; 6/26Clinicians place comfort measures only (CMO) orders for hospitalized patients at the end-of-life when a decision has been made to focus on patient comfort and allow the natural dying process to occur. Our primary aim was to assess the associations of specialty palliative consults (SPC) or documented goals of care conversations (GOCC) with in-hospital mortality among patients with CMO orders. Of 6,789 hospitalized patients with CMO orders ... seventy-three percent died in-hospital, and 22% were discharged with hospice. SPC placed anytime during hospital admission were associated with lower in-hospital mortality ... and higher discharge with hospice ... In contrast, documented GOCC anytime during admission were associated with higher in-hospital mortality ...  and lower discharge with hospice ...

Survival variation and predictors of length of stay in US hospice patientsInternational Perspectives and Future Directions for Practice, Research, and Policy; by Ian Duncan, Xiyue Liao, Terri Maxwell; 6/26End-of-life (EOL) patients in the US Medicare program represent a large and growing population, as well as a disproportionate share of Medicare’s costs. Survival of patients in hospice is, however, highly variable, implying an opportunity for improved management by enhancing the prediction of survival. Actuaries, health economists, policy analysts, and health services researchers have studied expenditures at the EOL for Medicare decedents for many years, finding that survival at EOL is highly variable. We discuss the utilization of hospice benefits for patients at the EOL in the United States.

Saturday newsletters focus on headlines and research - enjoy!

An end-of-life care approach defining a new standard of careJAMDA; by David N. Hoffman; 6/26The Institute for Healthcare Improvement (IHI) Leadership Alliance established an End-of-Life Care/Ending-Life Care Accelerator to define a continuum of care for patients as they progress from curative care, to palliative care, to hospice care, to final care planning, including ending life care interventions such as Medical Aid in Dying (MAiD), Voluntarily stopping eating and drinking (VSED), and palliative sedation. This accelerator defined as its goal the task of breaking down barriers between care providers which has been illuminated by research recently conducted by the Completed Life Initiative (CLI). CLI’s research efforts in this area started with an ongoing examination of nationwide hospice organization policies to provide referral for active intervention at the end of life. That effort was refocused on the widespread noncompliance of California and Washington state hospice organizations with a state law requirement to post on the organizations website a list of interventions made available by the hospice organization.

Nonprofit-private equity joint ventures worth scrutiny, PESP report says Fierce Healthcare; by Anastassia Gliadkovskaya; 7/7/26 At least 568 healthcare facilities operate through nonprofit-private equity joint ventures, according to a new report calling for scrutiny into those arrangements. The figure is likely an undercount, considering only public data were used. The report (PDF) was published by the Private Equity Stakeholder Project (PESP), a nonprofit that advocates for more disclosure about private equity deals. More than a fifth of private equity (PE)-owned hospitals operate under joint venture arrangements with nonprofit health systems. ... Such joint ventures extend beyond hospitals, spanning subsectors such as inpatient rehab, hospice, home health, behavioral health, ambulatory surgery centers and urgent care, per the report.

Missed opportunities to promote flourishing in cancer care: a brief examination of multiple myeloma Supportive Care in Cancer; by Natalie Tuckey, Hannah R. Wardill, Xavier Symons, Melissa Cantley, Kathina Ali, Hayley Beer, Gregory B. Crawford, Angelina Yong & Matthew Iasiello; 7/8/26... We propose that certain elements of flourishing, such as meaning and purpose, deep personal relationships, and cultivating virtue, can be uniquely realized if targeted appropriately toward the end of life. ...  Participants reported personal growth following their diagnosis through acceptance, meaning-making, and connection, yet reported the loneliness of dying with cancer with a desire to have discussions about death with their clinicians in addition to them maintaining treatment. On the contrary, health professionals were hesitant to discuss death with their patients, balancing hope in treatments with preparation for dying. We argue that the hesitation to discuss death thwarts the opportunity to flourish and that existing solutions such as dignity therapy, meaning-centered psychotherapy, early palliative care, and multidisciplinary support can close this gap without diminishing hope in treatments.Editor's Note: For a recent, similar research article about "flourishing," examine "Flourishing within vulnerability: on human fragility and the conditions for a habitable environment."

Silverado announces leadership transition as Wayne Sanner assumes role of Chief Executive Officer and President FDL Reporter, Irvine, CA; Press Release; 7/9/26 Silverado enters a new chapter as Wayne Sanner assumes leadership, building on founder Loren Shook’s legacy of innovation and compassionate care. ... Effective July 1, 2026, Wayne Sanner assumed the role of Chief Executive Officer and President of Silverado. At the same time, founder Loren Shook transitioned to the role of Chairman of the Board, Executive Chairman, and Founder, where he will continue full time to support the culture and development of Silverado while providing strategic guidance and helping shape Silverado’s future.

Reynolds creates Iowa Medicaid fraud task force Insurance Newsnet; by Marissa Payne; 7/9/26 Gov. Kim Reynolds signed an executive order Wednesday [7/8] creating a new task force geared toward eliminating Medicaid fraud, waste and abuse, joining in the federal government's crackdown on potential misuse of public assistance programs. Reynolds signed the order establishing the Iowa Medicaid Fraud Elimination Task Force, which the Republican governor's office says will seek to ensure funds are used to support Iowans who qualify for benefits. "Safeguarding federal programs like Medicaid from bad actors requires accountability at every point in the process, from member eligibility verification to provider enrollment and billing," Reynolds said in a statement. 

Deep summer is when laziness finds respectability. ~ Sam Keen

Big Bend Health announced as parent company of Big Bend Hospice, reflecting expanded continuum of care across North Florida Big Bend Health; Press Release; 7/9/26 Big Bend Hospice, North Florida’s trusted nonprofit leader in end-of-life care for more than 40 years, today announced the formal introduction of Big Bend Health as its parent company; a strategic brand evolution that reflects the organization’s growing continuum of care while reinforcing Big Bend Hospice as its primary and most recognized service. Big Bend Health, formerly known as Seven Oaks Health, unifies Big Bend Hospice and its related healthcare services under one cohesive continuum of care. While the parent name will be used primarily for formal and legal purposes, the community will continue to see Big Bend Hospice as the forward-facing brand and the cornerstone of compassionate end-of-life care.

[Germany] Doctor with “lust for murder” convicted in deaths of 15 patients in Germany, sentenced to life in prison Europe Says; 7/8/26 A German palliative care doctor accused of killing 15 patients and described by prosecutors as having “a lust for murder” was convicted Wednesday and sentenced to life in prison. The 41-year-old Berlin doctor, identified only as Johannes M., allegedly killed 12 women and three men between September 2021 and July 2024 using deadly cocktails of sedatives. On at least five occasions, he allegedly set fire to the victims’ apartments to cover up the killings. ... The doctor allegedly “administered an anesthetic and a muscle relaxant to his patients without their knowledge or consent,” the Berlin prosecutor’s office said in a statement. “The latter paralyzed the respiratory muscles, leading to respiratory arrest and death within minutes.”

Hospice of New York revamps hospital-based Hospice IPU, Palliative Program Hospice News; by Jim Parker; 7/8/26 Hospice of New York has reinvigorated its inpatient unit at Wyckoff Heights Medical Center, as well as developed an inpatient palliative care program. The program begins with one nurse practitioner and one social worker. Today it not only includes those disciplines, but also an attending physician and two nurses, according to founding nurse practitioner Simon Ubabov of Hospice of New York. Ubabov manages the palliative care service while the attending physician oversees the hospice inpatient unit. “Palliative care, hospice IPUs increase not just objectively the patient’s experience, not just the monetary remuneration that the facility gets, but more importantly the overall care that these patients get at the end of life,” Ubabov told Hospice News.