Literature Review

Visiting 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.

Sought-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.

Chico 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.”

Pennant 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. 

CMS 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.

Strengthening 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. 

Doyel: I didn't know how strong and kind my special Mom was. Not until she started dying. Indianapolis Star, Indianapolis, IN; by Greg Doyle; 10/1/25 The last time we talked, I told my mom the truth: I’d missed just how wonderful she was. Make no mistake, I knew she was wonderful. Kind, considerate, strong – she checked all the best boxes. And generous? Mom’s the most generous person I’ve ever known, and I’ve known it for years. But I didn’t know just how generous she was. Not until she started dying. Didn’t know how strong she was, either. Not until she was so weak she couldn’t stand on her own two feet. That’s when I finally saw it. ...

Human judgment: The magic ingredient for making AI work across aging services disciplines McKnights Senior Living; by Kimberly Marselas; 9/29/25 From tackling a scabies outbreak in a long-term care facility to scheduling shifts and helping write plans of correction that satisfy regulators, a range of aging services providers are eagerly already putting artificial intelligence to work. But what is it not doing for them? Taking the place of human staff members, their workplace knowledge or their clinical judgment. That was a resounding takeaway of a recent McKnight’s Tech Summit webinar exploring how AI technologies are supporting care teams role by role. 

CMS telehealth waivers, virtual hospice re-certification, expire Hospice News; by Jim Parker; 10/1/25 The regulatory flexibilities related to telehealth that the U.S. Centers for Medicare & Medicaid Services (CMS) implemented during the COVID-19 pandemic have expired. This includes the ability of hospices to perform patient re-certification face-to-face encounters via telehealth. Also expiring are waivers that expanded the scope of practitioners eligible to provide telehealth services, as well as flexibilities that removed geographic requirements and expanded originating sites for telehealth services, including or federally qualified health centers and rural health clinics. The government’s failure to extend or make permanent the telehealth re-certification waiver is a “grave mistake,” according to Tom Koutsoumpus, CEO of the National Partnership for Healthcare & Hospice Innovation (NPHI).

Peace is not the absence of conflict, but the ability to cope with it. ~ Mahatma Gandhi

Confidential conversations in palliative care: An ethnographic exploration of trust and interpersonal relationship between nurse and patient Journal of Clinical Nursing; by Tove Stenman, Bodil Holmberg, Ylva Rönngren, Ulla Näppä, Christina Melin Johansson; 9/30/25 Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations. ... Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.

Instilling hope: A comprehensive model of cancer care for younger adults Targeted Oncology; by Andrea Eleazar, MHS and Shane Dormady, MD, PhD; 9/29/25 In the past decade, the incidence of numerous cancer types has increased, particularly among younger adults under age 50. For younger adults, many of whom are primary breadwinners of their households or in the height of their educational or professional careers, a cancer diagnosis at this life stage can be unexpected and jarring. ... In an interview with Targeted Oncology, Shane Dormady, MD, PhD, medical director of El Camino Health Cancer Center, describes the unique needs and challenges of younger adults, outlines El Camino Health’s comprehensive care strategy, and offers insights and considerations for treating and interacting with this patient population.