Literature Review

The balancing act: How caregivers navigate the stress of work, family, and caring for a loved one Delaware LIVE; by Staff Writer; 12/12/25With two-thirds of U.S. caregivers struggling to manage both employment and home duties, experts say planning, boundaries, and support can prevent burnout. ... Insights from national research and guidance from Delaware Hospice, Oasis Senior Care (a leading consultant for families), and Easterseals Delaware & Maryland’s Eastern Shore underscore a central message: you don’t have to do this alone, and thriving — not just surviving — is possible. ...

TCMH Hospice of Care online auction raises record amount Houston Herald; by Helania Wulff; 12/11/25 The TCMH Healthcare Foundation announced that this year’s Hospice of Care online auction and new in-person wrap-up party set a new all-time fundraising record, bringing in $38,454.64 to support its Hospice of Care program. The hybrid format, online bidding throughout the week, capped with a live auction-style finale at Piney River Brewing on Friday night, helped drive engagement and push the event past last year’s record total. 

4 hospice buyers acquire Traditions Health Hospice News; by Jim Parker; 12/3/25 Traditions Health has been acquired by four hospice providers, each dividing the company’s assets across their geographic footprints. The Care Team, VitalCaring, LifeCare Home Health Family and Mission Healthcare have each purchased a portion of Traditions Health’s locations. Financial terms of these transactions are undisclosed. Traditions was formerly a portfolio company of the private equity firm Dorilton Capital Partners. 

Medicare's AI prior authorization pilot sparks backlash over incentives to deny care Complete AI Training | Insurance; by Joren Erne; 12/7/25 CMS will pilot AI prior auth in traditional Medicare across AZ, NJ, OH, OK, TX, WA through 2031. Expect tougher reviews, vendor incentives, and pushback on denials and delays. ... For insurance professionals, this is a signal: CMS is importing private-plan utilization tactics into fee-for-service Medicare, with financial incentives tied to denial-driven cost savings. Expect policy, operations, and provider relations to feel it. 

Hospice margins dropping despite utilization gains Hospice News; by Jim Parker; 12/9/25 Hospice margins are falling despite record-high utilization, according to data from the Medicare Payment Advisory Commission (MedPAC). The commission has released its draft recommendations to Congress, repeating its annual call to eliminate hospice payment rate increases in future years. “For fiscal year, 2027, Congress should eliminate the update to the 2026 Medicare base payment rate for hospice,” MedPAC indicated in its draft recommendations. ... The average Medicare fee-for-service margin for hospices fell to 8% in 2023, down from 9.8% in 2022 and 14.2% in 2020, according to MedPAC. Among for-profit providers, the average 2023 margin was 13.7%, whereas nonprofits in aggregate showed a loss at -1.3%. These numbers exclude cap overpayments and non-reimbursible costs. These declines occurred during a time of record-breaking demand. Hospice utilization in 2024 reached the highest rate it has ever seen at 53%, MedPAC reported. More than 1.8 million Medicare decedents received hospice care that year for a total of 148 million days of service. [MedPAC 12/5/25 report here.]

Poured out and given: The lived experience of self-care among hospice nurses in rural Appalachia Journal of Hospice and Palliative Nursing; by Amanda Camden, Sandra P Thomas, Lisa C Lindley, Lisa Davenport, Ali Winters; 12/5/25, Online ahead of print Hospice nurses encounter profound challenges that make self-care both essential and deeply complex. ... The findings suggest that practicing self-care must be augmented by other actions such as systemic changes, caseload limits, leadership training, and structured emotional support systems. This study highlights the urgent need for health care systems to prioritize hospice nurses' well-being and help sustain compassionate nursing care.

AARP: 55 percent of family caregivers use tech to coordinate care McKnights Home Care; by Donna Shryer; 12/9/25 Technology adoption is surging on both sides of the caregiving equation. AARP estimates there are about 63 million unpaid caregivers nationwide, and among those caregivers age 50 and older, 55% now use one or more digital tools to manage routines, coordinate care or track health. Among all adults age 50+ (unpaid caregivers and care recipients), 78% say they rely on technology to stay connected with friends and family, according to AARP’s newly released 2026 Tech Trends and Adults 50-Plus report.Guest Editor's Note, by Judi Lund Person: As AARP points out, today’s caregivers are increasingly likely to use technology to coordinate care for their loved ones. Are hospice and palliative care providers up to the challenge – if your plumber can notify you that they are 15 minutes away, is there technology in place that will alert the caregiver that the hospice nurse or aide is 15 minutes away? How are you equipping your care teams to communicate with caregivers effectively, efficiently, and securely? Remember, a CAHPS Hospice question is, "How often did the hospice team let you know when they would arrive to care for your family member?"

Healthcare fraud enforcement trends to expect in 2026 JD Supra; by Arnall Golden Gregory; 12/8/25Key Takeaways

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!   Also, remember our Job Board to find staff for the new year!

CHAP celebrates 60 years in home-based care Community Health Accreditation Partner (CHAP); email and website; 12/5/25 This year, CHAP marked a milestone that speaks volumes about our legacy and our future: our Diamond Jubilee. Sixty years of progress, partnership, and innovation came to life as our incredible team gathered to celebrate not just an anniversary, but the people who make our mission possible every day. It was a moment to honor the tradition that began in 1965 and continues to shape home-based care across the nation; a tradition built on excellence, compassion, and a shared commitment to the providers we serve. As we reflected on six decades of impact, the celebration reminded us of something even more powerful: the strength of our present and the promise of what’s next.Editor's Note: Hospice & Palliative Care Today celebrates CHAP immeasurable contributions to improving patient / caregiver / family care, staff education and standards, organizational systems, and more!

Value bias and ethnocentrism and its effect on advance care planning: Mind the gapJournal of General Internal Medicine; Jeffrey T Berger, Dana Ribeiro Miller; 11/25After decades of efforts by academic and professional organizations and by governmental agencies to promote advance care planning, less than half of adults in the USA have formally executed advance directives. For patients who have completed these documents, studies find limited impact on end-of-life care. In this paper, we discussed ways in which bias towards certain values in the health care enterprise including ethnocentrism, the centering of one set of cultural norms, may contribute to the public's ambivalence and the relative inefficacy of advance directives. We offer a more expansive perspective on this aspect of clinical care with the goal of serving all patients more effectively.

Adolescents' and young adults' perspectives on decision-making and the emotional experience of having advanced cancerJournal of Pain and Symptom Management; by Nelda Itzep, Jessica Moore, Colleen Gallagher, Michael Roth, Peyton Martin, Mike Hernandez, Karen M Moody; 12/25Adolescents and young adults (AYAs) with advanced cancer represent a unique and vulnerable population. Little is known about the optimal approach to support their medical decision-making needs... Most participants reported acceptance and peace with their illness, yet many struggled with changes in physical appearance, the unfairness of getting cancer, and angry feelings related to their illness. Participants also reported high levels of therapeutic alliance with their doctors. These AYAs reported remaining hopeful and future oriented despite their prognosis. They also reported a strong belief that AYAs should be involved in decision-making.