Literature Review

Highest Medicare Hospice Utilization Rates Posted in CY 2025!1520ai / Hospice Analytics press release; by Cordt T. Kassner; 7/20/26Medicare hospice utilization reached a record high of 51.9% in calendar year (CY) 2025, according to preliminary analysis by Cordt T. Kassner, PhD. Utilization measures the share of Medicare deaths that occurred under hospice care – a consistent, conservative metric used in annual reporting... States leading the nation in hospice utilization (all >60%) include: Utah (67.7%), Rhode Island (62.1%), Florida (60.2%), and Wisconsin (60.0%)... As previously published , hospice utilization serves as a key indicator of both access and quality in end-of-life care... Data-driven insights like these remain essential for improving care for patients and families nationwide. [Download the entire article, including two detailed graphs, here.]

Some kids come here for vacation. Others come to die. Either way, parents are grateful USA TODAY, San Leandro, CA; by Madeline Mitchell; 7/20/26 ... There are mainly two kinds of families who come to George Mark's Children's House. Some come for respite, entrusting their medically fragile but otherwise stable children to skilled nurses while parents leave for a much-needed break from around-the-clock caregiving. Others come for pediatric end-of-life care, a rare and essential service that changed the trajectory of CEO Shekinah Eliassen's life. These parents stay with their children at George Mark and can bring the patient's siblings, too, to soak in their last days together. "This type of service, I believe, should be part of the system of pediatrics," Eliassen says, adding that families never see a bill for their visits. Her son, Lars, died at George Mark when he was 21 days old, after he was born having seizures. 

New easy-to-navigate web edition: A history of care - 250 years of American need, service and hope Composing Life Out of Loss, partnered with Hospice & Palliative Care Today; by Joy S. Berger; 7/20/26 Growing out of your overwhelming response to our July 4th, 2026 commemoration, we’re now releasing a new web edition of A History of Care: 250 Years of American Need, Service and Hope to carry this work forward. We invite you to use this living history—in your own setting and across our field—as we write the next chapters of care together.

Nurse practitioner: my patient qualified for hospice. I couldn’t get her there The Examiner News; by Diane Pagan; 7/15/26 ... I’ve been Marie’s primary care nurse practitioner for seventeen months. She was referred to me at the time by her PCP because she could no longer physically manage going into the office. She suffered from dementia and her gait was worsening ... Marie’s daughter chose a hospice agency close to her home. The agency reviewed my referral and notes and accepted Marie into their program. The next step was to send them a Certificate of Terminal Illness (CTI) stating that Marie had a terminal illness with an anticipated life expectancy of 6 months or less. Then the obstacle arose. I couldn’t sign the form. ... The inability of nurse practitioners to sign a CTI does not stem from their lack of education or clinical expertise in determining when a patient is nearing end of life. The restriction is rooted in federal Medicare law, written more than 40 years ago, when the role of nurse practitioners was very different than it is today.

VITAS medical director: improve hospice referrals for cancer patients Hospice News; by Jim Parker; 7/16/26 Hospice utilization among some cancer patients is leveling off and slowing growth, but healthcare providers and medical educators can adopt certain strategies to move the needle. This is according to Dr. Ileana Leyva, regional medical director for VITAS Healthcare. ... Neuro-degenerative, lung and cardiac diseases are gaining more prominence among hospice diagnoses. In 2024, senile degeneration of the brain was the most common terminal diagnosis among Medicare decedents at 9%, followed by Alzheimer’s at 6%, according to the National Alliance for Care at Home. Chronic obstructive pulmonary disease rounded out the top three at 4.2%. Lung cancer was the 11th most common diagnosis that year, at 2.1%, the highest rate for any form of cancer. Hospice News spoke with Leyva about the barriers that prevent cancer patients from accessing hospice sooner and what stakeholders can do to drive improvement.

Japan pushes to expand children’s hospices through new consultation service Europe Says, Osaka, Japan; Press Release; 7/15/26 For children with life-limiting illnesses or severe disabilities, even simple experiences such as playing freely or having friends stay overnight can be difficult. Children’s hospices aim to make such experiences possible while also providing support for their families, and efforts are underway to expand the number of these facilities in Japan. Tsurumi Children’s Hospice in Osaka, which opened in 2016, launched a consultation service in April to help people establish similar facilities across the country.

Most Americans prefer to die at home, but the US healthcare system often prevents it ArcaMax; by Karen Lutfey Spencer; 7/14/26 Ask people what they want at the end of their lives, and overwhelmingly the answers will revolve around comfort, dignity and time at home with loved ones. Yet the U.S. healthcare system often thwarts these wishes. Most Americans say they want to die at home, but only one-third do. What could be an intentional last chapter may instead become a roller coaster of hospitalizations and decisions made with incomplete information. News headlines reflect the challenges of facing the end of life in crisis mode. ... Unfortunately, these crisis scenarios are happening to millions of families each year.

Relationships between advance care planning engagement, patients’ religious practices, and spirituality American Journal of Hospice and Palliative Medicine; by Robyn M. Axel-Adams, MS, MDiv, BCC, HEC-C, Emily Fox Ludden, MDiv, MGS, and Alexia M. Torke, MD; 7/2/26Background: Research has shown that people who consider themselves religious have a lower advance directive (AD) completion rate. However, advance care planning (ACP) includes a broader range of activities that are important in determining medical treatments. ... Conclusions: In contrast to prior findings of lower AD completion in more religious individuals, this study found that higher religiosity and spirituality are associated with higher ACP engagement. These results suggest ACP opportunities offered for religious congregations or spirituality focused communities may be especially successful.

Arden Home Health and Hospice celebrates Grand Opening of Vicksburg branch Vicksburg Daily News (VDN), Vicksburg, MS; Press Release; 7/10/26 Arden Home Health and Hospice held a ribbon-cutting and open house to mark the grand opening of its new Vicksburg hospice branch at 1650 US 61, Suite D. The new branch expands Arden’s established home health presence in Vicksburg, adding hospice services for patients and families in Claiborne, Jefferson, Warren, Yazoo, Holmes, Humphreys, Sharkey, and Issaquena counties. ... Prior to this expansion, families in these communities were forced to travel significant distances for advanced hospice care.

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 ...

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.