Literature Review

Chapters Health System announces expansion of care in Sarasota County PR Newswire, Temple Terrace, FL; by Chapters Health System; 8/11/26 Chapters Health System announced that it received another certificate of need to develop a Chapters Health Hospice program in Sarasota County in Florida. The award expands the organization's footprint and offers the chance to bring industry-leading chronic illness care to the Sarasota community. ... Chapters Health provides hospice care for more than 21,000 individuals each year across Florida through its comprehensive care model, ...  Thanks to the support of the Chapters Health Foundation, the organization also provides more than $10 million in charitable and uncompensated care each year to those in need.

How California’s hospice industry spiraled out of control — and cost millions in fraud Los Angeles Daily News, Los Angeles, CA; by Jason Henry; 8/9/26 A quiet change in California law in 2018 unleashed a deluge of new hospices and spurred millions of dollars in Medicare fraud that state and federal authorities are still trying to unwind. ... It all started with three paragraphs added, at the request of the California Department of Public Health, to the end of an omnibus bill in 2018. CDPH had a backlog of 72 applications for hospice licenses at the time and wanted legislators to provide an alternative to a major bottleneck: its own inspectors. Under SB 1495, hospices could choose to pay a third-party accrediting organization for the inspection needed for a license, instead of waiting weeks or months for the next available state employee. ... Unlike a restaurant, which must undergo fire, building and health inspections, the vast majority of hospices in California could suddenly obtain a license, and even approval to bill Medicare, without a public employee stepping foot on the property. ...

52 hospitals closing departments or ending servicesBecker's Hospital Review; by Andrew Cass; 8/7/26A number of healthcare organizations have recently closed medical departments or ended services at facilities to shore up finances, focus on more in-demand services or address staffing shortages. Here are 52 department closures or services that are ending or have been announced, advanced or finalized that Becker’s reported since Jan. 1: ... [#40 names, "Minot, N.D.-based Trinity Health is suspending home health and outpatient hospice services. ...] 

Mandatory mortality surprise question screening in the ED: Identification and associations with end-of-life care outcomesJournal of Palliative Medicine; by Nancy Kim, Karen Jubanyik, Peiyuan Liu, Giselle O'Connor, Ling Han, Rohit B Sangal, R Lynn Fiellin, Jennifer Kapo, Elizabeth Prsic, Shelli Feder; 7/26Early identification of patients with serious illness remains challenging in the emergency department (ED), where clinical decisions are made under time constraints. The mortality surprise question (MSQ) is a brief prognostic screen that may help identify patients needing end-of-life services. Results: Among 113,397 admissions (74,816 patients), MSQ completion was 100%; 7.8% received a "No" response. A "No" response was strongly associated with increased palliative care consultation ... , ACP documentation ... , hospice referral ... , comfort-measures-only orders ... , hospice disposition ... , higher inpatient mortality ... , and increased 30-day readmission ... Palliative care consultation occurred earlier among MSQ "No" than MSQ "Yes" encounters.

"It felt like throwing in the towel": Family caregiver perspectives on end-of-life decision making in chronic obstructive pulmonary diseaseJournal of Palliative Medicine; by Natalia Smirnova, Tivona Batieste, Sarah H Cross, Samir Jamdar, Catherine S Peterson, Camille P Vaughan, Dio Kavalieratos; 7/26Chronic obstructive pulmonary disease (COPD) has an unpredictable trajectory and high symptom burden, complicating end-of-life (EOL) decisions around place of death and hospice use. We conducted semi-structured interviews with bereaved caregivers of people with COPD who received pulmonary care at a U.S. academic center and died within 12 months. Fifty-six percent of decedents received hospice; 33% died at home. Caregivers described five themes: missed prognostic cues and poor communication; hospice as both loss and relief; home as ideal but hospital as default; financial influences on decisions; and mismatch between hospice and COPD needs. Caregivers identified a readiness gap driven by prognostic uncertainty, communication challenges, and financial constraints.

Hospice's bad reputation amid fraud crisis will hurt patients, industry experts warn U.S. News & World Report; by Laurie Udesky and KFF Health News; 7/30/26... “The fraud situation has done a lot of damage to the reputation of hospices overall and undone a lot of the progress that had been made in destigmatizing hospice,” said Lauren Hunt, an associate professor at the University of California-San Francisco’s Philip R. Lee Institute for Health Policy Studies who focuses on hospice care. “Policymakers should pursue targeted strategies that root out fraud and abuse without overburdening the many providers who are doing the right thing.” ... Hunt said she’s heard from California healthcare providers who are reluctant to refer patients to hospice because they’re unsure the patients will receive high-quality care and from patients who don’t know which hospice providers they can trust. 

Why traditional primary care fails frail elders and the future need for specialized models | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Bethany Snider; 7/29/26 Traditional primary care wasn't designed for today's frail elders—and that gap may be one of healthcare's greatest challenges. As America's population ages, healthcare leaders face an urgent question: Is the traditional primary care model enough to care for frail older adults with complex medical, functional, and social needs?  In Part One of this thought-provoking conversation, Chris Comeaux welcomes Dr. Bethany Snider, Chief Medical Officer of Everent Health, to explore why the future of serious illness care requires a fundamentally different approach. Together, they unpack the emerging concept of the frail elder practice—a longitudinal, interdisciplinary model that extends beyond office visits to meet patients where they are, both physically and emotionally.

Why traditional primary care fails frail elders and the future need for specialized models | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Bethany Snider; 7/29/26 Traditional primary care wasn't designed for today's frail elders—and that gap may be one of healthcare's greatest challenges. As America's population ages, healthcare leaders face an urgent question: Is the traditional primary care model enough to care for frail older adults with complex medical, functional, and social needs?  In Part One of this thought-provoking conversation, Chris Comeaux welcomes Dr. Bethany Snider, Chief Medical Officer of Everent Health, to explore why the future of serious illness care requires a fundamentally different approach. Together, they unpack the emerging concept of the frail elder practice—a longitudinal, interdisciplinary model that extends beyond office visits to meet patients where they are, both physically and emotionally.

Public Policy Agenda & Toolkit National Coalition for Hospice and Palliative Care; Press Release; 5/4/26 The National Coalition for Hospice and Palliative Care’s Public Policy Agenda outlines a unified, consensus-driven set of priorities to strengthen palliative care and hospice for patients, families, and caregivers across the lifespan. Developed through collaboration among national member organizations, the agenda provides a coordinated framework to guide policy and advocacy efforts at both the national and state levels. It reflects shared priorities to improve access, advance quality and equity, support the workforce, and promote sustainable, value-based care.

Implementing the PAR scale in a pediatric concurrent care setting: A quality improvement projectJournal of Hospice & Palliative Nursing; by Taylor Ronne, Andrea Cahill, Kassidy Horst, Leeza Struwe, Kelly Gonzales; 6/26Pediatric patients in concurrent hospice and palliative care often face fragmented communication regarding family goals of care during acute hospitalizations. This quality improvement project evaluated clinician and care coordinator experiences with the implementation of the Preference for Acute Rehospitalization Scale at Children's Nebraska. A pre- and postimplementation survey design ...  assessed awareness of family goals, confidence in decision-making, and perceptions of the tool among an interdisciplinary team. While clinicians expressed general openness to standardized communication tools, results showed no statistically significant differences in survey items, highlighting that successful adoption in complex pediatric settings requires sustained education, seamless workflow integration, and robust interdisciplinary engagement to ensure treatment remains aligned with family preferences.

700 rural hospitals at risk of closing, by state Becker's Hospital Review; by Madeline Scheetz; 7/22/26 Seven hundred rural hospitals across the U.S., or about one-third of all rural facilities in the country, are at risk of closing due to severe financial challenges, according to a July 21 Center for Healthcare Quality and Payment Reform analysis. The analysis comprises 264 hospitals that are at immediate risk of closure, according to the report. In almost every state, rural hospitals are at risk of closure. In most states, more than 25% of rural hospitals are at risk and in 11 states, 50% or more are at risk. ... More than 100 rural U.S. hospitals have closed in the past decade, with 110 closing since 2015, according to the report. Fifty-three hospitals have ended inpatient services since the beginning of 2023 to qualify for federal grants only available to rural emergency hospitals.