Literature Review

Nursing home ratings and characteristics predict hospice use among decedents with serious illnessesJournal of the American Medical Directors Association; by Ellis C Dillon, Chae Man Lee, Wenqi Gan, Doreek Charles, Germine Soliman, Julie Robison; 4/26Approximately one-third of older Americans experience a nursing home (NH) stay within 3 months of death, but it is unclear how NH characteristics influence end-of-life care.  Short-term (vs long-term) NH stays were associated with increased odds of hospice use and short hospice use. Individuals with long-term stays had lower odds of hospice use with stays at NHs with the highest (vs lowest) CMS ratings for quality measures and staffing ... Those with short-term stays had lower odds of hospice use with stays at NHs with the highest CMS Health Inspection ratings. People with long-term stays at NHs that were part of a chain, had Alzheimer's care units, or had more beds had increased odds of hospice care. Conclusions and implications: Among Connecticut Medicaid-insured decedents with NH stays, people with long-term stays and stays in NHs with better CMS ratings had lower odds of hospice use. Assistant Editor's note: This summary article highlights an important issue and an excellent opportunity for future analysis in a broader context. Intuitively, we'd like to see highly rated NHs have higher hospice utilization. 

The financial and social costs of caregiving: 2026 U.S. News survey U.S. News & World Report; by Annika Urban; 5/4/26 For many of the more than 60 million American caregivers, small acts of love to help out a loved one escalate into a major commitment. This 2026 U.S. News survey examines the emotional and financial burden of caregiving and how home health agencies fit into their support network.

What a new hospice center means for Cleveland – beyond health care: Bill Finn Cleveland.com, Cleveland, OH; by Bill Finn, President and CEO of Reserve Care (formerly Hospice of the Western Reserve); 5/3/26 Cleveland is no stranger to reinvention. We are a city shaped by resilience, by industry and by a deep commitment to one another. That spirit is what makes this moment so meaningful as Reserve Care opens a new lakefront care center, designed not only for patients and families, but for our entire community. ... Set along Lake Erie, the space was intentionally designed to feel different from a hospital. ... Every detail, from the views of the water to the quiet areas for conversation, supports a single goal: to ease stress and create a sense of peace. But the impact goes beyond the walls of the building. ...

End-of-life doctors reveal 5 common fears people face in their final moments SavingAdvice.com; by Amanda Blankenship; 5/3/26  Most people avoid thinking about death, but doctors who work in hospice and palliative care say the same fears come up again and again. ... Research shows that death anxiety is common, with many people experiencing fear tied to the process of dying, not just death itself. ... here are five of the most common fears [identified by these doctors] among people facing their final moments.

[Singapore] Factors associated with caregiver burden among family caregivers of patients on home-based palliative care: A systematic reviewPalliative Medicine; by Wei-Ling Koh, Jerrald Lau, Chermaine Ang, Choon Meng Yee, Sara Ho, Ker-Kan Tan; 4/26Home hospice services are increasingly central to palliative care as more patients express preference for care or death at home. In these settings, the role of family caregivers becomes crucial.  Heterogeneity across studies highlighted uniqueness of patient-caregiver dyads on caregiver burden - for instance, family caregivers with multiple social roles may face heightened pressure from meeting patients' care demands. Other factors include logistical, financial or care arrangement matters. Caregiver burden interventions should adopt multi-pronged approaches to ensure holistic support for patients and family caregivers, such as incorporating both medical and psychosocial support to enhance wellbeing of both parties.

U.S. hospice market size to reach $45.3 billion by 2033 Grand View Research; April 2026 The U.S. hospice market size is estimated to reach USD 45.3 billion by 2033, registering a CAGR of 4.8% from 2026 to 2033, according to a new report by Grand View Research, Inc. 

OHSU grapples with falling rank on patient safety measures OPB, Oregon Health & Science University; by Amelia Templeton; 4/27/26 [The context begins with an "abrupt firing" of the CEO for OHSU Health. The excerpt below is further into the article, with relevance for hospice providers and your partnerships with hospitals.] Mortality — the number of observed patient deaths versus the number expected — was the other major contributing factor to OHSU slipping in Vizient’s ranks. Edwards shared several caveats with the board as to why she believes OHSU is performing better than its ranking indicates, particularly on the mortality score. For example, some patient deaths may have been counted differently by Vizient due to the closure of a hospice program. That could account for up to a third of the change in OHSU’s mortality grade, she said. And an internal review of the mortality data suggested that some OHSU patients’ medical charts weren’t accurately capturing how sick or complex they were.

VITAS banks on length of stay, referral mix management Hospice News; by Jim Parker; 4/27/26 VITAS Healthcare has been working to balance admission numbers from different settings and manage length of stay to prevent further payment cap liabilities after a rough go in the last months of 2025. Starting late last year VITAS began emphasizing hospital-based referrals in its admissions processes, which typically result in shorter length-of-stay patients. As of the fourth quarter of 2025, which marked the start of Fiscal Year 2026, the company has virtually eliminated that cap liability in Florida. This trend has continued into 2026, according to VITAS CEO Joel Wherley.

Who pays for hospice care in a nursing home? U.S. News & World Report; 4/23/26 ... Some people who pursue hospice care through nursing homes do so after a period of skilled nursing care, whereas others move to a nursing home in direct pursuit of hospice. However you time your transition, initiating hospice is a big decision.. To make sure you or your loved one is ready to make the change, consider the differences between how nursing homes provide hospice treatment and skilled nursing care, and how you’ll fund the transition.

New research shows earlier hospice election could save Medicare over $1 billion annually National Alliance for Care at Home, Alexandria, VA; Press Release; 4/23/26 A new analysis commissioned by the Research Institute for Home Care (the Institute) reveals that if Medicare beneficiaries elected hospice care just five days earlier, the program could save between $1.19 billion and $1.5 billion annually.  The analysis, conducted by ATI Advisory, demonstrates how modest, clinically appropriate changes in hospice timing could generate significant Medicare savings while improving patient outcomes. These findings are particularly relevant as Medicare spending on hospice services increases by nearly 10% annually, and overall enrollment of Medicare beneficiaries using hospice continues to grow.

Chapters Health System launches new pediatric program PR Newswire, Temple Terrace, FL; Press Release; 4/23/26 Chapters Health System announced the launch of Chapters Kids, a system‑wide pediatric hospice and palliative care program. Chapters Kids will expand resources for pediatric patients and families throughout the Chapters Health System service area and unite existing pediatric programs from several affiliates. "The launch of Chapters Kids is another critical step forward as we work toward fulfilling our mission of taking care of patients, or taking care of those who do," said Andrew Molosky, President and CEO, Chapters Health System.

End-of-life guidelines [in the ICU] emphasize unified care American Association of Critical-Care Nurses, in "Clinical Voices April 2026"; 4/21/26 New guidelines for end of life (EOL) care in the ICU call for clearer communication with families, stronger support for decision making and coordinated teamwork across disciplines to align treatments with what patients can realistically achieve and reduce suffering. “Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICU ,” in Critical Care Medicine, highlights the need for standardized processes, including identifying legal surrogates, using shared decision making tools and adopting protocolized withdrawal pathways. Additional priorities include early palliative care involvement, spiritual support and focused education to reduce conflict. Recommendations are summarized in three major areas:

“This is the beginning”: DOJ signals intensifying health care fraud enforcement in California Pillsbury; by Christopher Lee, Dylan M. Aste, Fank Kalinski; 4/16/26 Recent U.S. Department of Justice (DOJ) and California Attorney General enforcement activity sends a clear signal that California health care entities that interact with government programs—in particular the hospice and home health industries—are now under intense scrutiny. Companies in these sectors should prepare for subpoenas, Civil Investigative Demands, and searches as a result of federal and state agencies conducting independent and parallel investigations. This uptick in government enforcement is sure to spur qui tam relators and whistleblowers. Unprepared California hospice and home health companies may face significant civil, and even criminal, exposure.