Literature Review

Hospices facing a US caregiving ‘crisis’ Hospice News; by Holly Vossel; 6/2/25 Family caregivers in the United States are being challenged by a swelling aging population inneed of greater support and stronger policy infrastructures. Much room for improvement exists at both state and federal levels when it comes to recognizing the important roles that family caregivers play, according to Steven Lee, co-founder and CEO of ianacare, a Boston-based patient and caregiver resource company. More innovative care models and disease-specific reimbursement options have widened pathways for hospice providers to improve family caregiver support, Lee said in a recent Hospice News Elevate podcast. But these fall short of addressing the diverse scope of practical, emotional and financial needs, he stated. Editor's note: This article has an excellent map of US states with caregiver categories for "Well-Supported," "Safe for Now," "High Risk," and "Critical" (courtesy of Otsuka America Pharmaceutical). Additionally, our sponsor Hospice Analytics provides the National Hospice Locator, for caregivers/families to find hospices that serve in each US county, and sorted by their quality scores. And, our sponsor Composing Life equips hospice organizations with caregiver/family video libraries that span the continuum of serious illness, hospice, and grief care. 

HOPE Tool Anxiety: What are we forgetting in the rush to prepare?Teleios Collaborative Network (TCN); by Melissa Calkins and Ashley Espy; 5/30/25 Panic is in the air.  With the HOPE assessment tool set to replace HIS, hospice teams are racing to prepare—scrubbing workflows, updating systems, and trying to wrap their heads around new clinical documentation demands.  But amid the rush, it's easy to overlook critical gaps: non-clinical staff being left out of planning, unclear timelines, poor communication, or the complete absence of a project lead.  HOPE isn't just about compliance—it's about execution. If we don't step back and ask what's missing, we risk rolling out a system that nobody is truly ready for.Steps to Operationalize the HOPE Tool:

SpiriTrust Lutheran says Home Care & Hospice operations will wind down across three counties, end service on July 18th Tri-State Alert, Chambersburg, PA; Press Release; 5/29/25 Earlier on Thursday [5/29], News Talk 1037FM was alerted to a WARN notice from SpiriTrust Lutheran as to a closure of a portion of their business. Throughout the process, that notice has been narrowed down to their Home Care & Hospice (HCH), with the company announcing their plans to discontinue operations out of their Franklin County office which serves clients in Franklin, Adams and York counties. The official closure will be July 18, 2025. ... SpiriTrust Lutheran says that roughly 65 home care and hospice employees will be affected by the shutting, but  some are expected to be reassigned or offered positions within the SpiriTrust Lutheran family of Life Plan Communities ... SpiriTrust Lutheran officials cited the organization’s ongoing challenges mirrored those confronting many similar organizations nationwide – significant increases in the cost of delivering care due to staffing shortages; rising benefit expenses; and the escalating prices for medical supplies and pharmacy. 

Empath Health to sell service center location Hospice News; by Jim Parker; 5/29/25  The Florida-based senior care provider Empath Health is selling one of its administrative service centers, located in Pinellas County in its home state. The center was initially established by Suncoast Hospice, which is now an Empath Health affiliate. The sale is part of Empath’s effort to “realign its physical footprint” to invent more directly in home-based, patient-centered care, according to a statement from the organization. “Selling an underutilized administrative building allows us to reinvest in the people, programs and technology that bring comfort, dignity, and support into homes and communities,” said Jonathan Fleece, president and CEO of Empath Health, in the statement. “It’s a return to our roots and a recommitment to the future.”

AI readiness isn’t a new challenge — it’s a familiar oneBecker's Health IT; by Polly Parrent; 5/28/25As AI sweeps across healthcare headlines, it’s tempting to view it as a brand-new frontier, something fundamentally different from previous health IT efforts. But in reality, AI is not a departure from the digital transformation journey we’ve already been on; it’s a continuation. A recent survey from Nordic and Modern Healthcare on AI readiness in healthcare brings this full circle: the same foundational elements that enabled the introduction of electronic health records (EHRs) — infrastructure, governance, data, and workforce training — are the same critical elements for successful AI adoption.

[United Kingdom] Hospice cuts staff and beds to secure its future BBC News, Yorkshire, UK; by Alex Moss; 5/23/25A hospice in Huddersfield has announced it has made 19 staff redundant and reduced the number of inpatient beds in order to save its future. The Kirkwood provides end-of-life care to about 2,000 patients each year but its chief executive Michael Crowther said it had faced a "perfect storm" of rising operational costs over the past few years. ... He said: "This has been the single hardest decision we have ever had to make." Another nine staff members have agreed to cut their hours and several others have decided to retire to help reduce the annual costs by £1.7m, the hospice added. ..."As you can imagine, this has been one of the most difficult periods in The Kirkwood's history. ..."Editor's note: Read more--directly from The Kirkwood--at "Securing Our Future Together: A New Way Forward." 

Proposed California budget calls for prior authorization for hospice in Medicaid Hospice News; by Jim Parker; 5/22/25 The proposed California budget would require prior authorizations for hospice care within the state’s Medicaid program. Currently, Medicaid managed care plans who provide coverage through the state’s Medicaid system, Medi-Cal, may not perform prior authorizations for hospice. California’s Department of Health Care Services (DHCS) indicated in a 2025-2026 budget revision that this could save $25 million over the next two years and more than $50 million in the long term. If enacted, this would make California the first state in the nation to implement such a rule, according to the California Hospice & Palliative Care Association (CHAPCA). The association contends that the anticipated $25 million in cost savings is “speculative and fails to account for the downstream costs and systemic burdens this proposal would create,” according to a position paper shared with Hospice News. ... CHAPCA recommended to the state government three alternative approaches: ...

Proposed bill would require MA to pay for hospice care Hospice News; by Jim Parker; 5/21/25 Rep. David Schweikert (R-Ariz.) has introduced the Medicare Advantage Reform Act, which among other provisions would require health plans to pay for hospice care. If enacted, the bill, numbered H.R. 3467, would make wholesale changes to the Medicare Advantage program. It would mandate capitated payment models, change risk adjustment methodologies and create new exemptions for physician self-referrals, among other provisions. The potential impacts of moving hospice into Medicare Advantage at this time would be “devastating,” according to the National Alliance for Care at Home. 

A proposal to remove hospice providers from a state review poses a threat to patient care The Boston Globe, Boston, MA; by Diana Franchitto; 5/16/25 The General Assembly should maintain rigorous standards and oppose rolling back Rhode Island’s Certificate of Need process, writes HopeHealth president and CEO. ... As the president and CEO of HopeHealth Hospice & Palliative Care, I am proud that Rhode Island offers some of the highest-quality hospice care in the nation. But right now, legislation before the General Assembly could put that quality at risk.A proposal in Governor Dan McKee‘s fiscal 2026 budget would eliminate the requirement that hospice providers be scrutinized by Rhode Island’s Certificate of Need (CON) process. Some may position this as an effort to streamline government, but those of us who work in hospice care know better. The CON process isn’t one of the flashier, public-facing functions of state government, but it has a direct impact on the quality of health and hospice care that Rhode Islanders receive throughout their lives. ... Exempting hospice from meeting the rigorous standards that a CON requires poses an immediate threat to the quality of patient care. ...

Dementia patient discharged from hospice over Medicare requirement. Here’s why it happened WKMG-6, Deltona, FL; by Erika Briguglio and Louis Bolden; 5/14/25A Volusia County family is left scrambling after their loved one is abruptly dropped from hospice care. To qualify for hospice, patients must have a life expectancy of six months or less. However, for dementia patients, the prognosis can be unpredictable. Hospice care can be extended as long as the patient continues to meet Medicare requirements. Unfortunately, these requirements are why Amy Yates lost coverage for her 91-year-old grandmother. ... “I think it’s she hasn’t died fast enough, and it’s costing them money that they don’t want to spend,” Yates told News 6. ... What Yates’ family is dealing with is what Medicare calls live discharge, and they are not alone. The Hospice Foundation of America reports that 17% of people in 2022 who were admitted to hospice care were discharged; about 6% of the total caseload was discharged because they no longer met Medicare requirements for care under the hospice benefit.Editor's note: What are your hospice stats for live discharges? For Length of Stay (LOS)? This factor--with the face-to-face recertification requirement--is crucial. Unfortunately, many hospices misused President Jimmy Carter's extraordinarily long LOS with misleading information about hospice care. They watered down "end-of-life" care and never mentioned anything about a basic recertification process. Warm, user-friendly language can be used with integrity, authenticity, and patient/caregiver support.

Pine Tree Hospice hosts 29th Annual Variety Show The Piscataquis Observer - The Voice of Rural Maine, Dover-Foxcroft, ME; by Staff; 5/5/25 On a rainy, dreary Saturday in April, the volunteers of Pine Tree Hospice presented the group’s 29th Variety Show and created a little sunshine at the Center Theatre for the 100 attendees. The corps of volunteers ran the show from greeting attendees to taking tickets to selling tickets for the quilt raffle to running the first annual pie faffle. The Annual Variety Show, a major source of funding for the group’s volunteer-based non-medical support services, raised nearly $8,000.

The Carilion office driving 139 projects Becker's Hospital Review; by Kelly Gooch; 5/5/25 Roughly five years ago, Roanoke, Va.-based Carilion Clinic recognized the need for an organizational pivot to better align system strategic plans with major operational initiatives. That led to the creation of its Enterprise Project Management Office, which leaders say has already yielded results. At the outset, senior leaders sought to build an internal group that could consistently implement and support the organization’s strategic plan.  Carilion — an integrated health system with seven hospitals, home health services, imaging, pharmacies, urgent care centers, a ground and air transportation network and a more than 800-member multispecialty physician group — had previously housed pockets of project management within various departments, ... However, the health system’s goal was more standardization, as many project managers were splitting their time between project management and day-to-day operations.