Literature Review

Report sounds alarm about private equity’s growing involvement in PACE McKnights Home Care; by Adam Healy; 9/24/25 The Program of All-inclusive Care for the Elderly (PACE), a program funded by Medicare and Medicaid, is an increasingly attractive target for private equity investors. This may be a cause for concern, according to a new report by the Private Equity Stakeholder Project. “Private equity sees PACE as a guaranteed revenue stream, not a care model,” Michael Fenne, report author and PESP’s senior healthcare research coordinator, told McKnight’s Home Care Daily Pulse Wednesday in an email. “The result is that PACE, once a nonprofit-driven model focused on keeping seniors healthy at home, is increasingly being treated as a financial opportunity for investors.”

Nevada hospital wins half-billion fraud verdict against Universal Health Services Reno Gazette Journal; by Jason Hidalgo; 9/29/25, updated 9/30/25 Saint Mary’s Health Network earned a big win in court after a jury awarded it half a billion dollars in its case against Universal Health Services. A jury in Washoe County awarded the Prime Healthcare affiliate $510 million after it found Universal Health Services liable for fraud against Saint Mary’s during the COVID-19 pandemic. The verdict included punitive damages. "This verdict affirms that the weaponization of corporate power, betrayal of physician trust, theft of proprietary information, and reckless endangerment of patients will not be tolerated,” said Saint Mary’s Health Network CEO Derrick Glum in a statement. “The verdict restores justice and allows our hospital’s mission to serve our community with compassion and dignity to endure.”

Study provides new insight into loneliness among home care recipients McKnights Home Care; by Paul Katz, MD and Barbara Resnick, PhD; 9/22/25 ... A team of international Investigators, led by researchers at the University of Waterloo, recently reported on the link between loneliness and mortality among home care recipients in Canada, Finland and New Zealand. The study can be found in the July issue of the Journal of the American Medical Directors Association (Vol 26 (7) 105687 July 2025). ... Home care recipients may be more prone to loneliness, given mobility and sensory problems that limit engagement in the community.  ... Interestingly, investigators noted that individuals with less informal care had the highest rates of loneliness. An explanation may be that those with less complex health needs requiring  less support from family members may lead to more social isolation.

Americans choosing cremation at historic rates, NFDA report finds National Funeral Directors Association (NFDA), Brookfield, WI; Press Release; 9/18/25 Americans are choosing cremation more than ever before, setting a new milestone in funeral service trends for 2025. According to the National Funeral Directors Association (NFDA) 2025 Cremation & Burial Report, the U.S. cremation rate will reach 63.4% this year, more than double the projected burial rate of 31.6%. These shifting preferences reflect lasting changes in family priorities, funeral profession practices and cultural attitudes. Key 2025 Report Highlights: 

Has human life expectancy already peaked?Vice; by Luis Prada; 9/10/25 For most of the 20th century, human life expectancy skyrocketed. Advancements in hygiene science, a wide variety of medical innovations and discoveries ... have all helped our collective life expectancies tremendously. According to a new study, however, we may have topped out. In the study, published in PNAS and spotted by Science Alert, an international team of researchers crunched the numbers on people born between 1939 and 2000 in 23 high-income countries, using six different forecasting models.Editor's Note: I recall a hospice CE conference around 2005, where a healthcare data statistician presented projections on mortality trends. Based on the previous century’s gains, the data suggested that babies born then could live well past 100—with 120 years as a realistic possibility. This new study raises the provocative question of whether those optimistic forecasts may already have reached their limits.

SCAN continues to expand PACE business amid regulatory hurdles Becker's Payer Issues; by Jakob Emerson; 9/9/25 With its second Program of All-Inclusive Care for the Elderly center now open in South Los Angeles, SCAN Group is pressing ahead with a care model that faces steep regulatory challenges. The new 33,000-square-foot facility in Compton will provide low or no-cost medical, social and in-home services for seniors eligible for Medicare and Medicaid. The center builds on myPlace Health’s first PACE site, which opened near downtown Los Angeles in 2024. The two centers now serve 136 members, with enrollment expected to exceed 150 in the coming months. 

Training and practice gaps in nursing home palliative care: A cross-sectional study Journal of the American Geriatrics Society (AGS); by Manali Saraiya, Molly A. Nowels, Rose L. Carlson, Jerad H. Moxley, Catherine A. Riffin, Evan Plys, M. Carrington Reid, Isabella Hastings, Taimur Mirza, Ronald D. Adelman, Daniel Shalev; 9/7/25 We conducted a cross-sectional survey of clinical employees (N = 398) at seven NHs within a single integrated health system in New York State to (1) gauge attitudes toward and knowledge about palliative care, (2) estimate the extent of engagement with advance care planning, and (3) elicit perceptions of the most valuable components of palliative care for NH residents. ... Despite support for palliative care, gaps in knowledge and clinical engagement persist and vary by discipline. Discipline-tailored training and program design may improve palliative care delivery in NHs and help ensure more consistent, value-aligned care for residents with serious illness.

How to choose the right assisted living facility for your aging loved one Mediafeed.org; by Rebecca Schier-Akamelu; 8/19/25 When you tour assisted living facilities, you’ll have the opportunity to speak directly with staff members and, when appropriate, even residents. Asking questions about pricing, amenities, caregivers, the types of care provided, and community culture will help you and your loved one compare when it’s time to choose the best facility. Key questions to find the right fit: ... 

Amid growing 'scandal' of elder homelessness, health care groups aim to help NPR, Bristol, RI; by Felice J. Freyer; 8/16/25 At age 82, Roberta Rabinovitz realized she had no place to go. A widow, she had lost both her daughters to cancer, after living with one and then the other, nursing them until their deaths. Then she moved in with her brother in Florida, until he also died. ... Rabinovitz joined the growing population of older Americans unsure of where to lay their heads at night. But Rabinovitz was fortunate. She found a place to live, through what might seem like an unlikely source — a health care nonprofit, the PACE Organization of Rhode Island.

Governor creates new LTC oversight board, pledges to fill surveyor openings by year’s end McKnights Long-Term Care News; by Jessica R. Towhey; 8/12/25 A new politically appointed Nursing Home Oversight and Accountability Advisory Board is being proposed as a way to strengthen facility oversight in a state that has a 42% vacancy rate among its public inspectors. Gov. Glenn Youngkin (R) called for the board, which will consist of members appointed by the state Secretary of Health, in an executive order issued Monday. Both LeadingAge Virginia and the Virginia Health Care Association / Virginia Center for Assisted Living applauded the overall goals of the executive order but cautioned that resources to implement the directives are needed. Guest Editor's Note, Judi Lund Person: The Virginia governor, Glenn Youngkin, has taken steps to address surveyor vacancies and strengthen oversight for nursing homes in the state, calling on partnerships with other states for training. Advocates cited the state, as in many other states, is hampered by flatline funding from federal partners and the lack of clinical staff willing to fill surveyor roles.  

Blindsided: Some nursing homes across the country aggressively pursue friends and relatives for a loved one’s unpaid bill 14 News; by Jill Riepenhoff and Chris Nakamoto; 8/11/25 Toni Cook opened the letter from her mother’s nursing home and cried in horror. Lynn Marie Witt dropped to her knees and sobbed when she read the letter from her mother’s nursing home. Both women — stiff and grief-stricken over the loss of their beloved mothers — learned from those letters that the nursing homes intended to collect their mothers’ unpaid debts from them. Neither had any financial control over their mother’s bank accounts or assets after their deaths, court records say. They simply were loving daughters who signed paperwork to have their mothers admitted to a nursing home.

Amazon documentary exposes 'neglect and pain' in many nursing homes. It's only going to get worse. Morningstar; by Jessica Hall; 8/9/25  Susie Singer Carter's mom, Norma Pecora, suffered from Alzheimer's disease for 16 years and spent the last five years of her life in a nursing home. She died at age 89 after enduring sepsis, urinary-tract infections, bed sores and dehydration at a five-star facility in Los Angeles. ... In a new three-part documentary streaming on Amazon Prime (AMZN) called "No Country for Old People: A Nursing Home Expose," Carter walks viewers through her mom's early life, including her time as a singer for Capitol Records, as well as her final months - when she suffered from infections and other complications that required emergency hospitalizations while being cared for at a nursing home.