Literature Review

A ‘cloak of comfort’: an integrated approach to palliative care for cancer patients Sinai Health; 5/26/25 At Mount Sinai Hospital, palliative care is fully integrated into cancer care, providing comprehensive, person-centered support for those with advanced illness. Palliative care, derived from the Latin pallium meaning “cloak,” offers comfort and support to individuals with serious illnesses. Often misunderstood as solely end-of-life care, it actually provides relief at any stage of a life-threatening illness and can be provided in tandem with cancer treatment. This holistic approach addresses physical, emotional, and spiritual needs, aiming to improve quality of life for both patients and their families. In fact, early integration of palliative care can enhance symptom management, extend life and offer greater support to caregivers. Patients can receive care at Mount Sinai Hospital’s Cancer Care Clinic, at home through the Temmy Latner Centre’s home palliative care program, and in the palliative care unit at Hennick Bridgepoint Hospital.  

Medicaid hospice payments for room-and-board to resume in California Hospice News; by Jim Parker; 5/15/25 After years of nonpayment, the California Department of Health Care Services (DHCS) has instructed Medicaid managed care plans to pay hospices for nursing home room and board. The issue pertains to patients who are dually eligible for Medicare and Medicaid. When caring for patients in nursing homes, hospices typically pay for their room and board with the expectation that they will be reimbursed by Medicaid for those expenses. However, due to confusion among managed care plans that oversee Medicaid in most states, those hospices have not been receiving those payments.

‘Surprisingly hopeful’ story emerges about LGBTQ+ rights, efforts in senior living McKnights Senior Living; by Kimberly Bonvissuto; 5/14/25 ... The Human Rights Campaign Foundation and LGBTQ+ elder advocacy group SAGE on Tuesday released its 2025 Long-Term Care Equality Index, a national benchmarking tool focused on LGBTQ+ inclusion in senior living and care. The key takeaway, the organizations said, is the “defiant progress” occurring despite political attacks against inclusion efforts.  As cuts to the Medicaid program — which many LGBTQ+ older adults rely on — come more into focus, participation in the latest survey jumped 37% from the 2023 report, with 274 long-term care settings across 33 states expressing commitment to inclusive care for more than 29,000 residents and 18,000 staff members. Participants included independent living, assisted living, memory care, continuing care retirement / life plan and affordable housing communities, as well as skilled nursing facilities and hospice settings.

How a Butler University and Community Health Network partnership helped save 420 lives and $4.3 million Butler Stories, Indianapolis, IN; by Katie Palmer Wharton; 4/30/25 For healthcare professionals, data is more than just numbers—it is the foundation of better patient care, smarter decisions, and more efficient hospitals. But for many, data can feel overwhelming and difficult to use effectively. That’s why Butler University’s Office of Continuing and Professional Education teamed up with Community Health Network to create a hands-on professional development course that demystifies data and equips healthcare workers with practical analytics skills. Since launching in spring 2022, the program has empowered 185 Community Health Network professionals to break down data barriers, make informed decisions, and drive meaningful change in their organization. ... Armed with new data skills, Community Health Network employees built a dashboard to streamline the process. The results were nothing short of remarkable:

Patient, provider, and health system determinants of hospice Length of Stay Palliative Medicine Reports; by Eliza Thompson, Daniel Sanchez Pellecer, Gregory J Hanson, Shealeigh A Inselman, Jenn M Manggaard, Kevin J Whitford, Jacob J Strand, Rozalina G McCoy; 4/3/25Background: Benefits of hospice care, such as improvement in quality of life and reduced costs, depend on duration of enrollment in hospice services, making timely hospice referral essential. ... Conclusion: Based on a review of hospice referral patterns, the integration of hospice care into subspecialty practices, long-term care facilities, and advanced practice education could be an effective strategy to improve hospice LOS.

Iowa nurse sentenced to prison after patient deathBecker's Hospital Review; by Mariah Taylor; 4/25/25A former Iowa licensed nurse practitioner has been sentenced to prison after failing to help a nursing home patient who died of asphyxiation, the Des Moines Register reported April 24. Becky Manning, 70, was in charge of the overnight shift at Care Initiatives, a nursing facility in West Des Moines, during one night in February 2023. That night, an 87-year-old patient indicated that his tracheostomy tube in his neck needed to have fluids suctioned out. Ms. Manning, who was the sole nurse on duty, refused to do so after repeated requests. Earlier that night, she reportedly told the director of nursing that she was unwilling or unable to suction the tracheostomy tube and the nursing director told her to “watch a video and figure it out,” according to a lawsuit filed by the man’s family. The man died of asphyxiation.

Prevention of acute hospital transfers for long-term care residents at the end of life American Journal of Hospice and Palliative Medicine (AJHPM); by Kirsten Lanpher, DMS, MSPA, PA-C and Kirsten Brondstater, DMS, MSPAS, PA-C; 3/24/25 Findings: Long-term care residents are a vulnerable population with advanced comorbidities who often require high acuity care and are subject to preventable transfers to the hospital at the EOL. These disruptions in EOL care cause harm and complications, negatively impacting quality of care. The consequences of these events can be mitigated with early advance care planning to include documentation of EOL care goals, onsite medical clinicians to make critical decisions and provide care within LTC facilities, and adequate staffing with proper palliative and hospice care training. Conclusion: Immediate action is needed to advocate for this high risk population and implement interventions to prevent hospital transfers at the EOL, therefore improving quality of care and positively influencing LTC residents’ EOL experience.

Legacy even in defeat? Nursing home experts anxious about next moves on staffing efforts McKnights Long-Term Care News; by Kimberly Marselas; 4/21/25 Two weeks after a judge struck down federal staffing standards for all US nursing homes, questions about the rule’s future continue to swirl within the industry. Will the government appeal the District Court’s ruling in Texas and continue to fight for regulations that would force nursing homes to create more than 100,000 new jobs in coming years? How will a judge hearing a similar challenge in Iowa interpret similar arguments, and what happens if the rulings conflict with one another? ... Regardless of whether the rule goes away, industry insiders have one clear expectation: Its legacy will continue to chafe nursing home leaders, who will still face intense pressure to recruit quality staff and improve patient care.

Federal court strikes down minimum staffing rule: The details you might not know behind the decisionMcKnights Long-Term Care News; by Neville M. Bilimoria; 4/21/25On April 7, 2025, the US District Court for the Northern District of Texas struck down the federal minimum staffing Final Rule issued by the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. This was incredibly good news for nursing homes across the country for a variety of reasons ... The opinion from District Court Judge Matthew Kacsmaryk outlined the many laws and regulations America’s nursing homes are subject to in the healthcare arena, but it also recounted some deep history behind minimum staffing efforts that were previously unsuccessful, both by HHS and Congress.  ...

Death matters: Is there really no place like home when it comes to dying? Sequim Gazette, Sequim, WA; by Jeanette Stehr-Green Volunteer Hospice of Clallam County; 4/16/25 While not everyone has the chance to decide where they will die, most Americans say that given the choice, they would prefer to die at home. For most people, home is familiar and comfortable. It is more private than a room in a hospital or nursing facility, and more likely to allow intimate gatherings with family and friends. In the home, the dying person and their caregivers are more in control, deciding when to have visitors, eat, drink, or take medications. ... Planning, realistic expectations, and adequate support are key to keeping a dying person at home. Consider the following steps: ... Home might not be best ...

HHS cuts pose threat to older Americans' health and safety Newsweek; by Kristin Lees Haggerty and Scott Bane - The National Collaboratory to Address Elder Mistreatment at Education Development Center (EDC); The John A. Hartford Foundation; 4/17/2 On March 27, 2025, the federal government announced major cuts to the department of Health and Human Services (HHS). ... Sounding the Alarm for Elder Justice: The population of older adults is rapidly growing, and one in 10 experience abuse, neglect, and/or exploitation—a risk that is even higher for those living with dementia. ... Cutting services to older adults will increase these risks and costs. Moreover, ... 11.5 million family and friend caregivers provide over 80 percent of help needed for people living with dementia in the U.S. Without access to services like Meal on Wheels, adult day care, and respite care, we can expect caregiver burden and strain to increase significantly and with it, rates of elder abuse, emergency department visits, hospitalizations, and nursing home placements. We know this because of the abuse spike seen clearly during the COVID-19 pandemic, which doubled to over 20 percent of older adults, as services were limited, and older adults were socially isolated. HHS cuts are also likely to result in loss of specialized expertise in identifying and addressing elder mistreatment, so that when elder abuse does occur, we won't have the services to stop it and make sure it won't happen again.

A mother’s goodbye-Barriers to microtransitions in careJAMA Internal Medicine; Aval-Na’Ree S. Green, MD, MHA, CMD; Benjamin E. Canter, OTD; 3/25After a long, debilitating battle with lupus, my cousin died at the doorsteps of our health system. The funeral was at 11:00 am. I arrived at the facility at 8:45 am. Although the catheter was in place, my aunt was undressed, with remnants of breakfast on her gown. She had not been bathed. The staff and I wheeled my aunt outside and attempted to load her into the van. Once my aunt was in the chair, it could not fit through the van door. Because this transition was not a medical health care appointment, the facility did not coordinate the resources, including use of the van, that were necessary for it to occur successfully. In contrast, had this been a medical outing, such as a weekend dialysis appointment, the facility would have been required to provide transportation. If this microtransition had been treated like a major health care transition, perhaps it would have had a better chance of success. Nursing teams use checklists during major care transitions; similar procedures should apply to microtransitions.

What role do immigrants play in the direct long-term care workforce? KFF; by Priya Chidambaram and Drishti Pillai; 4/2/25 President Trump has made a slew of immigration policy changes focused on restricting entry at the border and increasing interior enforcement efforts to support mass deportation. While these actions are focused on undocumented immigrants, they likely will have ripple effects across immigrants of all statuses and millions more people living in immigrant families. Mass deportations could negatively impact the U.S. economy and workforce, given the role immigrants play, particularly in certain industries. ...