Literature Review

'Rehabbed to death’: Bringing more palliative, hospice care to SNFs Hospice News; by Kristin Easterling; 11/26/25 Patients in skilled nursing facilities (SNFs) can become trapped in a “rehabbed to death” cycle that could be prevented with better access to palliative care and hospice. The Patient Driven Payment Model (PDPM) used by SNFs could be harnessed to enable more palliative care and earlier admission to hospice, according to a study published in the Journal of the American Geriatrics Society.Editor's Note: Click below for the study and related articles we've posted.

BULLETIN: HHS repeals nursing home staffing rule provisions McKNights Long-Term Care News; by Kimberly Marselas; 12/2/25 The Department of Health and Human Services today repealed key provisions of the minimum staffing standards for long-term care facilities finalized in 2024. The move follows months of legal and legislative challenges, which had already rendered hourly staffing and registered nurse requirements moot. HHS said it was repealing provisions in alignment with the One Big Beautiful Bill Act, which imposed a nine-year moratorium on the rule’s staffing measures. ... Notice of the appeal was posted in the Federal Register Tuesday morning. Editor's Note: Click here for the official publication of this repeal, scheduled to be published on 12/3/25.

He built a nursing home empire despite state investigations. Now, lawsuits are piling upCal Matters; by Jocelyn Wiener; 11/20/25California nursing homes affiliated with Shlomo Rechnitz are facing lawsuits alleging that patients were raped, ignored and unnecessarily exposed to COVID-19. His companies deny the allegations. In February 2024, a Los Angeles County jury awarded $2.34 million to an 84-year-old nursing home resident named Betsy Jentz, finding that the facility had violated her rights on 132 occasions, at times leading to serious injuries. [Three more equally offensive cases.] All of these facilities have one thing in common: state records list Shlomo Rechnitz as an owner. Court documents show Rechnitz and his companies have denied all allegations in all of the cases.

Benzodiazepine or antipsychotic use and mortality risk among patients with dementia in hospice careJAMA Network Open; by Lauren B. Gerlach, Lan Zhang, Hyungjin Myra Kim, Joan Teno, Donovan T. Maust; 10/25Benzodiazepines and antipsychotics are commonly used in hospice to manage symptoms such as agitation, anxiety, and terminal delirium in people with ADRD [Alzheimer disease and related dementias], often in response to behaviors that are distressing not only to the patient but also to family caregivers and staff. While these medications can offer symptom relief, they carry risks, including falls, sedation, and confusion. In this national case-control study of nursing home residents with ADRD receiving hospice care, initiation of benzodiazepine or antipsychotic use was associated with increased 180-day mortality. While these medications may provide symptom relief in appropriate clinical scenarios, their use is associated with substantial risks. These findings highlight the need for careful prescribing decisions and the development of dementia-specific hospice prescribing guidelines.

States’ promising practices to improve care of serious illness National Academy for State Health Policy (NASHP); by Stacie Sinclair (Center to Advance Palliative Care) and Wendy Fox-Grage; 11/17/25 Every state has taken meaningful action in some capacity to improve care for residents facing serious illness, affirms a recent publication from the Center to Advance Palliative Care (CAPC). The report documents how states are using a wide array of policy levers — such as legislation, Medicaid innovation, public education, and workforce development — to improve access to and quality of palliative care. 

When Medicare sent patients home sooner, Mary Naylor built the safety net Penn LDI - Leonard Davis Institute of Health Economics; by Liz Seegert; 11/17/25 When Medicare’s diagnosis-related group (DRG) payment system took effect in October 1983, hospitals adapted quickly, discharging patients faster to manage fixed reimbursement rates. Heart failure patients who once stayed eight to 10 days were going home in three to four days. But LDI Senior Fellow Mary Naylor, then a fellow with what was then known as the U.S. Senate Committee on Aging and Finance, realized no one had thought about what happened after discharge. She saw how these shifts created new risks for older adults, as hospitals lacked the infrastructure to support care continuity. ...

[Hospice] Christmas drive ongoing for local nursing homes McAlester News-Capital, Stigler, OK; by Remus Martin; 11/11/25 San Bois Hospice [in southeast Oklahoma] is hosting a Christmas drive for local nursing homes lasting until Dec. 10. Stacey Harvey, marketing employee with San Bois Hospice, started the drive eight years ago with the organization. ... She said children are always remembered during Christmas time, but the elderly tend to be forgotten. They want to make sure people in the nursing home are not forgotten and receive gifts.

‘Best and worst of times’ as skilled nursing providers face more uncertainty McKnights Long-Term Care News, Boston, MA; by Kimberly Marselas; 11/3/25 In a year in which uncertainty and inaction have been common themes, LeadingAge executives acknowledged ... that aging services providers are increasingly split into haves and have-nots.  “We have all been navigating a great deal of uncertainty, and yet many organizations have had their best years, ... President and CEO Katie Smith Sloan told a standing room-only crowd. “Others are hanging by a thread, dependent on Medicaid, struggling on staffing, particularly in rural communities with old physical plants, and boards that are stuck on preserving the status quo. It is truly the best and worst of times.”

Living with dementia report emphasizes that even those with advanced disease have stories to share JAMA Medical News; by Rita Rubin, MA; 10/31/25 As the average age of the US population has risen, so has the number of people living with Alzheimer disease and related dementias. And yet, dementia is still a highly stigmatized condition, a new collection of essays published by the Hastings Center for Bioethics points out. Clinicians, caregivers, and loved ones could improve the lives of the more than 7 million people in the US who are living with dementia if they only recognized that such individuals still have their own stories to tell, even when they can’t express themselves the same way they did before their symptoms appeared. 

CMS’s Special Focus Facility Program for Nursing Homes has not yielded lasting improvementsOIG press release; 10/29/25This report evaluated the effectiveness of the Centers for Medicare & Medicaid Services’ (CMS) Special Focus Facility (SFF) program, the agency’s flagship effort to address quality problems at the nation’s poorest-performing nursing homes. OIG found nearly two-thirds of facilities that graduated from the SFF program between 2013 and 2022 later exhibited recurring quality issues. Among nursing homes that received a serious deficiency in the three years after graduating, 38% put residents at risk of serious injury, harm, impairment or death. For program improvement, OIG recommended that CMS use more nonfinancial remedies, assess enforcement effectiveness—especially for staffing deficiencies—and incorporate ownership data.Publisher's note: It's interesting to see what works - and what doesn't work - from the CMS / OIG perspective.

Engaging community health workers in Advance Care Planning  Hospice News; by Jim Parker; 10/24/25 Three organizations have developed an advance care planning training program in Illinois for community health workers that could potentially be adapted for other states. The seeds for the project were planted when the Illinois Public Health Association (IPHA) was awarded a grant by the Health Resources & Services Administration (HRSA). IPHA proceeded to engage the Illinois Hospice & Palliative Care Organization (IL-HPCO) and the HAP Foundation as subject matter experts to help develop the curriculum, as well as the education company Hospice Media, which filmed and designed the modules and workbooks.

Three tried-and-true strategies AHCA Gold Quality Award winners use to land and keep staff McKnights Long-Term Care News, Las Vegas, NV; by Kimberly Marselas; 10/22/25 Leaders of three of the nation’s best-performing nursing homes shared ... outside-the-box recruitment and retention strategies that have made robust staffing the linchpin of their respective quality-improvement journeys. ... Here, McKnight’s Long-Term Care News shares a few of the role model practices Peters and her two 2025 Gold National Quality Award peers rely on to create staff loyalty, even in highly competitive markets.

Study: Nearly two-thirds of nursing home residents were exposed to med combos linked to potential drug-drug interactions McKnights Long-Term Care News; by Foster Stubbs; 10/17/25 About 62% of nursing home residents experienced one or more drug-drug interactions (DDI) between 2018 and 2020, according to an October study published in the Journal of the American Geriatrics Society. Researchers examined 485,251 Medicare fee-for-service beneficiaries 66 years or older living in nursing homes with observable Medicare Part D prescription drug data. Data were drawn from Medicare claims linked to Minimum Data Set 3.0 clinical assessments.