Literature Review

HHS proposal slashes Medicare SHIP funds MSN; by Mary Helen Gillespie; 4/22/25 The Trump administration is proposing federal budget cuts to Medicare State Health Insurance Assistance Programs (SHIP) and seven additional elder health care safety net programs that assist older Americans. ... SHIP programs have been under the umbrella of the Health and Human Services agency Administration for Community Living. The pre-decisional budget lists funds for seven other ACL programs that would be eliminated are:

Jury convicts home health agency executive of fixing wages and fraudulently concealing criminal investigation U.S. Department of Justice - Office of Public Affairs; Press Release; 4/14/25 A federal jury convicted a Nevada man today for participating in a three-year conspiracy to fix the wages for home healthcare nurses in Las Vegas and for fraudulently failing to disclose the criminal antitrust investigation during the sale of his home healthcare staffing company.  According to court documents and evidence presented at trial, Eduardo “Eddie” Lopez of Las Vegas, Nevada conspired to artificially cap the wages of home healthcare nurses in the Las Vegas area between March 2016 and May 2019. The three-year conspiracy affected the wages of hundreds of Las Vegas registered nurses and licensed practical nurses who provide care to patients in their homes. During the pendency of the government’s investigation, Lopez then sold his home healthcare staffing company for over $10 million while fraudulently concealing the government’s criminal investigation from the buyer.  

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.

CMS halts spending for nonmedical in-home Medicaid services, likely affecting providers McKnights Home Care; by Adam Healy; 4/13/25 The Centers for Medicare & Medicaid Services told states last week that it would not approve future federal matching funds for designated state health programs (DSHPs) and designated state investment programs (DSIPs). These programs are widely used to help Medicaid beneficiaries remain at home and in their communities.

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. ...

Senior living demand hits all-time high: NIC McKnights Senior Living; by Kimberly Bonvissuto; 4/3/25 The demand for senior living is at an all-time high, with the first quarter seeing a record number of occupied units, almost 621,000, the National Investment Center for Seniors Housing & Care said Thursday afternoon [4/3]. Senior living occupancy rates increased 0.3 percentage points to 87.4% in the first quarter, up from 87.1% in the fourth quarter of 2024, according to the latest NIC MAP Senior Housing Market Fundamentals report. Independent living occupancy rose to 89%, up from 88.6% in the fourth quarter, whereas assisted living rates increased to 85.8% compared with 85.5% in the fourth quarter.

What happens when someone passes at home? It depends Bozeman Daily Chronicle, Bozeman, MT; Chris Remely "discussions with a funeral director"; 4/5/25 One of the most common questions we get asked as funeral directors is, “What happens if I pass away at home?” The answer is ... it depends. Home death is fairly common in the context of someone being on hospice care. For many individuals who have been given a difficult medical diagnosis that is terminal, they often prefer to be at home surrounded by loved ones for as long as possible. ... In this scenario, hospice will pronounce the death and work with the funeral home to transfer the individual into their care. ... However, when someone passes away at home and they are not on hospice, this is considered an “unattended death” — meaning a medical professional is not involved. In this case, the coroner’s office is required to investigate the death to determine the cause and manner of death — as well as pronounce the death. ... When someone from the coroner’s office arrives, they will do several things. They will visit with the next of kin and ask them questions about their loved one’s medical history and investigate the scene where the death occurred. Editor's note: Too often, hospices gloss over this all-important information for caregivers and families. Death is traumatic enough. Families are left in a lurch. Conflicts can erupt at the family's most vulnerable moments. Yes, timing and delivery for such sensitive information is important. Our sponsor Composing Life Out of Loss provides empathic, sensitive videos for hospice teams to use with caregivers and families, with interdisciplinary team guides for tending individuals' different readiness for education and preparation.

AGG talks: Home health & hospice podcast - Episode 10: Anti-Kickback Compliance for hospice and skilled nursing providers JD Supra; by Arnall Golden Gregory, LLP; 4/3/25 In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss recent OIG guidance on hospice and skilled nursing facility relationships, focusing on anti-kickback risks and fraud concerns. They cover key issues such as the importance of documenting fair market value for any services or space provided, being cautious of payments exceeding Medicaid room and board rates, and avoiding arrangements that appear to be made solely to secure referrals. Bill and Jason also touch on increased oversight and enforcement in the healthcare sector under a new presidential administration.

The most personal column I’ve ever written The Times, United Kingdom; by Professor Tanya Byron; 3/31/25 ... This column will be more personal than any other I have written in my now 20 years writing for The Times. I write it four days after my sister Katrina and I lost our beloved mum, Elfie, who ... had advanced end-stage dementia. Where do we start when trying to describe the many moments of heartbreak and the challenges that come with the long goodbye we have faced with our parents? Dementia is unpredictable. We say goodbye more than once and so the pain of bereavement does not begin at the time of death. Instead it is a prolonged pain marked by gradual losses. Watching a loved one slowly fade away over months or years brings grief, exhaustion and deep emotional turmoil. Amid all this is the experience of being on a rollercoaster of loss and hope, an experience that creates huge lurches between perceptions and emotions. There are moments of clarity and regression, ... [Continue reading ...]

Stetson University professor joins millions of Americans as she embraces caregiver role for her aging parents Spectrum News 13, Orlando/Deland, FL; by Nicole Griffin and Devin Martin; 3/31/25 According to the U.S. Bureau of Labor Statistics, more than 10 million Americans act as unpaid caregivers for an elderly parent on a regular basis. Millions in that group not only have a full- or part-time job, they are also part of the so-called “sandwich generation” — people who find themselves supporting their children and parents at the same time. ... Stetson University professor Wendy Anderson is part of that group. ... She has moved in with her parents to help care for her elderly father and mother, who is in at-home hospice care. [Continue reading ...]

Palliative care in home health: Misconceptions and market opportunities Home Health Care News; by Joyce Famakinwa; 3/28/25 While palliative care remains an uncommon offering among home-based health care providers, forward-thinking providers have recognized a growing market demand and are strategically expanding their service offerings to include palliative care solutions. Expanding service lines to include palliative care can help home-based care providers stand out from their peers, industry insiders told Home Health Care News. However, a significant knowledge gap is slowing the adoption of palliative care within the home health community. Home health care clinicians, patients and caregivers all report insufficient knowledge of palliative care, according to a recent study conducted by Columbia Nursing research and published in the Journal Home Healthcare Now. [Continue reading ...]

AGG, New Day’s Bill Dombi: Hospices’ ‘vibrant evolutionary path’ spurs legal growing pains  Hospice News; by Holly Vossel; 3/26/25 Today’s hospice landscape is reaching a pivotal point of evolutionary growth that has come with increased oversight as regulators seek to curb fraudulent activity in the space, according to Bill Dombi, senior counsel for the law firm Arnall Golden Gregory (AGG). ... He previously served as president of the National Association for Home Care & Hospice (NAHC) for 38 years prior to its affiliation with the National Hospice and Palliative Care Organization (NHPCO) in 2023 and was heavily involved in the establishment of the Medicare Hospice Benefit. ... [Dombi:] "... Hospice has been a very vibrant part of the health care world for quite a while now, but I think its energy levels are at an all-time high right now. And that’s energy levels in terms of not just public awareness and utilization of the services, but also the gained respect of recognizing that hospice is not a cottage industry anymore. Some people might label it as growing pains. I call it more of an evolution that naturally seems to occur in any field and in any organization."  [Continue reading ...]