When technology meets its limits: Integrating Medical Aid in Dying with withdrawal of a left ventricular assist device
Cureus; by Yvette Vieira, Paola Reveco; 6/26
As outcomes improve and patients [with advanced heart failure] live longer with [surgically implanted left ventricular assist devices], ... clinicians across disciplines are increasingly confronted with the complex clinical, ethical, and practical challenges that arise when life-sustaining therapy is dependent on implanted technology, particularly in the context of end-of-life decision-making. We present a case report of a 76-year-old man with advanced heart failure supported by an implanted cardiac pump [who wanted to pursue] ... medical aid in dying ... [in his own home] ... Deactivating a cardiac assist pump typically occurs in a hospital with intravenous sedation for the abrupt heart failure symptoms that can occur when the pump is turned off. An end-of-life care navigator and a carefully assembled interdisciplinary team providing medical aid in dying in conjunction with pump deactivation achieved the patient’s home death at his selected date. Coordinating implanted cardiac device withdrawal with medical aid in dying is clinically achievable, ethically defensible, and legally sound. Healthcare systems must develop written protocols, train hospice providers, provide anticipatory counseling, fund necessary infrastructure, and support this end-of-life care.

Toward home cancer care—Reducing time toxicity for the right patients with prostate cancer
JAMA Network Open; by David-Dan Nguyen, Bruce L. Jacobs; 6/26
Cancer care imposes a substantial burden, not only through the diagnosis itself and treatment-related adverse effects but also through the time spent traveling to appointments, waiting, and receiving care. Even in advanced stages of prostate cancer, many patients live for years with a chronic disease trajectory that requires ongoing monitoring, repeated visits, and long-term systemic therapy. Bange and colleagues ask whether some of this burden can be alleviated by moving elements of care from the cancer center into patients’ homes through an enhanced telehealth model for patients receiving androgen deprivation therapy. Their intervention is distinctive in combining several strategies that have individually shown promise, including paired telehealth visits with home-based phlebotomy, remote blood pressure monitoring, and at-home injections. Their central finding is encouraging: this model appeared both feasible and highly acceptable to patients and clinicians.

Restarting medications after deprescribing in adults discharged from hospital to skilled nursing
JAMA Network Open; by Thomas J. Reese, Sandra F. Simmons, Eduard E. Vasilevskis, Emily K. Hollingsworth, Matthew S. Shotwell, Amanda S. Mixon; 6/26
Question: Among older adults discharged to skilled nursing facilities (SNFs) after hospital-initiated deprescribing, what is the frequency and timing of medication restarts ...? In this cohort study analyzing data from 2 randomized trials with a total of 598 participants, 15.9% of deprescribed medications were restarted. Higher health literacy and longer intervention exposure were associated with fewer restarts, whereas more prescribers, higher number of baseline medications, and fewer pharmacies were associated with medication restarts; restart during the SNF stay was associated with greater 90-day hospital readmissions. Conclusions: In this cohort study, approximately 1 in 6 deprescribed medications were restarted within 90 days, with nearly half occurring soon after SNF discharge. Patient factors and markers of care fragmentation were associated with restart, suggesting that enhancing transitional care and postdischarge support may improve the durability of hospital-initiated deprescribing.

“I wish to be in the same room as my wife so I can hold her hand”: CalvertHealth grants husband’s final wish
The Baynet, Calvert County, MD; by CalvertHealth; 7/19/26 
It was one final wish Phillip “Phil” Pfanschmidt shared after learning he had terminal cancer. Just days earlier, his wife of more than 66 years, Joyce “Joy” Pfanschmidt, had entered hospice care at CalvertHealth Medical Center. Now, Phil had entered hospice as well. When members of the palliative care team asked about his wishes, he didn’t hesitate. He wanted to be with Joy.
Caregivers across CalvertHealth worked together to make that wish a reality. Phil was reunited with Joy, and the couple spent precious moments together, hand in hand. Less than two hours later, Joy peacefully passed away with her hand resting on Phil’s arm. ...
In his autobiography, Born to Live, Phil reflected on what mattered most. “For the last 64 years [as of 2024], every morning when I wake up and every evening before I go to sleep, I give thanks for the woman sleeping beside me.” ... Phil passed away on Friday, July 10, just nine days after Joy.

Crushing and flexing: CMS proposes to expand its discretion to deny and revoke Medicare enrollment 
The National Law Review; by Karen S. Lovitch, Jane Haviland, Mintz; 7/14/26 
... Currently, CMS’s revocation authority allows it to revoke enrollment prospectively following notice to the Provider. Following revocation, the Provider is no longer allowed to bill Medicare. CMS’s proposal would not only make the revocation date retroactive to the date of alleged noncompliance (or other triggering event) but would also allow CMS to claw back payments to the retroactive revocation date. CMS estimates approximately $82 million in annual savings from this proposal, clearly indicating that CMS views it as a high-impact program integrity measure. CMS’s proposal is also notable because, if finalized, it would give CMS greater flexibility to address suspected fraud without considering criteria that might otherwise constrain its actions. For example: ...

HHS pausing $1 billion in Medicaid payments to California, Minnesota over fraud 
LI; by Mary Chastain; 7/21/26 
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have paused more than $1 billion in Medicaid payments to California and Minnesota due to fraud concerns. “That includes more than $887 million for California and over $200 million for Minnesota,” HHS Secretary Robert F. Kennedy Jr. said at a press conference. “If those states want that money, they need to provide documentation that these payments are legitimate.”

This global healthcare lesson could change America | part one 
Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Mark Stoltenberg; 7/22/26 
Some of the most innovative solutions to America's healthcare challenges aren't being developed in the world's wealthiest hospitals—they're emerging from communities with the fewest resources. What can American healthcare learn from global healthcare?  In our latest episode, Dr. Mark Stoltenberg, Harvard Medical School professor and Massachusetts General Hospital physician, joins Chris Comeaux to explore global healthcare, palliative care, hospice leadership, healthcare innovation, and the future of serious illness care in America. ... Drawing from his work leading global palliative care programs throughout Latin America, the Caribbean, Africa, and other underserved regions, he shares how resource-limited healthcare systems are pioneering solutions that can improve American healthcare, strengthen the healthcare workforce, and restore compassionate, person-centered care.

“It wasn’t just a lyric — it was him” 
Their Life Song; personal story by Amber Gould, original music about her father by Johnny Warren; 7/15/26
Grief doesn’t follow a timeline. Amber Gould knows this well. “There are little everyday moments that remind me of him,” she says. “Whether it’s a familiar place, a scent, or a memory that suddenly comes back, he’s still a part of my daily life. I couldn’t think of a better way to honor those memories and feel connected to him than through music.” That's where Johnny Warren and Their Life Song come in. After Amber responded to Johnny's "remembering" questions about her dad, Johnny--owner of Their Life Song--wrote a deeply personal song about him. Upon turning her memories into song, what Amber found wasn’t closure — it was connection. 
Editor's Note: Click here for Johnny's tender song about Amber's dad, "The River You Showed Me."

At the river you showed me
How to slow down and breathe
How the trees and the water
Could bring a heart some peace
You were strong, you were laughter
You were the hand that held us near
And the love you gave your girls
Stilll carries us from here.

New easy-to-use web edition: A history of care - 250 years of American need, service and hope 
Composing Life Out of Loss, partnered with Hospice & Palliative Care Today; by Joy S. Berger; 7/20/26 
Growing out of readers' overwhelming response to our July 4th, 2026 commemoration, we’re releasing a new web edition of A History of Care: 250 Years of American Need, Service and Hope to carry this work forward. Use this living history—in your own setting and across our field—as we write the next chapters of care together. You and your teams can enter the story wherever it meets your work today:

• Table of Contents
• Prelude
• 1776–1866: Founding and Fracture
• 1867–1936: Industrial America and Reform
• 1937–1976: War, Rights, and Hospice Origins
• 1977–2006: Hospice and Palliative Care Take Shape
• 2007–2026: Trauma, Equity, and Moral Distress
• Coda – Composing the Next Movement of Care
• Key Sources

Share these links with your executive team, key leaders and colleagues in other organizations, and let it spark questions about integrity, access, workforce, and what your organization will add to this larger story. To explore using A History of Care in your leadership, education, or conference teaching, learn more here or contact me directly.

Restaurant owner shelves Easter plans to fulfill dying man's last wish to feed his hospice nurses 
Daily Good; by Good News Network; 4/7/26 
Frank Ozimek spent his final days in hospice care, but what occupied his mind wasn't his own suffering -- it was how to thank the nurses who had tended to him with such devotion. When his brother Ken struggled to find a restaurant open on Easter to fulfill Frank's wish to feed the hospice staff, Tommy Milani, owner of a local pizza shop, didn't hesitate: "Absolutely, whatever you need, Ken." Milani set aside his holiday plans and delivered pizzas to the entire nursing staff, completing a circle of care that began with strangers and ended with gratitude. In his last act, Frank found a way to say what perhaps mattered most -- that he had seen the kindness given to him, and wanted to give it back.  

Reporting Face-to-Face encounter conducted by a hospice physician or hospice nurse  practitioner for recertification via telecommunications technology on hospice claims, effective January 1, 2027 
U.S. Department of Health & Human Services |CMS; CMS Manual System, Change Request 14495; 7/10/26 
Effective January 1,2027, face-to-face encounters using telecommunications must be reported using a modifier or G code on the hospice claim. Guidance was released on July 10, 2026 and can be found in CR 14495 and MM14495. 

VITAS medical director: improve hospice referrals for cancer patients 
Hospice News; by Jim Parker; 7/16/26 
Hospice utilization among some cancer patients is leveling off and slowing growth, but healthcare providers and medical educators can adopt certain strategies to move the needle. This is according to Dr. Ileana Leyva, regional medical director for VITAS Healthcare. ... Neuro-degenerative, lung and cardiac diseases are gaining more prominence among hospice diagnoses. In 2024, senile degeneration of the brain was the most common terminal diagnosis among Medicare decedents at 9%, followed by Alzheimer’s at 6%, according to the National Alliance for Care at Home. Chronic obstructive pulmonary disease rounded out the top three at 4.2%. Lung cancer was the 11th most common diagnosis that year, at 2.1%, the highest rate for any form of cancer. Hospice News spoke with Leyva about the barriers that prevent cancer patients from accessing hospice sooner and what stakeholders can do to drive improvement.

If you think you can bribe me with a drive to the mountains to go to a cute coffe shop and sit on some rocks and watch water run over them, then you're absolutely correct.