Regulatory leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire 
Fierce Healthcare; by Noah Tong; 4/17/25 
Department of Health and Human Services (HHS) reorganization plans appear to have been revealed through a leaked Office of Management and Budget (OMB) document. The 64-page PDF with HHS’ plans were first reported by Inside Medicine and later reported by The Washington Post and other news publications. In an update, Inside Medicine said the entire document was authenticated by The Washington Post. ... While the restructuring was broadly announced, and individual offices have been reportedly axed in recent weeks, the leak provides greater insight into how the reorganization, firings, reductions in force and office eliminations and consolidations will fundamentally alter the agency.

This weekend: Passover and Easter with hospice patients and families
Hospice & Palliative Care Today; by Joy Berger, DMA, FT, BCC, MT-BC, editor in chief; 4/17/25 
This weekend brings a confluence of the Jewish Passover and Christian Easter holy days. Whatever your faith system, understanding at least a bit about the diverse faith systems of those you serve matters. We provide these hospice-specific resources as references:

• The National Institute for Jewish Hospice: NIJH enhances a hospice’s ability to respond to the diverse needs of Jewish patients and their families in a caring, dignified manner, consistent with Jewish heritage and values
• Celebrating Easter in Hospice Care: Spiritual Support and Renewal: by Faith & Hope Hospice & Palliative Care
• Spiritual Support in Hospice Care: video by Nathan Adelson Hospice
• Holidays - Holes and Wholeness: bereavement video for coping with holidays, birthdays and anniversaries throughout the year, by Composing Life Out of Loss (a newsletter sponsor)

8 health system CEOs on the turbulence defining 2025 
Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 4/16/25 
From capacity constraints to reimbursement pressures, health system CEOs are navigating a changing healthcare landscape. One of the top concerns in 2025 is the potential for Medicaid funding cuts. A recent report estimates hospitals could face a $31.9 billion loss in revenue if federal proposals to scale back Medicaid expansion move forward. CEOs from across the country — including safety-net systems, academic medical centers and expanding regional providers — recently shared how they are preparing for continued uncertainty and what strategies they are prioritizing in response.

Carolina Caring Foundation’s “Flights & Bites” fundraiser raises over $45,000 for compassionate care 
Carolina Caring, Hickory, NC; 4/17/25 
The Carolina Caring Foundation is celebrating the remarkable success of its 4th annual Flights & Bites fundraiser, which took place on Thursday, April 3rd, 2025, at Moretz Mills in Hickory, NC. This year’s event exceeded expectations, raising over $45,000 to support Carolina Caring’s mission of providing compassionate care to patients and families. Guests at the fundraiser were treated to an exquisite culinary experience titled “Passport to Flavor,” featuring tastes from around the world. “Carolina Caring Foundation expresses heartfelt gratitude to all sponsors and donors for their generous support in making our fundraiser a tremendous success,” stated Tara Bland, CFRE, Executive Director of the Carolina Caring Foundation. 

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 ...

Integrating social determinants into palliative care 
Hospice News; by Holly Vossel; 4/16/25 
Strong staff education and reimbursement are among the keys to successfully integrating social determinants of health within a palliative care program. Screening tools developed by the U.S. Centers for Medicare & Medicaid Services’ (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Supplemental domains include financial stability, employment and family and social support, among others.

Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association 
AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25  
... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.

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.

Inside Amazon's strategy to partner with digital health companies 
Modern Healthcare; by Brock E.W. Turner; 4/15/25 
While Amazon's splashy acquisitions have generated significant buzz, a foundational piece of the technology and e-commerce giant's healthcare business is focused on partnerships with digital health companies. Amazon launched its Health Benefits Connector in January 2024 with digital health unicorn Omada Health for patients with high blood pressure and diabetes. The service allows users to input information about their insurance plan and potentially identify covered services from Amazon’s partners. 

Without support, seniors aging in place may elect facility-based care, study finds 
McKnights Home Care; by Adam Healy; 4/16/25 
Older adults aging in place may rethink whether they want to receive care at home if they do not receive certain aging-in-place supports from their care providers and loved ones, according to a new study published in the Journal of the American Geriatrics Society. The researchers interviewed nearly 300 older adults receiving care at home and in long-term care facilities. ... The first theme was participants’ personal health experiences. ... Similarly, loss of health of loved ones and friends may also influence where patients want to receive care. ... The final factor influencing older adults’ aging preferences was time, the study found. 

Cybersecurity contracts at risk as HHS cuts 150 IT workers: Report 
Becker's Health IT; by Naomi Diaz; 4/15/25 
The Department of Health and Human Services could face a critical breakdown in its IT and cybersecurity systems after a sweeping reduction in force that eliminated key staff and leadership, Wired reported April 14, citing four current and former agency employees. More than 150 workers in HHS’ Office of the Chief Information Officer were among hundreds of administrative staff laid off April 1, according to the report. These employees were responsible for contract renewals and cybersecurity licenses and oversaw operations at the department’s Computer Security Incident Response Center — the hub for detecting and responding to cyberthreats across the department. Sources told Wired the cuts left no one in place to renew critical cybersecurity contracts, some of which are set to expire as soon as June.

One last game: student builds virtual reality experience for hospice patients 
Clemson News; by Sam Cannon; 4/15/25 
At Clemson, a dedication to innovating health care and fostering wellness means more than just training the next generation of doctors and nurses. For Class of 2025 student Rob Martin, it has meant curating meaningful moments for members of his community. ... [Rob] joined the Tandem VR™ team, a concept invented by Olivia McAnirlin, Virtual Reality and Nature Lab co-director at Clemson, which helps people connect to past experiences and complete “bucket lists” with their loved ones. As part of this project, local hospice care patients were asked what they would want the chance to experience one more time before they pass. When the overwhelming response from patients was a Clemson football game, a research team of undergraduate and graduate students, practitioners and faculty got to work.

Executive Personnel Changes - 4/18/25

• Alivia Care--based in Jacksonville, FL--welcomes DeAnna Beverly, DNP, MBA, MSN, as Chief Compliance and Quality Officer

Social Media Watch 4/18/25

• Susan Nelson posted congratulations to the Ochsner Health Spirit of Leadership Project of the Year - the inpatient hospice and palaitive care unit at Ochsner Medical Center New Orleans.
• Melissa Calkins posted HOPE isn't just a clinical update - it's a major operational shift, linking to Hospice News' article HOPE tool's range of "huge impacts" on hospice workforce.
• California Hospice and Palliative Care Association (Sheila Clark) welcomes Zaundra Ellis as their new Regulatory and Compliance Specialist.
• Hospice & Palliative Care of California posted The role of hospice: Comfort, care, and support.
• Vantage Hospice & Palliative Care posted The benefits of early hospice referral.

You must let suffering speak, if you want to hear the truth. ~ Cornel West 

Editor's note: Today commemorates "suffering" with the Christian Good Friday and the Jewish Passover of liberation from enslavement. Whatever one's faith system, a core component of hospice and palliative care is to relieve "suffering": physical, emotional, mental, relational, spiritual. Evidenced throughout our newsletter's issues, labor/employment strikes are rooted in "suffering": financial, stress, workplace violence, more. To relieve suffering, we must first see and hear it, acknowledge and understand it, and compassionately seek to relieve it. May we quiet our selves to tune into others' suffering. To hear truths. To take action with our best servant-leadership wisdom.