Literature Review

Family caregivers' understanding, expectations, and emotional responses during transition to a palliative care unit: a qualitative study Empirical Research Qualitative; by Filipa Vieira-Matos and Paulo Reis-\Pina; 8/2/26 Aim: To explore how family caregivers interpret palliative care and respond to admission to a palliative care unit as a critical transition in care. ... Results: Admission was experienced as a critical transition. Three interrelated themes were identified: understanding of palliative care, expectations regarding care, and emotional responses. Participants described partial familiarity with palliative care but frequently associated referral with terminal illness. Expectations focused on comfort and clear communication. Emotional responses included fear, uncertainty, and ambivalence, particularly when referral occurred abruptly. ... Impact: Admission was experienced as a transition involving meaning-making, expectation formation, and emotional adjustment. Findings may inform nursing practice in inpatient palliative care by supporting caregiver-centered transition support.

Frailty predicts more than age: strategies for hospitalists Medscape; by Julie Peck; 8/25/26 An 85-year-old who remains active and independent may recover from pneumonia more quickly than someone 20 years younger with multiple chronic illnesses, poor nutrition, and declining mobility. Growing evidence suggests that frailty — a state of diminished physiologic reserve and increased vulnerability to stressors — is one of the strongest predictors of prolonged hospitalization, complications, functional decline, discharge to post-acute care, readmissions, and mortality, often outperforming chronological age alone.

The Department of Justice's National Fraud Enforcement Division: a new era of coordinated fraud prosecution and what it means for corporate America Epstein Becker Green | Health Law Advisor; by Leah Brownlee Taylor, Erica Sibley Bahnsen, Sarah M. Hall, Andrew Beshai, Alkida Kacani, Gianna Costello; 8/21/26 On August 13, 2026, the Assistant Attorney General for the U.S. Department of Justice (“DOJ”) National Fraud Enforcement Division (the “NFED”), Colin M. McDonald, released a memorandum outlining NFED’s enforcement priorities. The memorandum is the first memo of this kind from NFED. The establishment of NFED earlier this year represented a watershed moment for federal fraud prosecution, as it established DOJ’s first-ever division dedicated exclusively to combating fraud against taxpayer dollars and taxpayer-funded programs. With a stated goal of having 500 prosecutors and staff by August 24, NFED seeks to deploy “cutting-edge data analysis” across a “whole-of-government” effort. The establishment of NFED signals a fundamental shift in federal fraud enforcement, ... The NFED memo identifies five priority areas for federal fraud prosecution:

A retrospective mixed-methods analysis of falls among patients in a social model hospice residential care home American Journal of Hospice and Palliative Medicine; by Carol S. Weisse, PhD, Kelly Melekis, MSW, PhD, Lam Nguyen, Cort Collier, BS, and Nadia Kelley, MPH; 8/9/26 ... In the 24-hour period prior to patients’ falls, opiates were shown to be the most frequently administered medication followed by benzodiazepines, with higher rates of falls among patients who consumed both of these medications in combination. Most falls occurred in the bedroom or bathroom and were related to toileting needs. Results suggest that informal caregivers may benefit from additional training when supporting hospice patients’ toileting needs, especially when they have received opiates and benzodiazepines. Results illustrate caregivers’ efforts to balance fall risk with patients’ desire for autonomy as a central element of home hospice care. Editor's Note: What systems do you have in place for reporting, responding to, and reducing patient falls, especially in homes? At a minimum, you need to have these in place:

What an AI-enabled finance function actually looks likHighspring; by Bryan Rhody; 8/24/26 Many finance leaders are asking how AI can create value. The better question is what distinguishes finance functions that successfully scale AI from those still experimenting. Key takeaways:

Ethics of artificial intelligence prognostication in palliative care: perspectives from a national survey of palliative care physicians BMJ Supportive Palliative Care; by Ahmed Y Alasmar, Lauren Gunn-Sandell, Stacy M Fischer, Regina M Fink, Elizabeth Juarez-Colunga, Eric G Campbell, Matthew DeCamp; 8/2-/26, online ahead of print ... Although global consensus is emerging about the importance of ethical principles for artificial intelligence (AI), such as respecting autonomous choice, promoting patient well-being, reducing bias, trust, and more, little is known about how palliative care physicians perceive these issues. This study aims to improve understanding of palliative care physicians' perspectives about the ethics of AI-based prognostication. Conclusion: Palliative care physicians see the potential of AI-based prognostication to improve palliative care and also express ethical concerns. Implementation of AI requires context-specific ethical guidance responsive to palliative care, where relationships and communication are paramount.

Hospice nurses at Minnesota-based Allina Health vote to authorize 7-day unfair labor practice strike CBS News Minnesota; by Nicholas Lentz; 8/24/26 Hospice nurses who work for Minnesota-based Allina Health have voted to authorize a seven-day unfair labor practice strike, the union representing them said on Monday. According to Service Employees International Union Healthcare Minnesota and Iowa, all workers who cast a ballot on Friday voted in favor of the strike. The authorization comes amid negotiations to reach a first contract that have been happening for more than a year, SEIU said. Members allege Allina Health is opposed to "creating a fair compensation system that would give nurses extra pay for extra work"  and refuses to pay salaried registered nurses a holiday premium when they are required to work on holidays. The union added that the company also doesn't allow hospice nurses to flex their schedules.

CMS hospice payment suspensions slamming vendors Hospice News; by Jim Parker; 8/21/26 ... CMS earlier this year began suspending Medicare payments to hundreds of hospices allegedly due to suspected fraud. ... Evidence indicates that some legitimate hospices were caught up in the dragnet due to patients being discharged for valid reasons, such as a revocation of the benefit, moving out of a provider’s service area or transfer to another hospice. ... These regulatory actions have had a ripple effect on vendors, according to a DME company CEO that spoke to Hospice News on background. “These hospice agencies are being suspended. They’re not getting paid,” the DME CEO told Hospice News. “If they’re not getting paid, their employees are not getting paid. DME providers like us are not getting paid. Pharmacies are not getting paid. Any other contractor they have is not getting paid.” This has placed some vendor businesses in peril, and some of them have been considering layoffs of their own, another DME provider ... told Hospice News, “We’ve been trying to keep everybody on board, keep them employed, keep them paid for as long as we possibly can.”

Start by doing what is necessary, then what is possible, and suddenly you are doing the impossible. ~ Francis of Assisi

Modernizing payment integrity in an era of systemic fraud MedCityNews; by Christian Bass; 8/21/26 Across the United States, Medicaid and Medicare fraud cases are surfacing with increasing frequency — and scale. From improper billing and undocumented services to upcoding and duplicate claims, these cases span federal programs and state-administered Medicaid plans. Once perceived as isolated misconduct, these cases are now being exposed as a systemic challenge, revealing vulnerabilities in reimbursement oversight that affect payers, regulators, and ultimately taxpayers. ... Gaps in reimbursement oversight and recovery will only widen, unless plans modernize how they detect, investigate, and recoup improper payments. Organizations that respond quickly will be positioned to manage the financial and regulatory headwinds.

Pittsburgh Caregivers get federal lifeline as dementia cases swell across Allegheny County hoodline; by Ryan Miller; 8/21/26 Caregivers looking after loved ones with dementia in Pittsburgh now have a new federal tool to lean on, and it is already showing up at a day center in Squirrel Hill. The Anathan Club, run by the Jewish Association on Aging, has begun connecting families to the Guiding an Improved Dementia Experience Model, a Medicare program that can cover up to $2,500 a year in respite care for qualifying beneficiaries. The Guiding an Improved Dementia Experience Model, known as GUIDE, was developed by the Centers for Medicare and Medicaid Services and launched nationwide on July 1, 2024, as an eight-year voluntary pilot running through June 30, 2032, according to CMS. Nearly 390 provider organizations across the country are participating.