Literature Review

68% of hospices lack star ratingsHospice News; by Jim Parker; 6/18/25 The proportion of hospices that do not have a star rating from the U.S. Centers for Medicare & Medicaid Services (CMS) is growing. CMS introduced the hospice star rating system in 2022 to help patients make informed decisions about which provider to choose. They appear on CMS’ Care Compare website. The scores are based on Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results. Between August 2022 and that same month in 2024, the number of hospices without a star rating rose from 3,912 to 5,086, an average of 68%, according to a new study published in Health Affairs.

'Walk for Hospice' raises $160K for patient programsCBS News 6 WRGB, Albany, NY; by Stephanie Ryan; 6/14/25Grey skies couldn't keep walkers away from a good cause Saturday. An estimated 1,000 people turned out for the 25th Annual “Walk for Hospice” held at Siena College. Walkers of all ages participated in the fundraiser in honor or in memory of loved ones. There was food, fun, facepainting, and music from The Refrigerators. The event raised an incredible $160,000 for patient programs, like music and massage therapies to comfort patients, a special Wish Fund, and Camp Erin – a bereavement camp for children and teens who have lost a significant person in their lives.

College Station store hosts Hospice Brazos Valley’s benefit this Father’s Day KBTX, Bryan, TX; by Abigail Truman; 6/9/25This Father’s Day, Hospice Brazos Valley is partnering with Murdoch’s Ranch and Home to encourage families to spend their holiday with classic cars, barbecue, and supporting a good cause. Guys, Gears, and Grills is an event that gives you a chance to do all of dad’s favorites while raising money to support Brazos Valley Hospice. “We’re the only nonprofit hospice in the Brazos Valley, meaning we’ll never send you a bill... And we gave over $250,000 in complementary care last year,” Collen Broussaurd with Brazos Valley Hospice explained its mission.

Chapter 6: Medicare’s measurement of rural provider quality MedPAC; 6/12/25 ... Because of low patient volumes in many rural health care settings, there are practical challenges in measuring some individual rural providers’ quality of care and in holding these providers accountable in quality reporting programs. ... The Commission acknowledged these difficulties when it established specific principles to guide expectations about quality in rural areas. These principles were developed with hospitals in mind but could be applied to other providers. ... [On page 4 of 40] Rural skilled nursing facilities and dialysis facilities had lower shares of providers with publicly reported quality results compared with their urban counterparts; in contrast, rural home health agencies and hospices had higher shares of providers with publicly reported quality results compared with their urban counterparts.Editor's Note: For ranking of hospices by quality scores, examine the National Hospice Locator, provided to the public by Hospice Analytics (a sponsor of this newsletter). 

Families demand end to Medicare waiting period for early-onset Alzheimer’s patients Washington Examiner; by Elaine Mallon; 6/15/25 Jason Raubach was diagnosed at 50 years old with early-onset Alzheimer’s disease — a diagnosis that affects nearly 200,000 Americans. He received the diagnosis in 2018, completely upending life for his family. His youngest child was just a freshman in high school. ... Shortly before receiving an official diagnosis, Jason Raubach lost his job, having to move his family onto a consolidated omnibus budget reconciliation act health plan, or COBRA plan, which allows a person to keep their health insurance even after losing their job. “It wasn’t cheap,” Elizabeth Raubach said.However, once diagnosed, Jason Raubach had to wait two and a half years before he could receive coverage under Medicare, health insurance for those 65 years and older or those with qualifying disabilities. But Elizabeth Raubach, along with dozens of other caretakers for people diagnosed with Alzheimer’s, called on Congress in a letter to eliminate the 29-month waiting period required for those under the age of 65 to receive coverage under Medicare. ...

The only thing wrong with trying to please everyone is that there's always at least one person who will remain unhappy. You.  ~Elizabeth Parker

Mindfulness and relaxation interventions reduce depression, negative affect and stress in widow(er)sJournal of Loss and Trauma; Lindsey M. Knowles, Deanna M. Kaplan, Melissa Flores, Sydney E. Friedman, Mary-Frances O’Connor; 6/25Mindfulness training (MT) and progressive muscle relaxation (PMR) interventions show promise for improving bereavement-related grief (Knowles et al. 2021). Mindfulness training (MT) develops the systematic and secular practice of focusing one’s attention on present moment experiences, emotions, and thoughts, from an open, nonreactive, and nonjudgmental perspective (Bishop et al., 2004). Progressive muscle relaxation (PMR) facilitates physiological and psychological relaxation via a systematic release of generated bodily tension (Bernstein et al., 2000). MT and PMRhave been shown to reduce depression relapse, and improve depression, perceived stress, mindfulness and/or quality of life in clinical and non-clinical populations ...

Strategies to prepare hospice providers to interact with adolescents with a parent in hospicePalliative & Supportive Care; William Grayson, Denice Kopchak Sheehan, Pamela S Stephenson, Kristen DeBois, Caitlin Sheehan; 5/25The sample included 18 young adults (18-28 years old) whose parents died in hospice or palliative care while they were adolescents (12-18 years old). Semi-structured interviews were conducted virtually via Microsoft Teams. The participants described a variety of skills that are important for hospice providers to know. They provided specific suggestions for hospice providers who seek to help adolescents navigate this critical time when their parents are dying or have recently died. These results can also be used to inform the development of interventions that assist hospice providers with strategies tailored to an adolescent's specific needs.

Can a chatbot be a medical surrogate? The use of large language models in medical ethics decision-makingNEJM-AI; Isha Harshe, B.S., B.A.; Kenneth W. Goodman, Ph.D.; Gauri Agarwal, M.D.; 6/25 The use of AI in health care has raised numerous ethical challenges. Issues concerning data privacy, accountability, bias perpetuation, and the identification of appropriate uses and users have prompted scholars and scientists to tackle these challenges. Our findings indicate that while AI systems may assist in identifying considerations and guidelines for ethical decision-making, they do not consistently demonstrate the flexibility of thought that humans exhibit when addressing novel ethical cases. AI can support ethical decision-making, but it is not currently capable of showing autonomous ethical reasoning for consultation regarding patient care.

Sacred moment experiences among internal medicine physiciansJAMA Network Open; Jessica Ameling, MPH; Nathan Houchens, MD; M. Todd Greene, PhD, MPH; David Ratz, MS; Martha Quinn, MPH; Latoya Kuhn, MPH; Sanjay Saint, MD, MPH; 5/25Some have described sacred moments as sudden intimacies or moments of deep memorable connection with another person. The health care setting is replete with opportunities for the types of human connections that lead to sacred moments, such as times of crises or grief, or conversely, times of great happiness. These moments leave participants with a sense of joy, peace, and empathy for the others involved. In this survey study of 629 physicians, 68% reported experiencing a sacred moment with a patient, and physicians who considered themselves very spiritual or possessing a strong sense of purpose in life or work had increased odds of experiencing a sacred moment. Both experiencing sacred moments often and discussing them with colleagues were associated with less burnout [and] improve[d] physician well-being.

Evaluation of reporting of race and ethnicity in hospice and palliative care researchJournal of Palliative Medicine; Kimberly S Johnson, Karen Bullock, Cardinale B Smith, Deborah B Ejem, Nadine J Barrett, A'mie Preston, Kenisha Bethea, Marisette Hasan, Ramona L Rhodes; 5/25The disproportionate impact of the COVID-19 pandemic on marginalized communities due to structural racism has led to an increased focus on diversity, equity, and inclusion in medical literature. Among the eligible articles reviewed, there were 48 unique racial and ethnic categories [and] the most common groups specified were White (N = 77), Black (N = 52), and Hispanic/Latino (N = 36). Over half of articles (n = 53, 60.2%) combined minoritized groups into a nonspecific category (e.g., "other"), and 30 (34.1%) articles specified White populations alone or White populations with a nonspecific category for other groups. Seventeen (19.3%) articles included over 90% White participants, and only 3 (3.4%) articles had a minority health or health disparity focus. In this review of high impact, practice changing articles, the lack of appropriate representation of minoritized racial and ethnic groups, frequent use of non-standard categories to describe race and ethnicity, and the small number of articles focused on health disparities raise concerns about the generalizability of research findings, equity in research processes, and attention to populations that experience disparities in palliative care outcomes.

[Ireland] Palliative care nurse specialists’ perspectives on spiritual care at end of life—A scoping reviewJournal of Hospice & Pallaitive Nursing; Dunning, Bronagh MSc, PGCert, BSc, RGN, RNT, FHEA; Connolly, Michael PhD, MSc, BA, RGN, RNT; Timmins, Fiona PhD, FAAN, MSc, BA (Open), BSc (Open), BNS, FFNRSCI, RNT, RGN; June 2025The purpose of this scoping review was to explore and to summarize the published literature on palliative care nurse specialist’s perspectives of spiritual care at end of life. The research demonstrates that specialist palliative care nurses perceive spiritual care as an important element of holistic care at end of life; however, these nurses also agree that spiritual care is lacking. This deficiency results from a lack of education in spirituality; experience of the nurse; the nurses’ own spiritual and religious beliefs and values, fears, and difficulties in communication; and the nurse-patient relationship. The findings demonstrate the necessity to increase the level of spiritual care education in nurse programs, educating nurses on the provision of spiritual care, and how to deal with conflicts in spiritual and religious beliefs.