Literature Review

The state of hospice: Impacts on equity, quality, and nursing-An AAN consensus paperNursing Outlook; by Laura Fennimore, Kathleen O Lindell, Marjorie M Godfrey, Melissa Reider-Demer, Patrick J Coyne, Ronda G Hughes, Sharon Kozachik, Masako Mayahara, Patricia L Thomas, Nelson Tuazon, Polly Mazanec; 4/26Hospice care has been an integral component of the United States healthcare system for over fifty years. Hospice has transitioned from a volunteer activity supported by philanthropy to a highly sophisticated business funded by Medicare, increasingly offered by for-profit and private equity companies. This consensus paper examines the current state of hospice care in the US and the impact of changing hospice business models on health equity, healthcare quality, and nursing practice. Recommendations include updating policies to account for private equity involvement, evaluating current quality measures, addressing the existing Medicare Hospice Benefit, ensuring transparency and oversight for hospice agencies, and ensuring patient and caregiver education about hospice services. These recommendations aim to preserve the fundamental values of hospice, supporting compassion, dignity, and comfort while ensuring the quality of care to patients and families in need.

Saturday newsletters focus on headlines and research - enjoy!

Palliative care intervention for patients with end-stage liver disease-A cluster randomized clinical trialJAMA Internal Medicine; by Manisha Verma, Victor Navarro, Andrzej Kosinski, Tamar Taddei, Richard Kalman, A. Sidney Barritt, Simona Jakab, Marina Serper, Eric Orman, Maya Balakrishnan, Mina Rakoski, Don Rockey, Kristel Hunt, Roniel Cabrera, Ayse Aytaman, Binu John, Gyorgy Baffy, Rohit Nathan, Elliot Tapper, Marina Roytman, Brendan McGuire, Nicholas Hoppmann, Christopher Woodrell, Marie Bakitas, Yang Yue, Bryce Reeve, Li Lin, Rebecca Tantala, Michael Volk; 4/26Palliative care improves quality of life (QoL) in advanced illnesses, but data in end-stage liver disease (ESLD) are limited. It is unknown whether palliative care delivered by hepatologists is effective when compared with palliative care specialists. This cluster trial found that palliative care delivered by trained hepatologists was comparable with palliative care delivered by palliative care specialists in improving QoL in patients with ESLD and was associated with greater improvement in patient satisfaction, demonstrating the effectiveness among enrolled patients.Assistant Editor's note: That's the beauty of palliative care. It can be layered upon many other specialties and sub-specialties and utilized by a variety of health care disciplines. The science of palliative care, the skill and knowledge base involved, is adaptable and valuable for almost anyone working in direct patient care in many different health care settings.

Trinity Homes sees home health, hospice transition Minot Daily News, Minot, ND; by MDN Staff; 5/21/26 Trinity Health has announced it has contracted with CHI Health at Home and Hospice and CaringEdge to provide hospice services to residents at Trinity Homes. Both are established Minot-area providers. Ensuring continuity of care has been the top priority throughout this transition, according to Trinity, which has worked closely with CHI Health at Home and Hospice and CaringEdge to facilitate a smooth transition for patients and their families. The transition of patients is complete, Trinity reported.

Early electronic advance directives reduce burdensome end-of-life care News Medical & Life Sciences | Wiley; 5/20/26 Advance directives document patient preferences for future care, including end-of-life. An analysis in the Journal of the American Geriatrics Society found that older patients with an advance directive that had been uploaded into the electronic health record at least six months before death were 25% less likely to experience potentially burdensome end-of-life care (19.9% versus 26.8%) and 31% less likely to have died in the hospital (23.2% versus 32.1%).

How resolving moral distress unlocks physicians’ potential AMA - American Medical Association; by Bobby Mukkamala, MD, President; 5/20/26 The inability to do what feels right affects physicians to a greater degree and can keep us from delivering the care we know our patients need. ... Across medicine, many physicians are confronting something deeper: moral distress. New research shows it is widespread, distinct from burnout, and carries serious consequences for physicians, patients and the healthcare system itself. 

Development of the revised CAHPS Hospice Survey Journal of Pain and Symptom Management; by Danielle Schlang, MA, Melissa A. Bradley, BA, and Rebecca Anhang Price, PhD; 5/18/26 ... Methods: We conducted a plain language review and environmental scan, refined existing survey instrument wording, drafted candidate survey items addressing new topics of interest, and conducted 7 rounds of cognitive interviews with a total of 59 family caregivers of hospice decedents. Results: Cognitive interview respondents consistently interpreted “respecting [the patient’s] wishes,” and “listening to the things that matter most” and found these concepts relevant to their family members’ hospice care experiences; in contrast, they found the phrases “cultural practices” and “choosing what to do next” confusing or unclear. ... Conclusion:  The revised CAHPS Hospice Survey simultaneously adds new topics prioritized by stakeholders and reduces survey complexity and length. Editor's Note: This journal article includes a downloadable "Journal Pre-proof" PDF. Its Appendix B (at pp. 27-33) provides a helpful table, "Comparison between Original and Revised CAHPS Hospice Survey Items, with Rationale."

States with the most, fewest licensed nurses per capita Becker's Clinical Leadership; by Mariah Taylor; 5/21/26 The National Council of State Boards of Nursing found the District of Columbia has the most licensed nurses per capita, while Utah is the state with the fewest for the second year in a row. ... Becker’s used 2025 Census data to calculate how many nurses are in each state per 100,000 population. Here are the five with the most and the five with the fewest nurses. ...Most [list starts with highest]: District of Columbia ... Alaska ... New York ... Minnesota ... Massachusetts ... Fewest [list starts with lowest]: Utah ... Washington ... Georgia ... Idaho ... Texas ...

Maui Hospice calms jitters after feds freeze new Medicare sign-ups Hoodline; by Marc Suzuki; 5/20/26Hospice Maui moved quickly this week to calm worried island families after federal officials hit pause on new Medicare hospice and home health enrollments. The Wailuku nonprofit stressed that long-standing, Medicare-certified providers like itself are not the focus of the federal action, and that patients already in its care will continue to receive visits, medications and support services without interruption. The organization also pointed families to a direct phone line for anyone who wants a real person to walk them through what the freeze does and does not mean.

Each May, Kennedy students raise money against cancer KELO Pierre, SD; by Bob Mercer; 5/18/26 Students at Kennedy Elementary School in Pierre are learning a valuable lesson. Giving can be the greatest gift of all. There was a friendly competition again during the first two weeks of May between the school’s 19 classrooms to see which one could raise the most money for a life-saving cause. It’s called Kennedy versus Cancer. Their goal was to raise $7,500 — and they’ve reached it once again. ... The money goes to Countryside Hospice. ... Kennedy Elementary students have been raising money to help the fight against cancer since their school opened in 2015. ... So far, more than $60,000 has been brought in.