Literature Review

Rethinking slow codes: Gina Piscitello, Parker Crutchfield, Jason WassermanGeriPal podcast; by Eric Widera, Alex Smith, Gina Piscitello, Parker Crutchfield, Jason Wasserman; 10/23/25I’m going to begin with a wonderful quote from a recent editorial in Bioethics by our guests Parker Crutchfield & Jason Wasserman. This quote illustrates the tension between the widely held view in bioethics that slow codes are unethical, and the complexity of real world hospital practice: “Decisive moral positions are easy to come by when sitting in the cheap seats of academic journals, but a troubling ambivalence is naturally characteristic of live dilemmas.” ... Today we talk about what constitutes a slow code, short code, show code, and “Hollywood code.” We talk about walk don’t run, shallow compressions, and…injecting the epi into the mattress! We explore the arguments for and against slow codes: harm to families, harm to patients, moral distress for doctors and nurses; deceit, trust, and communication; do outcomes (e.g. family feels code was attempted) matter more than values (e.g. never lie or withhold information from family)? ... One thing we can all agree about: the ethics of slow codes need a rethink.

Hospice & Palliative Care Network of Maryland calls for action on short hospice stays: New issue paper highlights urgent need for earlier access to careHospice & Palliative Care Network of Maryland press release; by Peggy Shimoda; 10/23/25The Hospice & Palliative Care Network of Maryland (HPCNM) has released a new issue paper, “Short Hospice Stays in Maryland: Ensuring Patient-Centered Care at End-of-Life,” revealing that Maryland ranks 46th nationally for hospice length of stay. With a median of just 18 days in 2024, patients and families miss the full benefit of hospice services that promote comfort, dignity, and peace at the end of life... “Short hospice stays are not just a clinical problem—they’re a systems challenge,” said Dr. Jennifer Kennedy, HPCNM Board Member and Chair of the Short Length of Stay Workgroup. “Earlier conversations, coordinated care, and improved discharge practices can help patients receive the care they deserve sooner.”

Exploring the mix of hospice program expansions, closuresHospice News; by Holly Vossel; 10/22/25Some hospices have recently launched new facilities and grown their geographic service reach as others shutter and transition ownership of their programs amid financial struggles. [Including:]

Health care in the USA: money has become the missionThe Lancet; by Adam Gaffney, Steffie Woolhandler, David U Himmelstein, Danny McCormick; 10/21/25Despite extraordinary scientific and medical resources, the US health-care system underperforms. In this Review we consider the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers.

Hospice exec evaluates possible ‘path forward’ for MA hospice carve-inMcKnight's Newsmakers Podcast; by Liza Berger, Joe Shega; 10/15/25The so-called “carve-in” failed when the Centers for Medicare & Medicaid Services halted the hospice portion of the Value-Based Insurance Design program last year. And just last month, providers were speaking out against the carve-in to lawmakers at the annual fly-in for the National Alliance for Care at Home. But the two value-based care programs — hospice and MA — are not necessarily incompatible, according to Joe Shega, MD, chief medical officer for hospice provider VITAS Healthcare. As long as all the stakeholders agree about the parameters — that benefits remain intact, that there is no delay in access — there can be a “path forward” for hospice to be part of the MA benefit, he told McKnight’s Home Care in a Newsmakers podcast.

Raising the bar in healthcare leadership trainingUConn Today; by Barbara O’Neill; 10/21/25“Clinical leadership training is vital to launching the next generation of our health care workforce,” says Raquel Manley, DMD, faculty and alum of the Urban Service Track/AHEC Scholars (UST/AS) Program, located on the UConn Health campus in Farmington. “Effective health care is based upon clear communication, conflict resolution, and teamwork for the health and well-being of our patients and community members. In my experience as an Urban Health/AHEC Scholar, coach, and faculty, I have found that today’s students are often very brilliant academically and in social settings but need coaching and counseling on leadership skills once they enter the workforce.” So why is this the case?

Survey update during government shutdown - REVISED Guidance, 10/21/2025CHAP blog; 10/21/25CMS posted and update to the memo, Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown (QSO- 26-01-ALL-Revised) on 10/21/2025 that provides updates to state survey activity during the ongoing federal government shutdown. The revised guidance appears in red text. CMS has instructed CHAP that our survey activity is unaffected, and we will conduct our survey accreditation business as usual.

CAPC and the National Kidney Foundation partner on The Case for Palliative Care in Kidney CareCAPC blog; 10/8/25New publication underscores how palliative care can improve outcomes for patients with advanced kidney disease. The CAPC and the National Kidney Foundation (NKF) have released a new publication, The Case for Palliative Care in Kidney Care, which emphasizes the critical need to integrate palliative care services into the treatment of patients with advanced kidney disease.

Why doctors hesitate to say ‘I'm sorry’ after errorsMedscape; by Paolo Spriano; 10/17/25Apologies are commonly defined as “a regretful acknowledgment of an offense or failure; a formal, public statement of regret.” In healthcare, apologies offered with honesty and transparency are an essential part of addressing medical errors. An effective apology acknowledges what happened, accepts responsibility, and expresses sincere regret for the patient’s suffering. When done properly, an apology can have profound healing effects for everyone involved. For clinicians, it can help ease feelings of guilt and shame; for patients, it can foster forgiveness and form the basis for reconciliation.

The 4 Ms with Dr. Khai NguyenTeleios Collaborative Network - TCNtalks podcast; by Chris Comeaux, Khai Nguyen; 10/22/25In this episode of TCNtalks, host Chris Comeaux welcomes Dr. Khai Nguyen, a geriatrician and age-friendly care champion for care-at-home with CHAP. They discuss the 4Ms framework for age-friendly care, which includes what matters, mentation, medications, and mobility.

How to talk to your loved ones about end of life wishes Those Nerdy Girls; by Rebecca Raskin-Wish; 10/17/25 It’s important to have discussions about what you want the end of your time on earth to look like and have a healthcare proxy and an advance directive in place. When my sister and I were teenagers, my mom sat us down, and in a potentially more dramatic fashion than the moment called for, she said, “Girls, my death could happen any moment, and we need to talk about it.” ...

Patients with advanced cancer often receive treatments that conflict with their goals Healio; by Josh Friedman; 10/20/25 Many patients with advanced cancer who prefer treatment that prioritizes quality of life receive therapies focused on preserving it. A retrospective analysis showed nearly 40% of individuals with advanced cancer who preferred treatment that improved their comfort felt clinicians gave them therapies meant to increase longevity.