Literature Review

VA in IM marks 75th anniversary as a mainstay for veterans’ care The Daily News, Iron Mountain, MI; by Betsy Bloom; 3/6/25 A winter storm didn’t stop the Oscar G. Johnson VA Medical Center from celebrating its 75th anniversary with an open house Wednesday. The facility opened on March 5, 1950 — it then was the largest construction project done in the Upper Peninsula — as strictly an inpatient hospital with 264 beds, primarily for treating World War II veterans ... [and much has] changed in 75 years. The medical center now serves about 22,000 veterans in the U.P.’s 15 counties, along with nine Wisconsin counties — more than 26,000 square miles, giving it the most rural patient base in the VA system. ...  Its hospice area now has a semi-private patio that allows even a full bed to be taken outside so those in end-of-life care can still enjoy some fresh air, said Mary Oman, [a] tour guide.Editor's note: Congratulations and thank you to the Oscar G. Johnson VA Medical Center for your history of innovating care for veterans--especially your rural care system and hospice care. 

Enloe Health to transition Palliative Care Program to new cancer center Action News Now, Chico, CA; by Matt Wreden; 3/7/25 Enloe Health is transitioning its Palliative Care Program to function under its soon-to-open cancer center. This shift means that Enloe Health will be phasing out its in-home palliative care services, a decision that has raised concerns within the local community. ... Enloe Health explained that this move is in line with the upcoming Symptom Management Clinic set to open as part of the new Cancer Center. Editor's note: Does this limit their palliative care services to only those with cancer? What about palliative care needs for persons with advanced heart disease? Strokes? Neurological diseases like ALS or Parkinson's? Advanced dementia?

"The hospice heart": Hospice industry battles misconceptions, staffing shortages as expectations grow Pharos-Tribune, Logansport, IN; by  Josh Flynn Pharos; 3/9/25 ... There are a lot of misconceptions about hospice care and one of the largest is that entering hospice care is equal to giving up. ...Hospice care is one of the fastest growing industries as the Baby Boomer generation continues to age. The hospice care industry was valued at $34.5 billion in 2022 and is expected to grow in value to $67.7 billion by 2030. But misconceptions about hospice care and nursing shortages could threaten that future success. ... Maria Rogers is the public relations liaison at Guardian Angel Hospice in Logansport and she has devoted herself to tackling the misconceptions that surround hospice care. ... “You don’t have to be actively passing away to receive our services,” Rogers said. ... Jennifer Edwards, executive director of Heart to Heart in Mishawaka and Logansport, said many families don’t understand the role of medicine in hospice care. While something like chemotherapy would be discontinued, a hospice staff would never discontinue medications or fail to treat new problems that came up. ...

Lending a helping harp: Music therapist Sarah Ohr uses the power of music in hospice care VolumeOne - Theme Issue "Death & Taxes"; by Barbara Arnold; 3/6/25... Dubbed the "hospice harpist," Sarah is a harpist and more. Music has been part of her life since a child growing up in Green Bay, where her parents adopted Sarah and her adopted brother Steve separately from South Korea.  ... “Harp and piano are my musical loves,” Sarah noted in an interview. ... Two events, which both occurred in early April 2018, served as life-changing catalysts for Sarah: her brother, Steve, was murdered in Chicago, and Sarah received a cancer diagnosis that would require major surgery. ... [Click on the title's link to read Sarah's career journey as a performer and into music therapy.] ... [Now, Sarah serves St. Croix Hospice in Eau Claire, WI as a board certified music therapist.] According to Sarah, there is a perception that a patient can request her to entertain them. In reality, in order for Sarah to offer support to a patient, medical necessity must be present. “First, I need to be called in as part of the care team, ... Next, I meet with the patient or the patient’s family to conduct an assessment. In super simple terms: is there social isolation, depression, anxiety, pain management, or a neurological reason, by which music can fulfill a need?"Editor's note: Find professional music therapists at the Certification Board for Music Therapists.

Understanding a patient’s AI medical journey The Hastings Center; by Ian Stevens, Erin William, Jean-Christophe Bélisle-Pion, and Vardit Ravitsky; 3/5/25As artificial intelligence becomes increasingly integrated into U.S. health care, patients should know the ways in which AI is being used in their care, concludes a new paper, “Bring a ‘Patient’s Medical AI Journey’ to the Hill.” Transparency is crucial for interactions between health care providers and individual patients, as well as for systemic level uses of AI, including:

748 hospitals at risk of closure, state by state Becker's Hospital CFO Report; by Molly Gamble; 3/6/25 Nearly 750 rural U.S. hospitals are at risk of closure due to financial problems, with nearly half of those hospitals at immediate risk of closure. The count of 748 at-risk rural hospitals comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS' most recent hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with 11 states having a majority of their rural hospitals in jeopardy. [Click on the title's link for the list.]Editor's note: On July 5, 2024, we posted from the same source (Becker's Hospital CFO Report) that "Since January 2005, 192 rural hospitals have closed or converted ... Of those hospitals, 105 have completely closed, and 87 have converted, meaning the facilities no longer provide inpatient services, but continue to provide some services, such as primary care, skilled nursing care or long-term care. Since 2020, 36 hospitals have closed or converted. Find the list here. This jump in number is both dramatic and traumatic for our rural communities.

Can default palliative care referrals increase consults? Medscape; edited by Gargi Mukherjee; 3/4/25 A default palliative care referral intervention increased palliative care consultations by more than fivefold and decreased end-of-life systemic therapy by more than half among patients with advanced cancer being treated in the community oncology setting. ...

Challenges to video visits for patients with non–English language preference-A qualitative studyJAMA Network Open; Marianna Kong, MD; Francine Rios-Fetchko, BA; Madelyn Olmos-Rodriguez, BA; Linda Branagan, PhD; Bradley Iott, MPH, MS, PhD; Therese Chan Tack, DO, MPH; Carol Yarbrough, MBA; Kevin Grumbach, MD; Alicia Fernandez, MD; 2/25Telemedicine, or synchronous video or audio-only visits, has made clinical encounters more convenient and accessible for many patients. Prior to the COVID-19 pandemic, video and telephone visits comprised a small minority of primary care visits, but by April 2020, approximately one-half of US physicians were treating patients virtually and nonurgent telemedicine video visits increased by more than 600%. In this qualitative study, participants with NELP [non-English language preference] perceived multiple barriers to video visits, including greater communication difficulties, lower medical evaluation quality, and technical issues. These findings suggest that addressable technical challenges associated with language barriers hamper access to video visits and decrease motivation for use and that interventions are needed to increase telehealth equity. 

Armed 60-year-old man arrested, accused of shooting at hospice nurse in Orange County ABC News 12, Vidor, TX; by Scott Eslinger; 2/28/25 A 60-year-old Vidor man was arrested after a hospice nurse accused of him of shooting at her outside a patient's home. Gordon Billy Ward, 60, of Vidor, was arrested on Thursday by Orange County [California] deputies and booked into the Orange County jail. He is currently being held there on a charge of aggravated assault with a deadly weapon, according to jail records. [Click here for the related California post.]

The Alliance commends introduction of legislation to extend hospice telehealth flexibilities  National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 2/28/25 The National Alliance for Care at Home (the Alliance) is pleased to support the reintroduction of the Hospice Recertification Flexibility Act in the House of Representatives. This bipartisan legislation, H.R.1720, would extend telehealth flexibilities for hospice face-to-face (F2F) recertification. The F2F encounter is performed by a physician or nurse practitioner to evaluate the patient and collect clinical information used in determining continued eligibility for hospice. Introduced by Representatives Carol Miller (R-WV) and Jared Golden (D-ME), the bill would extend the F2F recertification flexibility for providers until December 31, 2027. Beginning January 1, 2026, the legislation also includes important guardrails to ensure appropriate use and requires the Centers for Medicare & Medicaid Services (CMS) to create a modifier to collect data on when the F2F encounter is conducted via telehealth. The Alliance, then through its legacy organizations, worked with lawmakers to ensure continued care transformation and access to care for high-quality providers. [Click on the title's link to continue reading.]

Contemporary patterns of end-of-life care among Medicare beneficiaries with advanced cancer JAMA Network - JAMA Health Forum; by Youngmin Kwon, PhD; Xin Hu, PhD, MPSH; Kewei Sylvia Shi, MPH; Jingxuan Zhao, MPH, PhD; Changchuan Jiang, MD, MPH; Qinjin Fan, MS, PhD; Xuesong Han, PhD; Zhiyuan Zheng, PhD; Joan L. Warren, PhD; K. Robin Yabroff, PhD, MBA; 2/21/25Conclusions: In a contemporary cohort of older Medicare decedents originally diagnosed with advanced breast, prostate, pancreatic, or lung cancer, we found that many patients continue to receive potentially aggressive interventions at EOL at the expense of supportive care services. To make meaningful improvements in the quality of EOL care, a multifaceted approach that addresses patient, physician, and system-level factors associated with persistent patterns of potentially aggressive care will be required. Editor's note: Though published just one week ago--February 21--this journal article is already being used extensively, as demonstrated in our posts on 2/24 and 2/25.

Palliative care advocates at the World Health Organization executive board meeting ehospice; by Stephen Connor, Executive Director, Worldwide Hospice Palliative Care Alliance (WHPCA); 2/19/25 The World Health Organization (WHO) is in turmoil with the planned withdrawal of funding and membership from the USA. About 20% of the WHO budget is from the US and withdrawal of all USAID funding is causing serious problems worldwide. Many member states are increasing their dues to WHO to help offset this loss, but these are difficult times for public health. These issues were front and center at the meeting of the WHO Executive Board 3-11 February. .. The Worldwide Hospice Palliative Care Alliance (WHPCA) and the International Association for Hospice and Palliative Care (IAHPC) are the two organizations presently in official relations with WHO and we work together to cover the many health issues. Editor's note: For current information from USAID, visit www.usaid.gov.