Literature Review

Palliative care is essential for seriously ill patients—at any ageAMA (American Medical Association); by Kevin B. O'Reilly; 1/27/25 The AMA House of Delegates has adopted new policies outlining physicians’ ethical obligation to provide or seek optimal palliative care for patients with serious illnesses who can benefit from comprehensive management of pain and other distressing symptoms—not only those with terminal illnesses or on the precipice of death. “Physicians have clinical ethical responsibilities to address the pain and suffering occasioned by illness and injury and to respect their patients as whole persons,” says one of the new policies adopted at the latest AMA Interim Meeting, held in Lake Buena Vista, Florida. “These duties require physicians to assure the provision of effective palliative care whenever a patient is experiencing serious, chronic, complex or critical illness, regardless of prognosis.” 

Hospice of Savannah awarded grant for safety improvements NBC WSAV Savannah News, Savannah, GA; by Eric Dorsch; 1/27/25 Hospice of Savannah Inc. (HSI) has announced it has been awarded a grant for repairs and home modifications. HSI will receive $1,999,111 in Older Adults Home Modification Program grant funding to complete safety and functional home modifications and limited repairs in the primary residences of two hundred eligible homeowners and renters over age 62 with low income. The work aims to improve general safety, increase accessibility, reduce falls, and improve residents’ functional abilities in the home for their safe and successful aging in place. 

How innovation is changing [hospital] length of stayHealthLeaders; by Eric Wicklund; 1/23/25 Allina Health is using technology and new ideas to reduce the time a patient spends in the hospital. They're seeing improved outcomes, reduced costs and more capacity to treat patients who need to be hospitalized.  One of the key metrics in clinical care is patient length of stay (LOS), traditionally defined as the time between a patient's admittance and discharge from a hospital. ... New technologies like AI and concepts like remote patient monitoring (RPM) and Hospital at Home are helping healthcare executives gain a better understanding of LOS, and in turn they're reducing costs and improving care management.Editor's note: How do these hospital technologies interesect with and impact your referrals for palliative and hospice referrals? For discharges to home health or senior facilities that receive care from your agency?

Stillwater Hospice CFO: A winning recipe for improving rural hospice care Hospice News; by Holly Vossel; 1/23/25 Montana-headquartered Stillwater Hospice has found a successful rhythm to strategic rural-based growth and sustainability. The strategy hinges on building culture, staffing resources and a reputation for quality, according to CFO and Co-founder Chris Graham. Launched in 2017, the hospice company serves predominantly rural-based populations in Montana, northern Wyoming and South Dakota. ... What are the most significant concerns among rural-based hospice providers currently? How have the challenges of rural care delivery evolved in recent years? "Staffing is very hard. You’ve got to find staff who are willing and like to travel because they have a lot of windshield time. It’s also the logistics of remote care. We have patients that live 75 miles or more outside of a town, then once you get there it’s another 20 miles on a dirt road that could be covered in snow and ice. ..." [Click on the title's link to continue reading.]

University of Rochester Medical Center plans hospital-at-home program Becker's Health IT; by Giles Bruce; 1/21/25 Rochester, N.Y.-based UR Medicine plans to launch a hospital-at-home program in summer 2025. CMS approved the health system's flagship Strong Memorial Hospital in Rochester for acute hospital care at home in June 2024. The six-hospital system has since taken a "pragmatic and deliberate approach" to building the initiative, said Justin Hopkin, MD, chief of hospital medicine at University of Rochester Medical Center. "We are listening closely to what community members want and need, while observing how other health systems overcome challenges as they scale up their hospital-at-home programs," Dr. Hopkin told Becker's.

The 'paradigm shift’ of hospice service diversification Hospice News; by Holly Vossel; 1/17/25 Some hospices have delved deeper into service diversification to improve timely access and expand their patient reach, while others remain focused on end-of-life care delivery. The decision to launch into new service realms can come with a range of operational and reimbursement questions. Among the keys to diversifying services is establishing a business infrastructure that allows for innovative growth based on communities’ needs, according to Leslie Campbell, COO of Touchstone Communities. The San Antonio, Texas-headquartered company provides hospice, home health, veterans services, assisted living and skilled nursing services. ... Hospice leaders need to ensure that both back-office administrative and interdisciplinary teams are educated on how business growth impacts them, particularly when it comes to quality and compliance across the care continuum, Campbell stated.

CMS Call for Nominations: 2025 CMS Health Equity Award U.S. Centers for Medicare and Medicaid Services; by CMS Health Equity; via CMS email 1/13/25Nominations for the 2025 CMS Health Equity Award are now open to organizations working to advance health equity, showing others how to reduce disparities in health care access, quality, and outcomes. Nominations are due February 18 at 11:59 pm PT.  ... Health equity is defined by CMS as the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, and other factors that affect access to care and health outcomes. 

Guidelines for evaluating, diagnosing, and disclosing dementia published by Alzheimer’s Association Practical Neurology; 1/14/25 The Diagnostic Evaluation, Testing, Counseling, and Disclosure Clinical Practice Guideline (DETeCD-ADRD CPG) Workgroup, convened and funded by the Alzheimer’s Association, has developed new recommendations for clinicians to use when evaluating patients with possible Alzheimer disease (AD) or AD and related dementias (ADRD). An executive summary of the recommendations for use in primary care and other practice settings was published in Alzheimer’s & Dementia, along with a companion article summarizing specific guidance for specialists. The Workgroup included representatives from  primary, specialty, subspecialty, long-term, and palliative care disciplines as well as the fields of health economics and bioethics.  Editor's note: Click for open access to the Alzheimer's Association clinical practice guideline ..., executive summary of recommendations for primary care. 

Allevant Solutions shares over 10 years of insights into rural post-acute care patient outcomes PR Newswire, Mechanicsburg, PA; by Allevant Solutions, LLC; 1/13/25 Allevant Solutions, LLC shared key insights from its experience over a 10-year period showing that partnerships between larger acute care hospitals and rural critical access hospitals (CAHs) for post-acute care benefit patients, health care teams and hospitals. The aggregate, de-identified data reflects patient outcomes from over 100 CAHs across 24 states, specifically around the utilization of the swing bed concept – which Allevant calls Transitional Care.  A swing bed is the federal government's term for a patient bed in a small, rural critical access hospital that can be used for acute or post-acute care after a hospital stay.  Rural patients who have to leave their community for higher levels of care often have difficulty finding high-quality, continuing care when they are ready to return. 

Provider perspectives on implementation of adult community-based palliative care: A scoping reviewMedical Care Research and Review; Nicole Dussault, Dorian Ho, Haripriya Dukkipati, Judith B. Vick, Lesley A. Skalla, Jessica Ma, Christopher A. Jones, Brystana G. Kaufman; 1/25While community-based palliative care (CBPC) programs have been expanding, there remain important obstacles to widespread use. Since provider perspectives on CBPC remain underexplored, we conducted a scoping review to summarize provider perspectives regarding barriers and facilitators to implementation of adult CBPC in the United States. At the provider level, barriers included misperceptions of palliative care (PC) by referring providers and poor communication, while facilitators included multidisciplinary teams and referring provider education. At the organizational level, time constraints were barriers, while leadership buy-in and co-located clinics were facilitators. At the external environment level, limited PC workforce and inadequate reimbursement were barriers. Our findings suggest that efforts aimed at scaling CBPC must address factors at the provider, organizational, and policy levels.

The Alliance celebrates the Dole Act becoming law, protecting burial benefits for veteransNational Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 1/7/25 The National Alliance for Care at Home (the Alliance) issued the following statement in response to President Biden signing S. 141, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, into law on Thursday, January 2. This landmark legislation includes Section 301, Gerald’s Law, which addresses a critical gap in benefits for Veterans. Gerald’s Law ensures that families of terminally-ill Veterans receiving Veterans Affairs (VA)-furnished hospice care—whether at home, in a nursing home, or in another non-VA setting—retain access to their full VA burial allowance. “We are deeply grateful for the bipartisan support of Gerald’s Law and its inclusion in the Dole Act,” said Dr. Steve Landers, CEO for the Alliance. “This legislation ensures that Veterans and their families can choose hospice care in the setting that best meets their needs without risking the loss of crucial burial benefits. We thank Senators Moran, Tester, and Hassan, Representatives Ciscomani, Bost, Brownley, and Takano, and many others for their leadership, as well as President Biden for signing this important bill into law.”

Navigating Aging: The LGBTQ+ community relives old traumas as they face aging on their own Northern Kentucky Tribune; by Judith Graham; 1/5/25 Bill Hall, 71, has been fighting for his life for 38 years. These days, he’s feeling worn out. Hall contracted HIV, the virus that can cause AIDS, in 1986. ... This past year, Hall has been hospitalized five times with dangerous infections and life-threatening internal bleeding. But that’s only part of what Hall, a gay man, has dealt with. ... By 2030, the number of LGBTQ+ seniors is expected to double. Many won’t have partners and most won’t have children or grandchildren to help care for them, AARP research indicates. They face a daunting array of problems, including higher-than-usual rates of anxiety and depression, chronic stress, disability, and chronic illnesses such as heart disease, according to numerous research studies. High rates of smoking, alcohol use, and drug use — all ways people try to cope with stress — contribute to poor health. Keep in mind, this generation grew up at a time when every state outlawed same-sex relations and when the American Psychiatric Association identified homosexuality as a psychiatric disorder. Many were rejected by their families and their churches when they came out. Then, they endured the horrifying impact of the AIDS crisis.