Literature Review

November healthcare observances

Size of the financial incentives in Medicare’s Skilled Nursing Facility Value-Based Purchasing ProgramJAMA Network Open; by Robert E. Burke, Franya Hutchins, Jonathan Heintz, Syama R. Patel, Scott Appel, Julie Norman, Atul Gupta, Liam Rose, Rachel M. Werner; 9/25The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program seeks to reduce all-cause 30-day readmissions from SNF for traditional Medicare beneficiaries recently discharged from the hospital. Under SNF VBP, most SNFs receive a financial bonus or penalty up to 2% of their total traditional Medicare revenues each year, on the basis of their performance on 30-day readmission rates compared with other SNFs, or their own improvement in readmission rates over time. In this cohort study, we found that the size of the financial incentives at the SNF level are relatively small in terms of dollars and as a proportion of net operating income, and that most SNFs experienced substantial variability from year to year in their incentive payments. These 2 factors may have contributed to the relative lack of effectiveness of the SNF VBP program. First, if the level of the penalty is not sufficient to hire additional staff, purchase equipment (such as an x-ray machine or laboratory testing), or invest in new care processes, then SNFs will not be able to improve their ability to manage changes in patient condition. 

[UK] Use of HidraWear in a malignant fungating wound at end of life: A case studyWounds UK; by Alison Schofield; 9/25Malignant wounds are a devastating complication associated with cancer, which are challenging to manage and can be distressing for patients, family members and healthcare professionals (HCPs). Management of malignant wounds can differ significantly from that of any other wound type, particularly as they often occur at end of life. Increased awareness and communication around this difficult wound type is needed, including case studies and sharing of HCPs’ experiences. This case study describes the treatment of an end-of-life patient in a hospice setting, with a challenging malignant fungating wound (MFW). This case highlights the importance of palliative symptom management and the benefits of using HidraWear in practice.

From mom-care to action: Identifying the crises in eldercare Minnesota Women's Press; by Amy Gage; 10/15/25 “I didn’t set out to write a book,” author Judy Karofsky said. ... “My mom was my inspiration.” ... DisElderly Conduct: The Flawed Business of Assisted Living and Hospice (New Village Press, 2025) ... began as a notebook of jokes and one-liners that her mom would toss off during their time together. A one-time amateur comedienne, Lillian Deutsch “was an amazing personality,” Karofsky says. DisElderly Conduct walks readers through Karofsky’s journey through six assisted living facilities and eventual hospice care before her mother’s death in 2018. Several themes emerge in the well-researched book:

How Optum’s Amedisys deal could shake up the hospice marketHospice News; by Jim Parker; 10/21/25The acquisition of the home health and hospice provider Amedisys by the insurance mammoth UnitedHealth Group (NYSE: UNH) has far-reaching implications for the hospice community. The UnitedHealth Group subsidiary Optum, in June 2023 inked its agreement to acquire Amedisys in an all-cash transaction of $101 per share, or about $3.3 billion. After leaping a series of regulatory hurdles, including a U.S. Justice Department lawsuit, the deal closed in mid-August... The merger likely makes UnitedHealth Group one of the largest hospice providers in the United States.

Traumatic brain injury in late life tied to elevated dementia risk Medscape; by Liz Scherer; 10/13/25 Traumatic brain injury (TBI) in late life is associated with a significant increase in the risk for new-onset dementia. The risk is especially elevated (by as much as 69%) within the first 5 years following the injury, according to newly published study findings. Though TBI, which results from direct impact or indirect force to the head, has long been recognized as a midlife risk factor for dementia, the risk that TBI poses in adults aged 65 years or older has been unclear.Editor's Notes: Pair this with the article we recently posted, "Why are more older people dying after falls?"

[England] Ambulance team uses advanced ultrasound to help frail patients avoid hospital trips Emergency Services Times; by James Devonshire; 10/16/25 The East of England Ambulance Service (EEAST) is using cutting-edge medical technology to help elderly and end-of-life care patients receive treatment in their own homes, reducing the need for hospital admissions. The service’s advanced practice (urgent care) team has introduced point of care ultrasound (POCUS)—a portable diagnostic tool previously reserved for critically ill patients—to assess bladder and urinary conditions safely and effectively in community settings. Using the handheld Butterfly ultrasound device, paramedics can perform scans and interpret results via software on iPads, allowing for faster and more accurate diagnoses.

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.”

North Carolina hospitals wipe out $6.5B in medical debt Becker's Hospital Review; by Andrew Cass; 10/13/25 North Carolina’s medical debt relief program has surpassed its initial financial projections, relieving more than $6.5 billion in medical debt from 2.5 million residents over the past year. ... The North Carolina Department of Health and Human Services partnered with Undue Medical Debt — formerly RIP Medical Debt — to support participating hospitals and help them identify medical debt that is eligible for relief. Hospitals are continuing to work with Undue Medical Debt to facilitate full implementation of relief over the next year. 

Common hospice medications linked to higher risk of death in people with dementia EurkAlerts! American Association for the Advancement of Science (AAAS); by Michigan Medicine - University of Medicine; 10/14/25 ... [For] the growing number of Americans with dementia who enter hospice, their course is often long and unpredictable — making it especially important to ensure treatments align with each person’s goals and stage of illness. A new University of Michigan study published in JAMA Network Open finds that medications commonly prescribed to ease symptoms such as agitation, anxiety, and delirium — benzodiazepines and antipsychotics — may carry major unintended risks for people with dementia receiving hospice care. Among more than 139,000 nursing home residents with Alzheimer’s disease and related dementias enrolled in hospice between 2014 and 2018, those who began taking a benzodiazepine or an antipsychotic after enrollment were 41% and 16% more likely to die within six months, respectively, than very similar hospice patients with dementia who did not receive these medications.

Tomorrow is World Mental Health Day - Template Emails/Texts to Support Your Staff Hospice & Palliative Care Today; by Joy Berger; 10/8/25 In preparation for tomorrow's World Mental Health Day, Friday, October 10, 2025, we’ve created these sample email and text templates to help you easily share encouragement and support with your employees and volunteers — especially those who provide direct patient and family care. While this year’s worldwide emphasis is on “catastrophes and emergencies,” (e.g. natural disasters, war, et.al.) it loosely connects  to hospice work. Each visit a clinician makes has the potential for walking into a patient’s, caregiver’s, or family’s end-of-life “catastrophe” (“she’s dying!”) or “emergency” (pain, terminal restlessness). Supporting your staff through these ongoing, accumulated stresses is essential to sustaining your mission — compassionate hospice care.

Today is the 2025 World Hospice & Palliative Care Day: Achieving the Promise: Universal Access to Palliative Care Organized by the Worldwide Hospice Palliative Care Alliance; primary article by Stephen Connor; in preparation for 10/11/25This year we celebrate the 20th anniversary of World Hospice & Palliative Care Day (World Day). What started as ‘Voices for Hospice’ concerts around the world turned into a day to recognise hospice and palliative care starting in 2005. Having a day each year to recognise the importance of hospice and palliative care is a valuable part of every health care movement and is essential for advocacy and awareness raising. World Day is organized by the Worldwide Hospice Palliative Care Alliance each second Saturday in October, this year on 11 October 2025, on behalf of the global palliative care community, including international, national, and regional palliative care organisations such as the IAHPC, ICPCN, PallCHASE, APCA, EAPC, ALCP, APHN, and including national organisations such as the IAPC.Editor's Note: Additional links of interest include ...

Today is World Mental Health Day: October 10, 2025 Hospice & Palliative Care Today; by Joy Berger; 10/8/24The 2025 theme for World Mental Health Day is "Access to Services - Mental Health in Catastrophes and Emergencies." We've compiled these resources for you to use--not just today--but all year long.