Literature Review

The state where all hospitals have perfect health equity scores  Becker's Hospital Review; by Mariah Taylor; 9/2/25 Delaware is the only state where 100% of its hospitals scored perfectly on health equity measures, according to CMS data. The agency used hospital commitment to health equity data, such as social determinants of health data, race, ethnicity, language, gender identity, sex, sexual orientation and disability status to determine access to equitable care and coverage. Facilities were ranked on a scale of 1 to 5, with 5 being the highest score. CMS then compiled a ranking of states based on the percentage of facilities that received each score. Data was collected between January and December 2023 and was last updated Aug. 6. 

Baptist Health Floyd's 'Three Wishes' project provides comfort during end-of-life process FOX WDRB Media, Louisville, KY; Press Release; 9/8/25 Baptist Health Floyd patients and families facing end-of-life decisions now have extra support through the hospital's "Three Wishes" project. Baptist Health Floyd launched the Three Wishes Project a few months ago as a way to ease the burden faced by patients and their families who are nearing the end of their life. The program grants small, meaningful wishes to patients and their families, according to a news release. Baptist Health Floyd ICU RN Makenzie Stiffler, who leads the program, said "it is a way to humanize the death and dying process in ICU (Intensive Care Unit)." 

What executives can learn from how and why hospitals plan for a crisis Forbes; by Edward Segal; 9/2/25 

Palliative care use and end-of-life care quality in HR+/HER2- metastatic breast cancerBreast Cancer Research and Treatment; by Julia G Cohn, Susan C Locke, Kris W Herring, Susan F Dent, Thomas W LeBlanc; 8/25Metastatic breast cancer (MBC) is incurable, despite therapeutic advances, especially in hormone receptor positive (HR+) and human epidermal growth factor-2 negative (HER2-) disease. Of 102 patients, 85 died during the study period, and over half (55%) received aggressive EoL [end of life] care. Half had some form of SPC [specialist palliative care], and rates of aggressive EoL care were comparable between those who engaged with SPC and those who did not. The most common indicators of aggressive EoL care included multiple ED visits (28%) and hospital admissions (23%) in the last 30 days of life as well as in-hospital location of death (24%). Although 72% enrolled in hospice care, 9% of patients were on hospice for ≤ 3 days. This real-world study demonstrates that many patients with HR + /HER2- MBC [metastatic breast cancer] receive aggressive EoL care despite some engaging with SPC and many enrolling in hospice. 

Improved outcomes and cost with palliative care in the Emergency Department: Case-control studyThe Western Journal of Emergency Medicine; Brandon Chalfin, Spencer M Salazar, Regina Laico, Susan Hughes, Patrick J Macmillan; 7/25This small pilot case-control study included a subset of all patients referred by emergency physicians and hospitalists for palliative care within 24 hours of registration, physically present in the ED. CONCLUSION: Embedding hybrid physicians in the ED significantly shortened hospital stays and reduced charges for seriously ill patients. A notable secondary outcome was that 26.5% of ED visits in the case group did not result in hospital admission, compared to all controls being admitted ... In addition, more cases than controls had a code status of comfort care at discharge ... These findings support the further exploration of integrating such physicians into ED settings to enhance patient care and optimize hospital resources.

Advocate Health investing $3B across rural footprint: 8 things to know Becker's Hospital Review; by Alan Condon; 8/15/25 Charlotte, N.C.-based Advocate Health is investing more than $3 billion across its rural operations to preserve care access, expand services and build a sustainable pipeline of providers for the future. The investment comes at a time when nearly half of rural hospitals are operating at a loss and 800 are at risk of closure, according to an analysis by the Center for Healthcare Quality and Payment Reform. Twenty-one of Advocate Health’s nearly 70 hospitals are located in rural counties across six states, along with more than 320 rural clinics and a network of mobile and virtual programs [including hospice care]. 

Palliative delays associated with increased length of stay in older traumatic brain injury patientsThe Journal of Trauma & Acute Care Surgery; by Sarah A Hatfield, Parima Safe, Cleo Siderides, Anjile An, Cassandra V Villegas, Nicole Goulet, Robert J Winchell, Elizabeth Gorman; 7/25Trauma Quality Improvement Program guidelines recommend early goals of care discussions (≤72 hours) for older patients with severe injuries. Patients (55 years or older) with moderate to severe TBI [traumatic brain injury] ... were retrospectively identified at a level I trauma center (2020-2022). Conclusions: Delayed PI [palliative intervention] is associated with increased LOS [length of stay] in older TBI patients, with no survival difference compared with early PI. Palliative interventions should be introduced early to reduce morbidity in patients with potential poor prognosis.

Hospitals accused of hiding deaths, storing bodies for months, and not telling families Nurse.org; by Brandy Pinkerton, RN; 7/25/25 Families in the Sacramento area say they spent months, and in some cases years, desperately searching for loved ones who had vanished—only to discover that their remains had been left to decompose, unidentified and forgotten, in an off-site morgue operated by Dignity Health hospitals. Now, a series of lawsuits and regulatory audits allege that one of California’s largest healthcare systems demonstrated “callous, reckless, and outrageous failure” by neglecting to notify families of patient deaths, withholding death certificates, and consigning bodies to languish in storage, compounding the anguish of those left behind. 

Bipartisan bill offers ‘meaningful’ immigration reform that could help address senior living workforce needs, leaders say McKnights Senior Living; by Kimberly Bonvissuto; 7/1/25 A bipartisan immigration reform bill proposing a pathway to legal resident status for certain undocumented immigrants — including direct care workers — is earning the support of the senior living and care industry. The recently re-introduced Dignity Act of 2025 “offers the solution to our immigration crisis: secure the border, stop illegal immigration and provide an earned opportunity for long-term immigrants to stay here and work,” sponsor Rep. Maria Elvira Salazar (R-FL) had said in introducing the bill. [Its co-sponsor is] Rep. Veronica Escobar (D-TX).

Effect of a multi-component palliative care intervention on goals of care discussions for critical patients in the emergency departmentInternal & Emergency Medicine; by Julia Murray, Zacharia Grami, Katherine Benson, Christopher Hritz, Samantha Lawson, Corita Reilley Grudzen, Allison Cuthel, Lauren Talanda-Fath Southerland; 7/25Goals of care (GOC) discussions are vital to understanding patients' values and preferences during serious illness, but they occur infrequently during Emergency Department (ED) care. We report a single site sub-study of a stepped wedge pragmatic trial of a multi-component intervention of primary palliative care in the ED (PRIM-ER), focused on GOC conversations. The intervention did not change the proportion of patients receiving a GOC conversation in the ED ... [however patients] presenting with a cancer-related complaint ... or a respiratory emergency ... were associated with increased odds of a GOC conversation occurring. Of the 60 GOC conversations that occurred, 76.7% ... resulted in a change in code status, patient care plans, hospice, or updated advance care planning documents. While the intervention did not increase this secondary outcome of GOC conversations, the discussions that did occur frequently impacted ED care.Assistant Editor's note: This study concluded that the intervention employed in the ED did not increase the proportion of patients receiving GOC conversations. Yet the study also concluded that almost 77% of the patients who DID receive the conversation had a change in code status, care plan, hospice or advance care planning documents. This study clearly reminds us that GOC conversations, employed even in the ED, can help patients embrace a palliative approach to care when faced with serious illness.

Medicare Advantage growth drives changes in post-acute care Managed Healthcare Executive; by Briana Contreras; 7/28/25 A new report released today by Trella Health revealed major shifts are underway in post-acute care as Medicare Advantage (MA) enrollment grows, care transitions evolve and providers navigate the challenges of value-based care. The Post-Acute Care Industry Trend Report looked at national and state-level trends in home health, hospice and skilled nursing using the latest Medicare claims and enrollment data. One of the most significant shifts is the continued rise of MA enrollment. The report shared that as of February 2025, more than half of Medicare beneficiaries (55.4%) are enrolled in MA plans, with 30 states reporting MA enrollment over 50%. This shift is changing how patients access care—more so in home health.

Targeted palliative care may cut older adults’ risk of readmissions after elective surgeries: study McKnights Long-Term Care News; by Alicia Lasek; 7/27/25 Older adults with serious illness before elective surgery are at double the risk of extended hospital stays, readmissions, emergency department visits and costs, a new study has found. Targeting four key palliative care needs before surgery may help make the recovery period less burdensome for these patients and the healthcare system, the authors say. The study, published in the Journal of the American College of Surgeons, looked at seriously ill older surgical patients to see what palliative care interventions might help reduce the need for excess healthcare use post surgery. Among 2,499 older adults undergoing major elective surgery, [researchers reported] 63% were seriously ill, and 79% had four key palliative care needs:

Regional anesthesia for hip fracture surgery in older adults: A retrospective comparison of outcomes using ACS NSQIP dataGeriatric Orthopaedic Surgery & Rehabilitation; Arissa M. Torrie, MD, MHS; Gerard P. Slobogean, MD, MPH; Rachel Johnson, MD; Ron E. Samet, MD; Samuel M. Galvagno, DO, PhD; Robert V. O’Toole, MD; Nathan N. O’Hara, PhD, MHA; 6/25Surgical fixation of hip fractures in older adults is associated with significant morbidity and mortality. This study found that regional anesthesia, presumably using peripheral nerve block techniques, may offer advantages beyond pain control, with potential protective benefits in high-risk hip fracture patients. Future clinical trials should examine peripheral nerve block benefits beyond pain management, identify mechanisms of action, determine optimal techniques for different risk profiles, and assess long-term outcomes. By combining the insights from this study with carefully designed future research, researchers can work towards developing more effective, patient-centered approaches to anesthesia for older adults undergoing surgical fixation of hip fractures.