Literature Review

The complexity of multi-service organizations Teleios Collaborative Network (TCN); podcast by Christ Comeaux with Rebecca Ramsy and Mark Jarman-Howe; 7/30/25 Rebecca Ramsay and Mark Jarman-Howe, two dynamic leaders who are navigating the evolving world of hospice and multi-service healthcare with vision and heart,  share their experiences in managing diverse service lines, emphasizing the importance of culture, workforce resilience, and community engagement. Rebecca and Mark discuss the challenges of balancing mission and margin while fostering innovation and collaboration. The conversation underscores the importance of strategic planning, mentorship, and understanding regulatory frameworks to navigate the healthcare landscape effectively.  

Terminally ill nursing home patients face needless ER visits, hospital stays HealthDay; by Dennis Thompson; 7/28/25 Terminally ill nursing home residents are being hounded to their graves with needless trips to the hospital, a new study says. About 80% of ER visits by terminally ill nursing home residents are potentially avoidable, researchers report in the Journal of the American Medical Directors Association. Likewise, nearly one-third of hospitalizations among these residents were needless, the study says. Pneumonia, urinary tract infections (UTIs) and sepsis commonly resulted in needless trips to the hospital for terminally ill patients, but better health care and management at nursing homes could have kept these people out of the hospital, researchers argue. 

Post-acute care faces labor shortage amid immigration scrutiny Modern Healthcare, Post-Acute Care; by Diane Eastabrook; 7/23/25 Nursing homes and home care operators are scrambling to find replacements for foreign-born workers no longer eligible to work in the U.S. due to changes in immigration policy. Providers in Boston, Atlanta and other cities with large populations of immigrants, and Haitians in particular, say the loss of foreign-born workers in an already tight job market is making it increasingly difficult to meet the growing demand for care — and will likely drive up care costs. Last month the Homeland Security Department began notifying more than 500,000 Cubans, Haitians, Nicaraguans and Venezuelans that it terminated a Biden-era program that allowed them to live and work in the U.S. It said those who have not attained legal status to remain in the U.S. outside of the program must leave immediately. Despite court challenges, the federal government also aims to end another program in early September that grants temporary protected status to Haitians and Venezuelans who have lived in the U.S. for more than a decade. [Full access might require subscription.]

51 healthcare leaders’ takes on doing more with less Becker's Hospital Review; by Allie Woldenberg, Kelly Gooch, Mariah Taylor, Giles Bruce, Kristin Kuchno, and  Andrew Cass; 7/17/25 It’s a directive that hospitals and health systems of every size know well — whether sprawling academic medical centers, multistate nonprofit systems or rural, independent 25-bed hospitals. While the phrase isn’t new, the urgency behind it is intensifying. The nation’s healthcare workforce remains fragile, forcing leaders to distinguish between staffing gaps that are temporary hurdles or structural limitations. Revenue projections for health systems have shifted dramatically ... Against this backdrop, Becker’s set out to understand how health system leaders across the U.S. are interpreting and enacting the mandate to “do more with less” today. From June 9 to July 15, we spoke with executives across the country, in every type of market, hospital, and health system, to hear how they are navigating this evolving landscape. ...Editor's Note: Scan through these with a sharp eye toward improving the quality of patient care while "doing more with less." I applaud many of these leaders for not just focusing on cutting costs, but for using these crucial changes as a vehicle to improve patient care.

Video palliative care improves symptoms but not outcomes in rural hospitals, study reveals McKnights Long-Term Care News; by Donna Shryer; 7/15/25 Researchers from the University of Alabama at Birmingham recently studied whether video consultations could improve palliative care for patients age 55 and older in small hospitals lacking specialized end-of-life services. Participants had an average age of 73. The study, published in JAMA Network Open, found that culturally tailored video consultations — designed with community input to reflect patients’ cultural values and communication preferences — led to a clinically meaningful but not statistically significant reduction in symptom distress. ... [The] video consultations had little effect on hospital readmissions or emergency department visits. The research addressed a critical healthcare gap, as the study notes that only 70% of the Deep South has access to palliative care services, compared to 85-94% in other US regions. This disparity particularly affects rural communities where specialized end-of-life care is often unavailable. 

Humana agrees to purchase bankrupt Florida provider The Villages Health for $50m Healthcare Dive; by Rebecca Pifer; 7/8/25 The insurer’s bid is preliminary and kicks off an auction for the debt-laden provider, which decided to undergo bankruptcy after discovering it owed Medicare hundreds of millions of dollars.

The leadership norms CEOs are breaking Becker's Hospital Review; by Kristin Kuchno; 7/2/25 From rejecting strict hierarchies to forging unconventional partnerships, hospital and health system CEOs are challenging long-held leadership norms to build stronger, more responsive organizations. ... Here, six healthcare CEOs share the norms they have intentionally moved past — and what their teams have gained in the process.

St. Joseph’s Center of Trumbull to permanently close Aug. 9 Westfair Business Journal, Trumbaull, CT; by Gary Larkin; 6/30/25The Town of Trumbull and the state Department of Labor (DOL) have reported they are trying to help the 179 employees laid off by St. Joseph’s Center after its parent company [Genesis Healthcare] announced it was closing the nursing home on Aug. 9. ... St. Joseph’s Center has been serving Trumbull for more than 50 years with an array of services such as: independent living, short-term rehabilitation, long-term care, and hospice services. 

Measuring what matters: The untapped power of resident experienceMcKnight's Long-Term Care News; by Charles de Vilmorin; 6/25/25In today’s senior living and long-term care environment, doing well financially depends on doing good — truly good. Communities that thrive are the ones that deliver on the promise of person-directed living, where residents are not passive care recipients but active participants in a life of dignity, purpose and connection. This isn’t just a moral imperative — it’s a strategic one. The industry has long recognized the importance of resident quality of life, but often fails to define or measure it with the same rigor applied to occupancy or staffing ratios. This is a missed opportunity. Resident experience remains one of the most powerful, untapped levers for operational improvement, competitive differentiation and financial growth. It’s time we treat it like the performance driver it is.Publisher's note: The balance of "mission and money" is equally true in hospice.

Short notice, long love: A hospice wedding full of heart Citrus County Chronicle, Inverness, FL; by Mike Arnold; 6/16/25 Brendan Malone and Vanessa Rodriguez made a snap decision that would change their lives – and touch the hearts of everyone around them. The couple were driving up from Estero in the early afternoon of June 5 to visit Malone’s father, Michael “Big Mike” Malone, who had recently moved into Citrus Health and Rehab in Inverness and was also receiving care from Vitas Hospice. [Already engaged,] ... they made the decision to get married the next morning, at Citrus Health and Rehab. There were no tuxedo fittings, no cake tastings, no invitations sent. There was no time. There were flowers, guests, toasts, bubbles – and love. And “Big Mike” had a front row seat. Brendan Malone didn’t want to get married without the man who had been his biggest supporter by his side. ... What followed was a whirlwind of compassion, planning, and action from the staff at the nursing facility and the local hospice team. Within hours, they coordinated decorations, arranged courtyard seating, and made sure Michael could be present in his wheelchair for the ceremony.

A woman died in hospice at a Gilbert memory care facility. Her husband was arrested after staff say they found 'suspicious bruising and markings.' NBC News 12, Gilbert, AZ; Kyra O'Connor; 6/14/25 A man was arrested after staff at a memory care facility in Gilbert reported his wife had "suspicious bruising and markings" on her body, the city's police department said. The woman, who was not identified, passed away in hospice care. Gilbert police officers responded to a memory care facility around 9 a.m. on June 11. Staff at the memory care facility contacted police after noticing "suspicious bruising and markings" on a 58-year-old woman in hospice care who had passed away earlier in the day, at approximately 3 a.m. The woman's husband, 46-year-old Justin Davidson, was in the room at the time of her death, staff told police. ... Davidson was arrested and faces a first-degree murder charge, police said. The investigation is ongoing. Police did not give any further details. Police did not name the memory care facility where the deceased lived. 

Nursing home is pressuring my mother-in-law to enter hospiceAging Care - Caregiver Forum - End of Life - Questions; question posed by "concerned8"; 6/12/25 I am her Health Care Surrogate but as they won't declare her incompetent it has not come into effect. I believe the home's intent is to prevent me from making the decision regarding hospice and instead to pressure her to enter it in various ways. ... I am not anti-hospice and expect her to enter it in the near future, but want that to be my decision, not the home's (even if it's portrayed as hers).  ... [An answer from another reader" Our family has only had bad experiences with three different hospice companies. Contrary to what most people believe, many patients are placed on hospice for free equipment and free services. I was told this by more than one hospice worker.Editor's Note: This post raises numerous troubling perceptions, with descriptions of poor hospice experiences. 

Senior living and care leads healthcare bankruptcies again in first quarterMcKnight’s Senior Living; by Kathleen Steele Gaivin; 6/3/25Senior living and care bankruptcies hit a two-year high in the first quarter, increasing to seven from three in the fourth quarter of 2024. That’s the highest quarterly increase in two years, according to a new report from healthcare restructuring advisory firm Gibbins Advisors. Senior living and care bankruptcies accounted for more than 40% of total healthcare filings, according to the report. [Related]