Literature Review

CMS’s Special Focus Facility Program for Nursing Homes has not yielded lasting improvementsOIG press release; 10/29/25This report evaluated the effectiveness of the Centers for Medicare & Medicaid Services’ (CMS) Special Focus Facility (SFF) program, the agency’s flagship effort to address quality problems at the nation’s poorest-performing nursing homes. OIG found nearly two-thirds of facilities that graduated from the SFF program between 2013 and 2022 later exhibited recurring quality issues. Among nursing homes that received a serious deficiency in the three years after graduating, 38% put residents at risk of serious injury, harm, impairment or death. For program improvement, OIG recommended that CMS use more nonfinancial remedies, assess enforcement effectiveness—especially for staffing deficiencies—and incorporate ownership data.Publisher's note: It's interesting to see what works - and what doesn't work - from the CMS / OIG perspective.

Engaging community health workers in Advance Care Planning  Hospice News; by Jim Parker; 10/24/25 Three organizations have developed an advance care planning training program in Illinois for community health workers that could potentially be adapted for other states. The seeds for the project were planted when the Illinois Public Health Association (IPHA) was awarded a grant by the Health Resources & Services Administration (HRSA). IPHA proceeded to engage the Illinois Hospice & Palliative Care Organization (IL-HPCO) and the HAP Foundation as subject matter experts to help develop the curriculum, as well as the education company Hospice Media, which filmed and designed the modules and workbooks.

Three tried-and-true strategies AHCA Gold Quality Award winners use to land and keep staff McKnights Long-Term Care News, Las Vegas, NV; by Kimberly Marselas; 10/22/25 Leaders of three of the nation’s best-performing nursing homes shared ... outside-the-box recruitment and retention strategies that have made robust staffing the linchpin of their respective quality-improvement journeys. ... Here, McKnight’s Long-Term Care News shares a few of the role model practices Peters and her two 2025 Gold National Quality Award peers rely on to create staff loyalty, even in highly competitive markets.

Study: Nearly two-thirds of nursing home residents were exposed to med combos linked to potential drug-drug interactions McKnights Long-Term Care News; by Foster Stubbs; 10/17/25 About 62% of nursing home residents experienced one or more drug-drug interactions (DDI) between 2018 and 2020, according to an October study published in the Journal of the American Geriatrics Society. Researchers examined 485,251 Medicare fee-for-service beneficiaries 66 years or older living in nursing homes with observable Medicare Part D prescription drug data. Data were drawn from Medicare claims linked to Minimum Data Set 3.0 clinical assessments. 

Size of the financial incentives in Medicare’s Skilled Nursing Facility Value-Based Purchasing ProgramJAMA Network Open; 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. 

The pitfalls that derail home health providers’ new palliative care efforts Home Health Care News; by Joyce Famakinwa; 10/14/25 ... Though home health-operated palliative care is a rarity, companies like Visiting Nurse Health System, Contessa Health and Compassus have managed to successfully incorporate these services into their broader care delivery model. When structuring an effective palliative care services program, there are some common pitfalls home health providers should avoid. “One of the biggest ones is positioning palliative care as early hospice,” Nikki Davis, senior vice president of palliative care programs at Contessa, said at Home Health Care News’ FUTURE conference. “And just make sure that there’s also clear eligibility and referral pathways, so that when you’re partnering with your home health and hospice teams, you have those processes in place, so that it’s very clear who’s eligible for palliative care.”

Alzheimer’s Association, Maine Chapter sees largest turnout for annual fundraiser walk WABI-5, Bangor, ME; by Grace Bradley; 10/11/25 For more than two decades, folks have hit the streets of Bangor to help raise money and awareness for Alzheimer’s. On Saturday, Maine’s chapter of the Alzheimer’s Association says they saw the largest crowd yet of about 400 people for their largest annual fundraiser. “We provide free care and support for families and community members walking through this disease, whether it’s Alzheimer’s or other forms of dementia. So what we do enables us to do everything for free. But we also take a portion of that money and put it towards research,” explains Kris Baker, Development Manager of Alzheimer’s Association Maine. Editor's Note: Do you support and partner with the Alzheimer's Association?

Conspiracy of verticals:  Rethinking healthcare models with Peter Benjamin Teleios collaborative Network (TCN); video/podcast hosted by Chris Comeaux with Peter Benjamin; 10/8/25 In this conversation, Peter Benjamin and Chris Comeaux discuss the impact of COVID-19 on mortality rates, particularly the concept of 'death pull forward' and its implications for Hospice Care. Peter highlights the significant role of assisted living facilities in Hospice days and explores macro trends in healthcare, emphasizing the shift from vertical to horizontal care models. The discussion also covers the evolution of Palliative Care, frail elderly practices, and institutional special needs plans (iSNPs), while stressing the importance of measuring quality of care, particularly in pain management. 

Communication surrounding treatment preferences for older adults with dementia during emergency medical services responseJournal of the American Geriatrics Society; by Lauren R. Pollack, Danae G. Dotolo, Anna L. Condella, Whitney A. Kiker, Jamie T. Nomitch, Elizabeth Dzeng, Nicholas J. Johnson, Thomas D. Rea, May J. Reed, Michael R. Sayre, Erin K. Kross; 9/25Emergency Medical Services (EMS) providers, capable of rapidly delivering life-prolonging interventions, are often first to respond to acute health concerns for older adults in the United States. Prior work has shown a preference among many people with dementia for comfort-focused care near end-of-life. EMS providers treating critically ill older adults with dementia face challenges that may hinder their ability to elicit treatment preferences, in particular when responding to calls from professional caregivers. Direct communication with surrogate decision-makers may facilitate goal-concordant care.Assistant Editor's note: Being an RN for over 40 years, I have seen many changes in health care, especially in what is expected now of patients/families. I remember the day when nurses were not permitted to share with the patient his/her own BP reading; instead, we were to tell patients to "ask the doctor". Back then the doctor controlled almost all aspects of the patient's care, as well as the sharing of information with the patient about his/her own medical condition. I am glad those days are gone. Now, patients are expected to engage in ongoing discussions regarding advance care planning, execute written advance directives, and are expected to share their care preferences with health providers and loved ones and/or caregivers. It would be an ideal world where health care providers were continuously aware of evolving patient preferences and could always deliver goal concordant care. I believe we need to keep working toward this goal, but I also understand that this expectation can add burden to patients who are already extremely burdened with the many difficult aspects of serious illness. I believe that, as health care providers, we need to appreciate that some people simply cannot or will not share their preferences; it is simply too scary, too foreign, too difficult to do so.

Hospice of Santa Barbara’s No One Dies Alone Program ensures that those who are alone and actively dying, have someone at their bedside Santa Barbara Independent, Santa Barbara, CA; by Hospice of Santa Barbara; 9/29/25Hospice of Santa Barbara’s (HSB) No One Dies Alone (NODA) program has partnered with local senior living facilities in Santa Barbara for over a decade, providing compassionate volunteer support to seniors in their final 24 to 72 hours when family or friends are unavailable. Currently, NODA has 21 trained volunteers serving in the program. Before becoming a NODA volunteer, applicants must graduate from a six-week patient care training and serve as a patient care volunteer for a minimum of 9 months before attending a NODA specific training. Most NODA volunteers have been with the program for years and feel a strong commitment to the work they do.

Living with dementia: To improve lives, we need to change how we think and talk about this experience in aging societies EurekAlert! - AAAS (American Association for the Advancement of Science); peer reviewed publication by The Hastings Center; 9/24/25 To experience or even contemplate dementia raises some of the most profound questions: What does it mean to be a person? How does someone find meaning in life while facing progressive neurological deterioration? ... To improve the lives of our fellow citizens who are living with dementia or providing dementia care, all of us need to pay attention to how we imagine and talk about these interwoven and increasingly common experiences, concludes Living with Dementia: Learning from Cultural Narratives in Aging Societies, a special report published by The Hastings Center for Bioethics. This report responds to calls from health care and social service practitioners for new ways to depict and talk about dementia, a collective term for Alzheimer disease and related dementias. Editor's Note: Click here for free access to multiple articles in this crucial report, such as

Community turns out for Banner's Senior ExposCleveland Daily Banner, Cleveland, TN; by Will Bublitz; 9/19/25 Hundreds of seniors enjoyed the food, door prizes, free samples and information to improve their lives during the Living 55Plus Senior Expo, held Thursday in Wacker Commons at the PIE Innovation Center in Cleveland. This was the sixth year for this popular and free event sponsored by the Cleveland Daily Banner. It was co-sponsored by Bradley Medical Center, Cleveland Utilities, Garden Plaza of Cleveland, Ahlberg Audiology, Companion Funeral Homes and Life Care Center of Cleveland. "The 2025 55Plus Senior Expo was the best expo thus far, with the most vendors and attendees yet," said Joyce Taylor, publisher of the Cleveland Daily Banner. [Vendors included, but were not limited to Adoration Hospice, Hearth Hospice,  and Hospice of Chattanooga.]

Nursing homes failed to report 43 percent of falls with major injury and hospitalization among their Medicare-enrolled residents HHS-OIG; Report number: OEI-05-24-00180; 9/18/25