Literature Review

Iowa nurse sentenced to prison after patient deathBecker's Hospital Review; by Mariah Taylor; 4/25/25A former Iowa licensed nurse practitioner has been sentenced to prison after failing to help a nursing home patient who died of asphyxiation, the Des Moines Register reported April 24. Becky Manning, 70, was in charge of the overnight shift at Care Initiatives, a nursing facility in West Des Moines, during one night in February 2023. That night, an 87-year-old patient indicated that his tracheostomy tube in his neck needed to have fluids suctioned out. Ms. Manning, who was the sole nurse on duty, refused to do so after repeated requests. Earlier that night, she reportedly told the director of nursing that she was unwilling or unable to suction the tracheostomy tube and the nursing director told her to “watch a video and figure it out,” according to a lawsuit filed by the man’s family. The man died of asphyxiation.

Prevention of acute hospital transfers for long-term care residents at the end of life American Journal of Hospice and Palliative Medicine (AJHPM); by Kirsten Lanpher, DMS, MSPA, PA-C and Kirsten Brondstater, DMS, MSPAS, PA-C; 3/24/25 Findings: Long-term care residents are a vulnerable population with advanced comorbidities who often require high acuity care and are subject to preventable transfers to the hospital at the EOL. These disruptions in EOL care cause harm and complications, negatively impacting quality of care. The consequences of these events can be mitigated with early advance care planning to include documentation of EOL care goals, onsite medical clinicians to make critical decisions and provide care within LTC facilities, and adequate staffing with proper palliative and hospice care training. Conclusion: Immediate action is needed to advocate for this high risk population and implement interventions to prevent hospital transfers at the EOL, therefore improving quality of care and positively influencing LTC residents’ EOL experience.

Legacy even in defeat? Nursing home experts anxious about next moves on staffing efforts McKnights Long-Term Care News; by Kimberly Marselas; 4/21/25 Two weeks after a judge struck down federal staffing standards for all US nursing homes, questions about the rule’s future continue to swirl within the industry. Will the government appeal the District Court’s ruling in Texas and continue to fight for regulations that would force nursing homes to create more than 100,000 new jobs in coming years? How will a judge hearing a similar challenge in Iowa interpret similar arguments, and what happens if the rulings conflict with one another? ... Regardless of whether the rule goes away, industry insiders have one clear expectation: Its legacy will continue to chafe nursing home leaders, who will still face intense pressure to recruit quality staff and improve patient care.

Federal court strikes down minimum staffing rule: The details you might not know behind the decisionMcKnights Long-Term Care News; by Neville M. Bilimoria; 4/21/25On April 7, 2025, the US District Court for the Northern District of Texas struck down the federal minimum staffing Final Rule issued by the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. This was incredibly good news for nursing homes across the country for a variety of reasons ... The opinion from District Court Judge Matthew Kacsmaryk outlined the many laws and regulations America’s nursing homes are subject to in the healthcare arena, but it also recounted some deep history behind minimum staffing efforts that were previously unsuccessful, both by HHS and Congress.  ...

Death matters: Is there really no place like home when it comes to dying? Sequim Gazette, Sequim, WA; by Jeanette Stehr-Green Volunteer Hospice of Clallam County; 4/16/25 While not everyone has the chance to decide where they will die, most Americans say that given the choice, they would prefer to die at home. For most people, home is familiar and comfortable. It is more private than a room in a hospital or nursing facility, and more likely to allow intimate gatherings with family and friends. In the home, the dying person and their caregivers are more in control, deciding when to have visitors, eat, drink, or take medications. ... Planning, realistic expectations, and adequate support are key to keeping a dying person at home. Consider the following steps: ... Home might not be best ...

HHS cuts pose threat to older Americans' health and safety Newsweek; by Kristin Lees Haggerty and Scott Bane - The National Collaboratory to Address Elder Mistreatment at Education Development Center (EDC); The John A. Hartford Foundation; 4/17/2 On March 27, 2025, the federal government announced major cuts to the department of Health and Human Services (HHS). ... Sounding the Alarm for Elder Justice: The population of older adults is rapidly growing, and one in 10 experience abuse, neglect, and/or exploitation—a risk that is even higher for those living with dementia. ... Cutting services to older adults will increase these risks and costs. Moreover, ... 11.5 million family and friend caregivers provide over 80 percent of help needed for people living with dementia in the U.S. Without access to services like Meal on Wheels, adult day care, and respite care, we can expect caregiver burden and strain to increase significantly and with it, rates of elder abuse, emergency department visits, hospitalizations, and nursing home placements. We know this because of the abuse spike seen clearly during the COVID-19 pandemic, which doubled to over 20 percent of older adults, as services were limited, and older adults were socially isolated. HHS cuts are also likely to result in loss of specialized expertise in identifying and addressing elder mistreatment, so that when elder abuse does occur, we won't have the services to stop it and make sure it won't happen again.

A mother’s goodbye-Barriers to microtransitions in careJAMA Internal Medicine; Aval-Na’Ree S. Green, MD, MHA, CMD; Benjamin E. Canter, OTD; 3/25After a long, debilitating battle with lupus, my cousin died at the doorsteps of our health system. The funeral was at 11:00 am. I arrived at the facility at 8:45 am. Although the catheter was in place, my aunt was undressed, with remnants of breakfast on her gown. She had not been bathed. The staff and I wheeled my aunt outside and attempted to load her into the van. Once my aunt was in the chair, it could not fit through the van door. Because this transition was not a medical health care appointment, the facility did not coordinate the resources, including use of the van, that were necessary for it to occur successfully. In contrast, had this been a medical outing, such as a weekend dialysis appointment, the facility would have been required to provide transportation. If this microtransition had been treated like a major health care transition, perhaps it would have had a better chance of success. Nursing teams use checklists during major care transitions; similar procedures should apply to microtransitions.

What role do immigrants play in the direct long-term care workforce? KFF; by Priya Chidambaram and Drishti Pillai; 4/2/25 President Trump has made a slew of immigration policy changes focused on restricting entry at the border and increasing interior enforcement efforts to support mass deportation. While these actions are focused on undocumented immigrants, they likely will have ripple effects across immigrants of all statuses and millions more people living in immigrant families. Mass deportations could negatively impact the U.S. economy and workforce, given the role immigrants play, particularly in certain industries. ...

Global study finds 1 in 5 people with dementia receive no care McKnights Long-Term Care News; by Donna Shryer; 4/7/25 A comprehensive global study led by Yale School of Public Health researchers has revealed that at least 20% of people living with dementia receive no care helping them with daily living, regardless of their country’s wealth or development status. As the world’s population rapidly ages, this alarming care gap has persisted for years, creating what researchers describe as “a public health crisis.” The study analyzed data from over 10,000 individuals across the United States, England, 18 European nations, Israel and China. [Continue reading ...]

Strong social connections improve older adults’ well-being regardless of setting, study finds McKnights Long-Term Care News; by Donna Shryer; 4/7/25 Social connections, trust in others in their community and community cohesion significantly improve elderly well-being whether seniors live at home or in nursing facilities, according to a new comparative study published in BMC Public Health. However, researchers found that nursing home residents generally reported lower subjective well-being compared to their community-dwelling counterparts, even after accounting for health status and demographic factors. ... According to the authors, these findings “indicate the necessity for tailored interventions that address the unique needs of each care environment to promote healthier aging experiences. [Continue reading ...]

AGG talks: Home health & hospice podcast - Episode 10: Anti-Kickback Compliance for hospice and skilled nursing providers JD Supra; by Arnall Golden Gregory, LLP; 4/3/25 In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss recent OIG guidance on hospice and skilled nursing facility relationships, focusing on anti-kickback risks and fraud concerns. They cover key issues such as the importance of documenting fair market value for any services or space provided, being cautious of payments exceeding Medicaid room and board rates, and avoiding arrangements that appear to be made solely to secure referrals. Bill and Jason also touch on increased oversight and enforcement in the healthcare sector under a new presidential administration.

Primary palliative care in assisted living and residential care-A metasynthesisJournal of Hospice & Palliative Nursing; David, Daniel PhD, MS, BSN; Jimenez, Vanessa MPH, BS; Brody, Abraham A. PhD, RN, FAAN; 3/25Assisted living (AL) and residential care (RC) settings are experiencing substantial growth as older adults with lower care needs seek alternatives to nursing homes. Despite this trend, there is a lack of skilled nursing care to support palliative care (PC) in these environments. Studies highlighted challenges and opportunities for delivering primary PC in these environments, emphasizing the importance of addressing physical symptoms, psychological distress, social isolation, and spiritual needs among residents with serious illnesses. The metasynthesis underscores the critical role of primary PC in enhancing quality of life and care continuity for older adults residing in AL/RC settings. It also identifies gaps in current practices and emphasizes the need for tailored interventions and training to support care providers in delivering comprehensive PC to this population. By integrating qualitative research findings with the National Consensus Project guidelines, this metasynthesis provides a comprehensive overview of primary PC in AL/RC settings.