California Hospice and Palliative Care Association

10/25/2025

We Get No Do Overs in Hospice: Why We Hesitate to Say “I’m Sorry”

Recently, I read an article on Medscape by Paolo Spriano titled “Why Doctors Hesitate to Say ‘I’m Sorry’ After Errors.” His words stayed with me. In hospice, where every interaction can leave a lasting imprint, the idea of apology takes on an even deeper meaning.

Apologies in healthcare are often described as a professional obligation, a way to acknowledge what went wrong and express regret. But in hospice, I am sorry is far more than that. It is a human response that can heal the space between intention and perception. It reminds us that compassion often begins where perfection ends.

In our work, we all make choices and carry responsibilities that touch lives in profound ways. Whether we are nurses, social workers, chaplains, volunteers, or administrators, there are times when something we say or do, or fail to say or do, lands differently than we intended. Families may feel unseen, or patients may feel unheard. Their perception becomes our reality, and in hospice, that reality matters deeply.

That is why I am sorry is not just for doctors. It belongs to all of us. Saying those words requires courage. It asks us to bring our full selves into the moment, to let down our professional armor, and to be vulnerable. It means choosing connection over protection.

In hospice, we get no do overs. We have one chance to be present, one chance to build trust, one chance to comfort a family in their most tender moments. When we offer a sincere apology, we create space for healing, not only for those we serve but for ourselves as well.

At CHAPCA, we often speak about meeting patients and families where they are. Sometimes, that place is one of pain, disappointment, or misunderstanding. In those moments, I am sorry can bridge the distance between their experience and our intent. It can restore trust, reaffirm compassion, and remind us why we do this work — to walk beside others with honesty, empathy, and heart.

In hospice, we get no do overs. But we do get the chance, every day, to make things right through kindness, humility, and the courage to say, I am sorry. https://www.medscape.com/viewarticle/why-doctors-hesitate-say-im-sorry-after-errors-2025a1000s6g?form=fpf

10/14/2025

At its core, this type of conduct reflects beneficiary trafficking, not competition. Patients and families deserve care choices made freely and ethically, without manipulation or pressure. CHAPCA stands firm that integrity and accountability must guide every hospice referral and relationship.

Two Iowa hospice providers are embroiled in a lawsuit over allegations that one was “poaching patients.” National Hospice Management (NHP) operates

10/11/2025

Take a look at your latest Medicare Summary Notice and see if there aren't just one, but five different charges for orthotic braces. The Senior Medicare Patrol (SMP) is noticing a trend where scammers are billing for five different braces at a time: two wrist, two knee, and one back.

If you see these charges, or any others you don't think you should have, report it to our California SMP a 1-855-613-7080. If you live in another state, call the National SMP Resource Center at 877-808-2468 to find your state's SMP.

09/30/2025

“Sometimes people become white noise, and it just isn’t effective.”

But here’s the truth: I get called white noise because beneficiaries and community partners keep coming to CHAPCA. They come to CHAPCA because we show up.

They come to CHAPCA because no one is listening to their white noise. It is exhausting for them. They keep telling their story over and over again. Every time a beneficiary is left hanging in the middle of a broken system, the call comes to CHAPCA, and we step in to help.

If that makes CHAPCA “white noise,” then we’ll be the loudest noise they have ever heard.

Beneficiaries matter.

They are the reason we continue to ask the hard questions. They are the reason we continue to push forward. They are the reason we refuse to stay quiet.

So when people say that CHAPCA is white noise, they are missing the point. The voices of the beneficiaries and community partners cannot be dismissed, and CHAPCA will not let them be ignored.

Persistence is not noise.

It is how change happens. It is how truth gets heard. It is how beneficiaries, the very people this system is supposed to serve, receive the protection and care they deserve.

So yes, CHAPCA is the white noise. Because the beneficiaries and community partners continue to come back to us, and they keep coming back for more white noise.

We will discuss the noise in November. I hope it does not snow when I am there.

09/19/2025

Fantastic California Hospice and Palliative Care Association conference!

09/01/2025

If you get an unexpected call and they say they are from Medicare, Social Security, or the IRS, hang up. Do not give out personal information to someone who calls you claiming they are from Medicare or other government agencies. These places won't call you. If you’re unsure if it’s really them, call them back and ask if anyone was trying to reach you.

08/31/2025

Hospice of Humboldt well done!

Hospice of Humboldt has earned a five-star rating on Medicare’s Family Caregiver Survey, the highest possible score “and a reflection of the compassionate care we provide to patients and their fami…

08/28/2025

Protecting Home Health for Patients and Families

The Center for Medicare Advocacy recently submitted important comments on the proposed 2026 Home Health Payment Rule. Their message is clear: cuts to home health services are hurting the very patients Medicare is designed to protect.

Since the launch of PDGM, access to home health aides has dropped by 94 percent.

Even patients who meet every Medicare requirement are being turned away by agencies unable to provide care.

Medicare Advantage patients face greater barriers with more denials, fewer visits, and higher hurdles for families.

Restricting home health does not save money. It shifts costs to hospitals and nursing homes.

The comment letter calls on CMS to readjust the payment model and adopt an honest methodology that ensures patients receive the full scope of services authorized by law, including home health aides.

Investing in home health means better outcomes for patients, less strain on caregivers, and lower overall Medicare costs.

I urge policymakers to protect access to home health care. Patients and families deserve care at home, not fewer options and more barriers.

The Center for Medicare Advocacy recently submitted comments on 90 FR 29108, Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update Physician Fee Schedule Proposed Rule (7/2/2025). CMA’s comments focused largely on the payment system for Home Health decreasing access to car...

08/28/2025

California Hospice and Palliative Care Association-CHAPCA stands firmly with our home health partners. These proposed cuts are not just numbers on a page. They represent a direct threat to access, equity, and dignity in care. Patients deserve the right to remain at home, surrounded by family and support, without fear that critical services will disappear because providers cannot sustain them.

As the comment period continues through August 29, 2025, we urge you to raise your voice. Join the growing chorus demanding CMS revise this rule to protect patient access, preserve provider viability, and uphold the promise of compassionate, high quality care at home. Silence is not an option. Our patients, families, and communities are counting on us.

Home health operators and stakeholders have publicly criticized the U.S. Centers for Medicare and Medicaid Services’ (CMS) proposed home health payment

08/25/2025

CHAPCA is proud to share this story from our member Sharp HospiceCare. RN case manager Doug Corbin brings comfort and dignity to patients and families, including honoring Elizabeth Fischle, the first woman in the Coast Guard, on her 100th birthday. Through the We Honor Veterans program, Doug and fellow volunteers create moments of healing and connection for those who served. Donations to Sharp HospiceCare sustain programs like the Moore MountainView Home, ensuring compassionate care when it matters most.

https://youtu.be/7W-xVAs_gnk?si=FRuxMAag4em3rRR6

At Sharp HospiceCare, our mission is driven by the hearts, hands, and minds of our dedicated team. In this touching video, we highlight the extraordinary wor...

08/24/2025

We often hear the phrase, “Beauty is in the eye of the beholder.” In hospice, the same truth applies to quality.

Ask ten people what hospice quality means and you will hear ten different answers. Patients, families, providers, payers, and regulators each see it differently. None of these views is wrong, but none is complete on its own.

The Challenge of Perspective
I cannot speak from the regulator’s seat. I have never conducted a survey or written policy from their vantage point. But I know their role is vital. Regulations safeguard patients, create accountability, and set a baseline standard of care.

As hospice leaders and staff, we live a different reality. For us, quality often means the ability to respond quickly, to align our teams, and to meet needs with dignity and compassion. It is the work that happens in living rooms and at bedsides, not just in reports.

I remember a family who once told me that what mattered most was not the pain scale or the chart notes but the way a nurse held their father’s hand when he was afraid. In that moment, quality meant presence. It was not something you could capture on a form, but it was unforgettable to them.

For patients and families, quality is deeply personal. It may be relief from pain, the comfort of home, the reassurance of spiritual care, or the kindness of a gentle voice. Their definition of quality is rooted in experience, not in metrics.

Why Perspective-Taking Matters
If we only measure quality by what can be charted or scored, we risk losing the heart of hospice. If we only define quality by compassion and experience, we risk ignoring the accountability that protects patients across the system.

That is why perspective-taking matters. True hospice quality requires us to hold these viewpoints together. It asks us to step outside of our own frame and imagine how quality looks through the eyes of a patient, a nurse, a family member, or even a regulator.

A Shared Responsibility
The future of hospice depends on our ability to balance these views. Quality is not one definition but a tapestry of many. Our responsibility is to weave them together, never losing sight of compliance and never letting compliance overshadow compassion.

If beauty is in the eye of the beholder, then so is hospice quality. The question for each of us is this: Whose eyes are we willing to see through?

08/19/2025

According to the recently released 2024 Performance Data for the Senior Medicare Patrol (SMP) Projects, 54 SMP projects had 5,643 active team members conducting 22,752 outreach and education events and 283,724 individual interactions with or on behalf of beneficiaries.

SMP efforts led to $35.1 million in expected Medicare recoveries, $99,037 in cost avoidance for Medicare, , and others – and $6,071 in direct savings for beneficiaries. Read the full report: https://smpresource.org/what-smps-do/oig-report/.