Understanding Adult Hospices Caring for Children in California, 2018-2021.

This article focuses on the characteristics and trends of adult hospices in California that provided care to children from 2018 to 2021. Using publicly available data from the California Home Health Agencies and Hospice Annual Utilization Report, the study found that these adult hospices were predominantly small, freestanding, and served both urban and rural areas, with registered nurses as the primary caregivers for pediatric patients. Despite a 32% decline in the number of adult hospices caring for children during this period—particularly in northern California—financial factors and Medicaid familiarity were not barriers to pediatric care; most hospices demonstrated positive financial performance and substantial Medicaid reimbursement experience. The study also noted that adult hospices cared for a range of pediatric age groups, including infants, and adjusted services in response to changes in state pediatric palliative care policy, highlighting important implications for hospice care access and policy development.