Ep. 32: An Inside Look: APRN Billing in Hospice & Palliative Care

What if the key to reducing resistance to care isn't doing more, but approaching care differently? In this episode of HPNA Palliative Perspective, internationally recognized dementia care expert Teepa Snow, MS, OTR/L, FAOTA shares practical techniques for licensed practical nurses and nursing assistants that prioritize connection before providing care. From seeking permission and interpreting refusals to using body language, pacing, and creative storytelling, listeners will discover simple, actionable strategies that can improve comfort, trust, and communication across hospice, home care, and long-term care settings.

Advocacy doesn't begin in the legislature—it begins wherever nurses use their voices to improve care. In this episode of Palliative Perspective, HPNA Advocacy Committee member Janelle Williamson MSN, NP-C, APRN, ACHPN, FPCN, and Kansas State Representative Melissa Oropeza DNP, APRN, NP-C, CGRN, join the conversation to explore how nurses can influence healthcare at every level. From sharing patient stories and engaging in professional organizations to testifying on legislation and serving in elected office, they discuss the many ways nurses can shape policy and advance the profession. Together, they reflect on their own advocacy journeys, the leadership skills that grow from speaking up, and why nurses are uniquely qualified to inform healthcare decisions. The conversation also addresses a common challenge: many nurses don't see themselves as policy experts, despite being the clinicians closest to patients and families. Whether you're attending your first advocacy event, participating in an HPNA Hill Day, or simply wondering where to begin, this episode offers practical insights and inspiration to help you discover where your voice can make a difference. Advocacy isn't reserved for a select few—it's a natural extension of nursing practice, and every nurse has a role to play. HPNA Advocacy __________________________________________________________________________________________________________________________ Melissa Oropeza, DNP, APRN, NP-C, CGRN, is a board-certified Nurse Practitioner specializing in Gastroenterology at The University of Kansas Health System and a Kansas State Representative. With more than 27 years of healthcare experience, she has been a leader in advancing the role of Advanced Practice Providers and improving patient care through clinical practice, leadership, and advocacy. Throughout her career, Dr. Oropeza has championed the nursing and advanced practice professions. She founded and served as the inaugural Chair of The University of Kansas Health System's Advanced Practice Providers (APP) Council, where she established professional recognition programs, created an APP endowment fund, and launched the institution's first APP Symposium. Her leadership has created lasting opportunities for professional development, recognition, and advocacy for advanced practice providers. A nationally recognized healthcare advocate, Dr. Oropeza served on the Kansas State Board of Nursing and became the first actively practicing Nurse Practitioner elected to the Kansas House of Representatives in 2022. She currently serves as Chair of the Wyandotte-Leavenworth County Legislative Delegation and as Ranking Minority Member of the Kansas House Social Services Budget Committee, where she works to improve healthcare access, strengthen behavioral health services, and advance policies that support Kansas families and healthcare professionals. In addition to her legislative service, Dr. Oropeza continues to provide direct patient care and mentor future healthcare leaders. She is a strong advocate for healthcare access, mental health, and patient-centered public policy. Her professional honors include the 2017 Kansas Nurse Practitioner Advocate Award and numerous leadership and service recognitions throughout her career. In 2026, she received the Legislative Leadership and Collaboration Award for Mental Health Advocacy, recognizing her commitment to building bipartisan solutions and improving mental health outcomes for Kansans. Janelle Williamson, MSN, APRN, NP-C, ACHPN, FPCN, is a nurse practitioner with Palliative Medicine and Supportive Care at Stormont Vail Health in Topeka, Kansas. A nationally recognized leader in hospice and palliative care, she has held specialty certification in the field for nearly 15 years and was named a Fellow in Palliative Care Nursing in 2023—an honor recognizing significant contributions to the profession. She has been a strong advocate for improving access to palliative car

For many nurses, retirement marks not the end of a career, but the beginning of a new chapter of service. In this episode, former HPNA CEO Judy Lentz, PhD, RN, reflects on how retirement created an opportunity to reimagine her role in palliative care through volunteer leadership and the development of palliative care ministry within faith communities. Drawing on decades of experience in clinical practice, education, research, and organizational leadership, Judy explores how retired nurses and other healthcare professionals can continue to improve quality of life by supporting individuals and families living with serious illness. She also discusses the concept of the palliative care doula as one model for companioning individuals and families through serious illness, alongside practical examples of how congregations can become compassionate partners in care by providing spiritual, emotional, and social support that complements the work of interdisciplinary palliative care teams. The conversation also reflects on the evolution of hospice and palliative care, the enduring value of mentorship and leadership, and the fulfillment that comes from continuing to serve beyond a traditional career. Whether you're approaching retirement, considering volunteer opportunities, or looking for new ways to extend the reach of palliative care, this episode offers inspiration for finding purpose in the next season of professional life.

Prolonged mechanical ventilation in rural long-term care settings brings a unique set of clinical, ethical, and logistical challenges for care teams, residents, and their families. In this episode, we explore the realities of ventilator use in rural long-term care environments, where limited resources and geographic barriers can complicate care decisions and delivery. We also take a thoughtful look at the emotional and practical impact of ventilator discontinuation, highlighting the experiences of those directly affected. Join us for a nuanced conversation that sheds light on an often-overlooked aspect of long-term care and the difficult decisions that come with it.

In this episode of HPNA Palliative Perspective, we’re joined by Betty Ferrell—Editor of the Journal of Hospice & Palliative Nursing (JHPN), nurse, and internationally recognized researcher. As the leader of the End-of-Life Nursing Education Consortium, she brings a unique perspective shaped by decades of connection with hospice and palliative care nurses across the U.S. and around the world. Now in her 49th year in nursing—beginning in oncology and entering hospice as it emerged in the United States—Dr. Ferrell reflects on the remarkable growth of the field and where we stand today. At the heart of this conversation is the idea of a “professional home.” Drawing on the foundational work of pioneers like Florence Wald and Cicely Saunders, she highlights the enduring importance of interprofessional, whole-person care—and the need to stay grounded in those values as the field evolves. In a time that can feel complex and demanding, this episode offers a clear message: you don’t have to do this work alone. Finding your people, building community, and staying connected—through colleagues and organizations like the Hospice and Palliative Nurses Association—are essential to sustaining both practice and purpose. A thoughtful and reassuring conversation about belonging, connection, and the future of hospice and palliative nursing.