Abstract
The likelihood that Americans will receive good end-of-life (EOL) care varies widely, depending on where they live, what they know about quality EOL care services, and the type of care they choose. In Healthy People 2010, within the group of objectives addressing access to quality health services is objective 1-15: "To increase the proportion of persons with long term care needs who have access to the continuum of long term care services." Hospice care is included in the long-term care range of services. This article examines obstacles to palliative and EOL care that exist in the community setting, and outlines an action plan for change for community health nursing leaders of home-based certified hospice programs. Nursing leadership actions and health policy issues are addressed.