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End-of-life Care in Nursing Homes Lacking

Thursday, October 4, 2012 Nursing Profession News
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New Study Confirms Inherent Barrier to Receiving Hospice Care for SNF Patients
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ALEXANDRIA, Va., Oct. 4, 2012 /PRNewswire-USNewswire/ -- A new study, published online in the Archives of Internal Medicine, confirms that inconsistent reimbursement structures and regulations adversely affect many people receiving skilled nursing facility (SNF) benefits in the last months of life and hinders access to high-quality specialized end-of-life care. 
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The National Hospice and Palliative Care Organization (NHPCO) applauds this research and calls for reforms to address these barriers to hospice care.  According to the study, "1 in 11 elders died while enrolled in the SNF benefit" with most dying within 30 days of admission to the benefit after a hospitalization."  The authors state that the data "suggests that patients are being discharged from hospitals to nursing homes under the Medicare SNF benefit for end-of-life care." Yet, "…only 0.5% of decedents were enrolled in both programs" (SNF and hospice). 

According to NHPCO President and CEO, J. Donald Schumacher, "I wish I could say that the results are a surprise, but we have known for years that the reimbursement system and regulations for the SNF benefit discourages or at least delays access to hospice care."  Schumacher went on to state, "Our goal is to ensure that patients and families have the kind of care they need when and where they need it." 

NHPCO, the nation's largest non-profit membership organization representing hospice and palliative care programs and professionals, is committed to improving care at the end of life and expanding access to hospice care. The organization has a strong commitment to increasing awareness and understanding of the importance of advance care planning, encouraging patients to explore their healthcare goals and wishes, share those with family members and discuss them with their medical team.

The study authors explicitly state, "Families often face an uncomfortable choice: either they pay for room and board out of pocket to have access to hospice services, or they continue under the Medicare SNF benefit, relying on nursing home services for palliative and end-of-life services." The authors go on to say that "…for others who cannot receive SNF and hospice care concurrently for the same condition, this practice may lead to care that is not consistent with a patient's goals or to poorer quality end-of-life care."

"Families shouldn't have to forgo the benefits of hospice because of inconsistent polices.  Patients and families ought to be able to seek the right care, at the right time, for the right reasons," the authors concluded.

For information on hospice care, advance directives and helpful information on end-of-life care, visit NHPCO's consumer website, Caring Connections at: www.caringinfo.org.

Media Contact:Jon RadulovicNHPCO, Vice President of Communications703-837-3139 [email protected]

SOURCE National Hospice and Palliative Care Organization

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