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For-profit nursing homes more likely to deny residents hospice care at the end of life

Written by Diane Archer

A new study published in the Journal of American Medical Directors Association finds that for-profit nursing homes are increasingly offering their most vulnerable residents high-cost therapy at the end of life rather than hospice care. If someone you love is terminally ill in a nursing home, you may want to speak with the nursing home about different treatment options.

Because hospice care provides comfort at the end of life and does not involve curative treatments, nursing homes make far less money on providing hospice care to their residents than other treatments such as physical therapy. Not surprisingly, researchers found that for-profit nursing homes in particular tend to steer away from delivering hospice care. Rather, these nursing homes provide a large number of therapy services—high volume at great intensity—to their dying residents, which generates more income.

Over the last few years, a number of studies have found that for-profit nursing homes may not be providing as good care as non-profit nursing homes. A Kaiser Family Foundation report highlighted the many issues with chain nursing homes, which people should beware of. Another study found that Medicare Advantage plans were more likely to steer their patients to for-profit chain nursing homes. Yet another study revealed that Medicare’s nursing home ratings can be misleading and that you should not assume a five-star rating means good care.

The JAMDA researchers studied care provided to nursing home residents in New York State in the 30 days before they died. There is every reason to believe that nursing homes in other states behave similarly to those in New York. The financial incentives are identical.

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