According to a new study published in the Archives of Internal Medicine, Medicare’s skilled nursing benefits might need to be updated to include palliative care or hospice care services.
The study reports that about 30% orf Medicare beneficiaries spend their last days in skilled nursing facilities rather than in hospice care, even if the facilities aren’t properly equipped for end-of-life care. What’s disturbing is the fact that this could be due to Medicare’s reimbursement system.
An article on SeniorHousingCare.com notes that nursing homes more often provide short-term rehabilitation and long-term care, but aren’t always equipped for treating and preventing pain, which is the service provided in palliative or hospice care. As a result, some patients who may be better suited with hospice care are instead placed in nursing homes because it can be less expensive.
Medicare covers the first 100 days in a skilled nursing facillity for beneficiaries who qualify with a three-day-minimum hospital stay. However, room and board for hospice benefits are not covered and are often paid out of pocket. According to the researchers, they found that of 5,100 people between 1994 and 2007 who were discharged from the hospital, about 31 % used Medicare’s nursing home benefits during the last six months of their lives. About 9% died while using the benefits; and 0.5% who died were enrolled in both the skilled nuring and hospice care benefits.
In reference to the study, J. Donals Schumacher, president and CEO of the National Hospice and Palliative Care Organization said, “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 (skilled nursing facility) benefits discourages or at least delays access to hospice care.”