Hospice in the Nursing Home

As prescribed by statute, at least 80 percent of hospice services must be provided in the home. For some Medicare recipients, the nursing home is considered their primary residence. Thus, as the American population lives longer, with more chronic conditions, more individuals will spend their final days in the nursing home. Much like patients who live in their own house or with a loved one, these individuals benefit greatly from hospice services. Residents who enroll in hospice continue to receive supportive services from the nursing home, much like the supportive services provided by family and friends that the patient receives if he or she were at home; at the same time, they receive supplemental support and professional care for their terminal condition from the hospice agency.

Government regulatory and oversight agencies, such as the Office of the Inspector General (OIG) and the Medicare Payment Advisory Commission (MedPAC) have sought to better understand the unique relationship between hospice programs and nursing facilities, along with the needs of an increasingly large patient population being served by both provider communities.  Some of the areas being explored include payment streams, roles held by each provider community, patient length of stay and referral patterns.

HAN has developed the following resources to aid in the educational and advocacy efforts surrounding this issue: