High-cost rehab for dying seniors up 65% among some nursing homes

The proportion of nursing home residents who received physical, occupational and speech therapy in the last days of their lives increased 65 percent between October 2012 and April 2016, according to a study in The Journal of Post-Acute and Long-Term Care Medicine.

For the study, researchers from the University of Rochester School of Medicine and Dentistry in New York examined data from 647 nursing home facilities in New York and 55,691 long-stay deceased residents. The study authors focused on residents who received very high to ultrahigh rehabilitation services — such as physical, occupational and speech therapies — in the last 30 days of their lives, according to Bloomberg.

Lead author Helena Temkin-Greener, PhD, told the publication rehabilitation therapy has proved extremely beneficial to some nursing home residents when prescribed appropriately. However, for residents approaching the end of their lives, it could postpone more appropriate hospice or palliative care, and may even speed up seniors' decline. At the same time, the treatment has significant financial benefits for facilities.

"There's a possibility that nursing homes know a patient is approaching end of life, but the financial pressures are so high that they use these treatments so they can maximize revenue," Dr. Temkin-Greener said. On the other hand, "if it's being driven by a failure to recognize that a resident is approaching end-of-life, then it calls for improving the skills of nursing home teams."

Daniel Ciolek, associate vice president of therapy advocacy at American Health Care Association, told Bloomberg: "It is important for [skilled nursing facility] providers and their care teams to consider the risk-benefit of potential therapy interventions and dosage relative to the resident's current health status."

For the full Bloomberg report, click here.

Access the full study here.

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