Barrier to hospice increases hospitalization

Caught between skilled nursing and hospice care

Medicare reimbursement policies may encourage more aggressive care and hospitalization, less end-of-life hospice service for elderly dementia patients. Credit: Mike Cohea/Brown University

Because of a Medicare policy that prevents simultaneous reimbursement for skilled nursing and hospice care, many families cannot choose hospice for loved ones who reside in nursing homes. The result, new research shows, is that residents with advanced dementia who have Medicare skilled nursing home care without any hospice care have a far greater likelihood of dying in the hospital and receiving aggressive treatments such as feeding tubes or physical therapy within weeks of death.