Study: Eschewing Hospice, Nursing Homes Increasingly Send Dying Residents to Costly Rehab

Nursing home residents nearing the end of their lives are increasingly being sent to rehabilitation therapy for their final weeks of life. According to a new study published in the Journal of American Medical Directors Association, senior citizens at for-profit nursing homes are twice as likely to spend their last days at a rehabilitation center instead of a hospice. According to elder care experts, the primary motivation for forcing senior citizens through rehabilitation during their last days involves churning a profit for the nursing home, according to The New York Times. Rehabilitation services, such as physical, occupational, and speech therapy, are a significant source of revenue for nursing homes. Sending a resident to hospice for palliative care, on the other hand, ends the revenue stream for that resident.

The study’s appalling conclusions found that 14 percent of New York nursing home residents received some form of rehabilitation in the month before they passed away. Four percent received a significant amount of therapy each week – between 325 minutes to 12 hours each week – in their final month. Medicare typically covers rehabilitation services and the highest payouts go towards senior citizens receiving 12 hours of rehabilitation each week, or “ultrahigh levels” according to Medicaid. Disturbingly, the number of senior citizens receiving “ultrahigh levels” of rehabilitation in their final month increased 65 percent between 2012 to 2016.

In addition to finding that residents at for-profit nursing homes were twice as likely to receive rehabilitation in their final month, the study also found that nursing homes with more registered nurses and licensed nurses were associated with lower levels of end-of-life rehabilitation. While the research was limited to nursing homes in New York, federal data suggest a similar problem emerging across the country.

Elder care advocates say they are concerned about increased use of rehabilitation, especially among for-profit nursing homes. Nursing homes, rightly, point out that some forms of rehabilitative services are still beneficial in a person’s final months. For example, speech therapy can help a person swallow and communicate during the end of their life. For that reason, families should keep a close eye on their loved ones and feel free to question the care their senior citizen is receiving to ensure their family member is receiving the best care possible and not merely padding the profits of unethical nursing homes across the state.

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