End-of-life quality measures long overdue for nursing homes, researchers argue

To improve end-of-life care in nursing homes, appropriate quality measures should be created to “incentivize” providers and identify top performers, a group of researchers has argued in a new study.

“By 2020, the percentage of people who die in these institutions will grow to 40 percent,” said Helena Temkin-Greener, PhD, a professor of community and preventive medicine at the University of Rochester Medical Center and author on the study published in the Journal of Palliative Medicine. “And yet while we have seen an explosion of healthcare ‘report cards’ none of them can tell us which nursing homes are better at providing end of life care.”

The Centers for Medicare & Medicaid Services (CMS) compiles measures on the quality of care at nursing homes and publishes the data on Nursing Home Compare. Researchers said that while this information allows consumers to compare the performance of nursing homes for a number of aspects of care, it does not indicate how well a facility provides end-of-life care.

The study’s authors looked at two prototype measures:

●  the number of dying residents who were transferred to a hospital and subsequently died there; and

●  the use of hospice care in nursing homes.

Researchers said their goal was to demonstrate that such end-of-life care measures could be calculated from information that is currently available and then added to Nursing Home Compare.

The authors are also studying two other quality measures that may potentially signal the quality of end-of-life care: pain management and shortness of breath. The results of this study are expected to be published in a forthcoming paper.

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