David Stevenson, Ph.D.

 

Nursing homes have lagged in the area of palliative care, and need to take a seat at the table, according to researchers in a Health Affairs blog.

The lack of intertwinement between nursing homes and palliative care is due to a number of factors: regulations that favor rehabilitation, inadequate staff education around palliative care, financial disincentives, lack of reimbursement and misconceptions, write authors Mary Ersek, Ph.D., RN, David Stevenson, SM, Ph.D., and Justine Sefcik.

They note the Long-Term Care Commission for “the integration of LTSS with health care services in a person- and family-centered approach.” The authors described three models for palliative care in nursing homes.

These include partnerships with hospice agencies that result in fewer hospitalizations, improved pain and symptom management, and higher family satisfaction with care. Another option would be directed care paid for by Medicare Part B, or to offer payment models that integrate LTSS with acute or post-acute care. Another option would be a performance-based payment system.

While nursing homes should be held accountable for the quality of end-of-life care provided for all residents, they also should receive the resources needed to provide care that promotes quality of life, the authors added.