Quality measures needed to evaluate end-of-life care in nursing homes, study urges

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As the number of people who choose nursing homes for end-of-life care continues to rise, more quality measures are needed to help consumers judge quality, a new study recommends.

By 2020, 40% of Americans will receive end-of-life care in a nursing home, but experts assert that while there is increased adoption of healthcare facility “report cards,” none of them adequately reflect which facilities provide the best care in this area. They say this lack of information prevents potential residents and families from making informed choices.

“We know that there is a correlation between the publishing of quality measures and subsequent steps taken by providers — be that a nursing home or a hospital — to improve care,” Dana B. Mukamel, Ph.D., a professor in the Department of Medicine and senior fellow with the Health Policy Research Institute at the University of California, said.

Two quality measures are currently in use for nursing home end-of-life care by the Centers for Medicare & Medicaid Services. They include the number of dying residents who were transferred to a hospital and subsequently died there, and the use of hospice care in nursing homes, according to University of Rochester researchers. They hope that two more measures — assessing the level of pain and whether there is shortness of breath — will be added to CMS' list.

The study was published this week in the Journal of Palliative Medicine.