Hospice billing patterns raise questions about care in AL facilities, a report states.

Nursing homes could improve the comfort and dignity of residents who are dying by following practices common in home-based hospice care, according to the results of a large-scale trial.

More than 1,600 staff members at six Veterans Affairs Medical Centers participated in the trial, known as Best Practices for End-of-Life Care for Our Nation’s Veterans (BEACON). 

BEACON gave caregivers education and tools to communicate with dying individuals and their loved ones, and to implement care processes traditionally followed in home-based hospice care. The caregivers utilized an electronic order set devised to support the program.

The BEACON program led to “statistically significant” improvements in end-of-life care, researchers found. Caregivers were more apt to administer opioid medications to ease pain and antipsychotic medications to alleviate delirium, agitation and anxiety, the investigators found. The interventions also decreased the use of nasogastric tubes and increased the likelihood of an advance directive being in place.

Results appeared in the Journal of General Internal Medicine in January.