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High-intensity therapy being used in skilled nursing for near-death patients

October 8, 2018
by I Advance Senior Care
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Between 2012 and 2016, ultra-high rehabilitation services provided to nursing home residents in their final month of life spiked 65%, according to research from the University of Rochester, with overall end-of-life therapy use rising 20%. In addition, residents of for-profit nursing homes were almost twice as likely to receive high- to ultra-high therapy than those in non-profit buildings.

Those findings mirror trends identified by the Department of Health and Human Services Office of the Inspector General (OIG), lead researcher Helena Temkin-Greener told Skilled Nursing News.

“They don’t seem to be associated with changes in resident characteristics,” Temkin-Greener, a professor emeritus at the University of Rochester’s Department of Public Health Services, said. “So the residents’ care needs appear to stay the same over a period of time, but [there are] increases in the use of ultra-high therapy.”

The OIG found that between 2011 and 2013, the overall proportion of ultra-high therapy minutes grew from 49% to 57%, raising general concerns about the necessity of such services. Writing in the study, published in the October issue of JAMDA — The Journal of Post-Acute and Long-Term Care Medicine, Temkin-Greener and her colleagues noted that the OIG identified a hospice resident who asked to stop receiving therapy — but continued to receive physical therapy services five days per week for more than a month.

Still, the OIG’s probes didn’t specifically look at end-of-life therapy provisions. Temkin-Greener’s team analyzed data associated with 55,691 long-stay skilled nursing residents collected between October 2012 and April 2016 in New York State. Of that group, 7,600 received some kind of therapy during the month prior to their deaths.

Read the full story at Skilled Nursing News.

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