A recent report reveals that dying, elderly nursing home residents are increasingly being given intensive and expensive therapy in the last weeks of life before they die. This practice raises real concerns about the financial incentives and underlying reasons behind this practice.
The study by the University of Rochester revealed that the proportion of nursing home residents who are given "ultrahigh intensity" rehabilitation increased by 65 percent in a four-year period through April 2016. The federal Medicare program defines a "very high" amount of therapy (physical, occupational, speech etc.) as approximately none hours of therapy per week. Medicare defines an "ultrahigh" amount of therapy (physical, occupational, speech etc.) as more than 12 hours per week. Many residents were found to have been given the most intense amount of rehabilitation in the very last week of life immediately before dying.
The study analyzed data from almost 650 New York nursing homes and almost 56,000 long-term care residents. It was reported that nursing homes receive the largest payouts from insurance companies and Medicare for ultrahigh rehabilitation services.
These findings raise very serious concerns about the financial motives of New York nursing homes providing intensive therapy services immediately before death. There is a serious question as to whether the nursing homes are simply seeking to maximize their profits, especially given that for profit nursing homes are twice as likely to provide such end-of-life intensive rehabilitation services. For more information, see Bloomberg article here.
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