Will CMS Start Grading Nursing Homes on End-of-Life Care?

A growing number of people are expected to end their lives in a nursing home, but there’s no way to measure which facilities offer the best end-of-life care—and that needs to change, according to researchers in a recently published article.

The nursing home “report card” published by the Centers for Medicare and Medicaid Services (CMS) doesn’t consider the quality of end-of-life care, but using available data sources, it’s possible to develop prototypes for end-of-life quality measures, researchers argue.

“By 2020, the percentage of people who die in these institutions will grow to 40 percent,” said Helena Temkin-Greener, PhD, a professor of community and preventive medicine at the University of Rochester Medical Center and author on the study, published in the Journal of Palliative Medicine. “And yet while we have seen an explosion of healthcare ‘report cards’ none of them can tell us which nursing homes are better at providing end of life care.”


Using Minimum Data Set data that was linked to Medicare enrollment files, hospital claims, and hospice claims, the researchers estimated random effect logistic models to develop risk-adjustment models to predict two outcome measures (the place of death, and hospice enrollment), to construct to end-of-life quality measures.

Data to calculate quality measures is “readily available” and could be incorporated into the CMS Nursing Home Compare report card, the researchers conclude.

The study, End-of-Life Quality-of-Care Measures for Nursing Homes: Place of Death and Hospice can be accessed here.


Written by Alyssa Gerace

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