Hospice–Nursing Home Partnership Crucial as Boomers Age

More than a quarter of Americans dying from non-traumatic causes spend their last days in nursing homes, emphasizing the need for a partnership between hospice and nursing home care—especially as the baby boomer generation continues to age, says a LeadingAge report. 

Nursing homes are increasingly the sites for end-of-life care with about a half million older adults dying in these facilities each year, says LeadingAge. However, nursing home providers are faced with the challenges not just of offering high-quality end-of-life care, but also getting reimbursed for those services. 

Providing the sort of high-quality care for these individuals is challenging as nursing homes must abide by federal regulations. This can, however, create the potential for the “perfect partnership” between hospice/palliative care programs and nursing homes in the long-term management of seniors, says the report.


“We are proposing these requirements to ensure that long-term care (LTC) facilities (that is, SNFs and NFs) that choose to arrange for the provision of hospice care through an agreement with one or more Medicare-certified hospice providers would have in place a written agreement with the hospice that specified the roles and responsibilities of each entity,” CMS said in a proposed rule in the Federal Register that creates a regulation revising requirements nursing homes must meet in order to provide or arrange provisions for hospice care.

On the reimbursement side, Medicare only reimburses one provider of care at a time. That means a nursing home resident can either receive skilled nursing benefits or hospice benefits through Medicare—but not both, writes LeadingAge. Only if the Medicare skilled nursing care is unrelated to an individual’s terminal condition is that individual eligible to receive coverage for both services. 

By incorporating bereavement and end-of-life care into the nursing home, the inclusion of hospice in nursing homes can benefit residents as well as the nursing staff and non-hospice nursing home residents, says the report.


The responsibility of developing a working partnership between hospice and nursing home care far outweighs the alternative to do nothing collaboratively, says LeadingAge, and the professional relationships and partnerships between nursing homes and hospice providers are “crucial” to developing and maintaining best care practices in the skilled nursing industry.

View the full report here

Written by Jason Oliva