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Nursing home residents who are in the last days of their lives are going through hours of rehabilitation therapy that may have no benefit other than beefing up the facility’s profits, according to a new study published by The Journal of Post-Acute and Long-Term Care Medicine.
Researchers from the University of Rochester School of Medicine and Dentistry examined data from 647 nursing homes in New York State and 55,691 patient records. They found the proportion of residents who received “ultrahigh intensity” rehabilitation increased by 65 percent between 2012 and 2016.
For context, Medicare defines “very high” therapy as almost nine hours per week and “ultrahigh” therapy as more than 12 hours per week.
Researchers found that some nursing home residents received the highest concentration of rehabilitation even in their last week of life.
The study’s conclusion: “…facilities with a for-profit mission, and with higher staffing of therapists, may be incentivized to maximize therapy use, even among the sickest of the residents.
Helena Temkin-Greener, lead author of the study and a professor in the University’s Department of Public Health Services, told Bloomberg news that for-profit nursing homes were more than two times as likely to use high to ultrahigh intensity therapy than were nonprofit homes.
What’s more, Paul Ginsburg, director of the Brookings Schaeffer Initiative for Health Policy at the University of Southern California, says the problem isn’t confined to New York.
“This is a nationwide problem,” he told Bloomberg.
Starting Oct. 1, 2019, Medicare payment and policy changes may curb current financial incentives that encourage high-intensity treatment unless it is truly helpful.
That said, it’s always a good idea for consumers to ask whether their friends or family members should spend the last days of their lives doing hours of rehab.
Have you seen this happen to someone you love? Voices for Affordable Health welcomes your tips, thoughts and stories.