Specialty palliative care (PC) provides services similar to hospice without the need for terminal diagnosis. We used 2016/2017 survey data for 1,362 NHs to evaluate whether differences in PC consult use is associated with end-of-life (EOL) specific culture change practices, and assessed the relationship between EOL care and outcomes. EOL care was measured using six questions related to care for dying residents. NHs were categorized as offering: no PC consults, only external consults, or any internal consults. We used logistic regression to evaluate the relationship between consult type and EOL score above the median, controlling for NH structure, staffing, and case-mix. Compared to NHs with no PC consults, the odds of having an EOL score above the median were 1.71 (95%CI: 1.21,2.13) for NHs with only external and 2.19 (95%CI: 1.55,3.27) for NHs with any internal consults. Better EOL scores were associated with increased hospice use, but not reduced hospitalizations.
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