Medicare Hospice Care for Beneficiaries in Nursing Facilities: Compliance with Medicare Coverage Requirements

摘要

The Medicare hospice benefit allows a beneficiary with a terminal illness to forgo curative treatment for the illness and instead receive palliative care. The number of beneficiaries receiving hospice care has increased significantly in recent years, and some studies suggest that the use of hospice care has grown most rapidly in nursing facilities. In addition, previous Office of Inspector General work has raised questions about the hospice benefit for nursing home residents. However, little subsequent research has been done to examine hospice care for these beneficiaries, and almost no beneficiary-specific data exist. This report determines the extent to which hospice claims for beneficiaries in nursing facilities in 2006 met Medicare coverage requirements. We based this study on data from a medical record review of a stratified random sample of hospice claims for beneficiaries in nursing facilities in 2006. A companion report, Medicare Hospice Care: Services Provided to Beneficiaries Residing in Nursing Facilities, determines the nature and extent of hospice services provided to beneficiaries in nursing facilities.