Dying Patients Forced in Twice as Much "Rehab" in For-Profit Facilities

The New York Times reports on a study showing that residents of for-profit assisted living facilities are given twice as much "rehab" as those who are not, even when they are close to death, suggesting that the services are more about revenues than the patient:

Nursing home residents on the verge of death are increasingly receiving intense levels of rehabilitation therapy in their final weeks and days, raising questions about whether such services are helpful or simply a lucrative source of revenue.

That is the heart of a new study published in the Journal of the American Medical Directors Association, which found that the practice was twice as prevalent at for-profit nursing homes as at nonprofit ones.

More broadly, the study’s findings suggest that some dying residents may not be steered to hospice care, where the focus is on their comfort.

Although the research is based on a relatively small number of patients in one state, it echoes what federal regulators have found in recent years.

It’s also a fresh reminder that families should keep a close watch on, and ask questions about, the kind of care their relatives are getting in nursing homes.

“Some of these services are being provided in the last week and sometimes on the day of their death,” said Dr. Thomas Caprio, one of the study’s authors. Dr. Caprio, who specializes in geriatric medicine, hospice and palliative care, is an associate professor at the University of Rochester Medical Center.

Rehabilitation services — physical, occupational and speech therapy — are “a potential revenue source for these facilities,” he added. “And when the plan of care shifts to hospice care and palliative care, that revenue stream disappears.”