Aligning Prognosis, Patient Goals, Policy, and Care Models for Palliative Care in Nursing Homes: Comment on “Use of the Medicare Posthospitalization Skilled Nursing Benefit in the Last 6 Months of Life”

Using the Health and Retirement Study database, Aragon and colleagues¹ offer new insights into patterns of service use as older persons approach life's end. Major differences were observed in proportionate rates of hospice use in nursing homes for those who were community dwellers and subsequently died in the nursing home after using the Medicare skilled nursing facility (SNF) care benefit (19.3% of them had hospice care) compared with substantially fewer persons who died in a nursing home without first using the SNF benefit (44.5% of them had hospice care). Another notable finding was that almost half of 1081 community-dwelling decedents who used the SNF benefit died in a nursing home.