Medicare Hospice Care: Services Provided to Beneficiaries Residing in Nursing Homes

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In 2006, 31 percent of Medicare hospice beneficiaries resided in nursing
facilities. Medicare paid $2.59 billion for their hospice care, at an
average of $960 per week for each beneficiary. Hospices most commonly
provided nursing, home health aide, and medical social services. They
furnished an average of 4.2 visits per week per beneficiary for these
three services combined. They also commonly provided drugs.

The Medicare hospice benefit allows a beneficiary with a terminal
illness to forgo curative treatment for the illness and instead receive
palliative care, which is the relief of pain and other uncomfortable
symptoms. Medicare spending on hospice care and the number of
beneficiaries receiving it have increased significantly in recent years.
Previous Office of Inspector General (OIG) work has raised questions
about the hospice benefit for nursing facility residents. However,
little subsequent research has been done to examine hospice care for
these beneficiaries and almost no beneficiary-specific data exist.

This memorandum report found that hospices provided nursing services to
beneficiaries for 96 percent of claims, home health aide services for 73
percent of claims, and medical social services for 68 percent of claims.
Drugs were provided to beneficiaries for 96 percent of claims. In
addition, nursing services were provided at an average of 1.7 times per
week, home health aide services at an average of 2.2 times per week, and
medical social services at an average of 1.7 times per month.

This memorandum report is one in a series of four reports prepared by
OIG that examine the hospice benefit for nursing facility residents. It
is based on data from a medical record review of a stratified random
sample of hospice claims for beneficiaries in nursing facilities in
2006. The report also uses claims data for all Medicare beneficiaries
who received hospice care in 2006.

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