Hospice Visits and Perceived Hospice Quality Among Assisted Living Residents

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Hospice services are crucial for assisted living residents nearing end-of-life.
• Concerns persist regarding the quality and adequacy of hospice care in assisted living settings.

Purpose of the Study:

• To investigate the association between the frequency of hospice staff visits and perceived quality of care among assisted living residents.
• To differentiate the impact of clinical versus nonclinical hospice staff on quality ratings.

Main Methods:

• A cohort study analyzed Medicare claims data for 51,303 assisted living residents who died in 2018-2019.
• Data were linked to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey for quality assessment.
• Multivariable regression models examined the relationship between staff visits (clinical and nonclinical) and CAHPS ratings.

Main Results:

• Increased clinical staff visits correlated with improved emotional support, family ratings, willingness to recommend, and feeling respected.
• Nonclinical staff visits showed stronger associations with enhanced emotional support, willingness to recommend, and overall average scores.
• The average CAHPS rating for the cohort was 80.83.

Conclusions:

• Higher hospice staff visit frequency is associated with better perceived hospice quality in assisted living.
• Policies encouraging greater hospice staff engagement, particularly nonclinical roles, may improve end-of-life care experiences.
• Findings suggest a need to optimize staffing models to enhance care quality for this population.