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Identifying hospice-appropriate nursing home residents for physicians increased hospice referrals and enrolment

Intervention: all residents and/or surrogates were read scripted interview questions to assess the resident’s appropriateness for hospice care. Residents were deemed appropriate for hospice care if either the resident or surrogate (1) expressed goals for care that focused on comfort, (2) refused both cardiopulmonary resuscitation and mechanical ventilation, and (3) identified >1 need for palliative care. 107 residents were allocated to the intervention, in which the results of the interviews were faxed to the physician if the resident or surrogate met all 3 criteria for appropriateness of hospice care; physicians were asked to indicate if the resident had a prognosis of (6 months, and if so, if nursing home staff should arrange a hospice visit. 98 residents were allocated to usual care, in which all residents and their families were given a brief description of hospice services, and residents deemed appropriate for hospice were told that they could learn more about hospice care by speaking with their healthcare team.