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Council discusses nursing home palliative training, LNEC orientation and Yukon Center study on hospice in nursing homes
Summary
Council members reviewed options to expand palliative-care training in long-term care settings, suggested metrics tied to licensing renewals, and heard about a small Yukon Center on Aging study examining hospice access in nursing homes for dually eligible patients.
Council members discussed strengthening palliative care education for nursing home staff and possible metrics for licensing reviews that would encourage earlier hospice referrals and documented advanced care planning.
One council participant described an existing regulatory expectation: hospice providers that contract with nursing homes require a two-hour orientation for facility staff and said recorded webinars and curricula are available for reuse by providers. The council considered a "train-the-trainer" model to reach more staff at scale and discussed offering shorter or modular versions of the Learning Network for End-of-Life Care (LNEC) curriculum to reduce administrative burden on facilities.
Council members floated the idea of tying measurable metrics — such as education completion, hospice referral rates or presence of advance-care-planning processes — to licensing renewals to encourage earlier palliative care discussions. Members acknowledged that such metrics would be aspirational and could face resistance because of the time and cost demands on facilities.
The Yukon Center on Aging reported a small grant-supported study examining barriers and facilitators to hospice use in nursing homes for dually eligible (Medicare and Medicaid) and Medicaid-only residents. The research team has interviewed hospices with high and low nursing-home involvement and a small number of nursing homes (participants said roughly six hospices and eight to ten nursing homes were interviewed). Council members said Yukon will present more fully when their data are further developed and noted Yukon is scheduled to speak at a hospice and palliative summit in May.
The group also discussed the state moratorium on building new nursing-home facilities and a recent legislative proposal to allow new construction under a Certificate of Need-like (CLN) process in specific circumstances, which council members said would alter capacity dynamics in parts of the state.
No formal actions were taken; members agreed to follow up on training materials and to invite Yukon Center researchers to present findings when available.
