Terminally Ill Nursing Home Patients Face Needless ER Visits, Hospital Stays

Key TakeawaysMany hospital trips by terminally ill nursing home patients are unnecessaryAbout 80% of ER visits are potentially avoidableNearly a third of hospitalizations may be needless.MONDAY, July 28, 2025 (HealthDay News) — Terminally ill nursing home residents are being hounded to their graves with needless trips to the hospital, a new study says.About 80% of ER visits by terminally ill nursing home residents are potentially avoidable, researchers report in the Journal of the American Medical Directors Association.Likewise, nearly one-third of hospitalizations among these residents were needless, the study says.Pneumonia, urinary tract infections (UTIs) and sepsis commonly resulted in needless trips to the hospital for terminally ill patients, but better health care and management at nursing homes could have kept these people out of the hospital, researchers argue.These health problems “highlight some clear, actionable opportunities to improve care,” senior researcher Dr. Joseph Ouslander said in a news release. He’s a professor of geriatric medicine at Florida Atlantic University’s Schmidt College of Medicine in Boca Raton.“These are conditions we know how to manage better in nursing homes, using existing guidelines, care paths and preventive strategies,” Ouslander said. “With the right tools and staffing, many of these hospital transfers could be avoided, reducing both resident suffering and unnecessary health care costs.”For the new study, researchers analyzed data on more than 6,000 severely impaired residents of 264 nursing homes, of whom more than 5,800 were terminally ill. About 1 in 3 of these residents were hospitalized during the 12-month study.About 70% of ER visits among the severely impaired and 80% among the terminally ill were avoidable, researchers say.Likewise, about a third of hospitalizations were avoidable among both the severely impaired and terminally ill, results show.Among severely impaired patients, feeding tube problems were the most common reason for ER visits, researchers found.UTIs, seizures and low blood pressure also were common causes of hospitalization that could have been prevented with timely nursing home care, the study says.Pneumonia, UTIs, kidney failure and heart failure were most often linked to avoidable hospitalizations among terminally ill residents. Head trauma and fractures caused by falls, breathing difficulties and altered mental status were also common.Many of these hospitalizations could be prevented through clearer care protocols and timely symptom management, researchers said.Communicating health care preferences with families and residents could also make a huge difference. Documented care preferences can help avoid crisis-driven decisions and reduce needless transfers, researchers said.“To reduce potentially avoidable hospital transfers, we need to strengthen the capabilities of nursing home staff and ensure active involvement from skilled medical directors and clinicians,” Ouslander said.“This isn’t just about individual effort – it requires support from nursing homes, provider organizations and policymakers,” he added. “We need bold changes, like pragmatic national staffing standards, better-resourced facilities for complex care, and payment models that truly support high-quality, person-centered care for the most vulnerable residents.”More informationThe Institute for Healthcare Improvement has more on nursing home basics.SOURCE: Florida Atlantic University, news release, July 24, 2025 .What This Means For YouMany hospital trips by terminally ill nursing home patients can be avoided through better care and management..Sign up for our weekly HealthDay newsletter