# Palliative Care Consultations for Persons in the Medicare Skilled Nursing Facility (SNF) Setting

> **NIH NIH K23** · UNIVERSITY OF PENNSYLVANIA · 2020 · $123,692

## Abstract

Project Summary/Abstract
This K23 application describes the background and experience of the applicant, Joan Gleba Carpenter, PhD,
CRNP, ACHPN, and her plan to acquire the knowledge and training necessary to achieve her long-term goal:
to become an independent clinical investigator in developing and testing effective nursing home delivery
models of palliative care. Close to one-third of Medicare decedents use the Medicare skilled nursing facility
(SNF) benefit in the 6 months prior to death. SNF care often increases the risk for more aggressive, potentially
burdensome treatments and unrecognized or undertreated symptoms. Palliative care relieves suffering,
enhances communication, and improves end-of-life care and decision making for seriously ill older adults.
Palliative care consultation (PCC) is one approach that can potentially improve care for older adults with
advanced illness in SNFs, but it is not widely available. To improve end of life outcomes for frail older adults
and achieve independence, Dr. Carpenter has a developed a research and training plan in this application. The
specific research aims are to: 1) Establish the feasibility and acceptability of the SNF-PCC intervention by
determining: (a) percentage of all SNF patients who meet eligibility criteria; (b) percentage of eligible patients
who consent to participate; (c) percentage of consented patients who receive the SNF PCC and from whom all
data are collected; (d) clinician fidelity to the standardized SNF-PCC protocol (defined as 90% adherence to
protocol elements), and (e) surrogate satisfaction with the consult (acceptability), defined as ratings of 4 and 5
on the Consultation Satisfaction Questionnaire (1-5 scale; higher scores reflect greater satisfaction); 2)
Estimate the effect size of the SNF-PCC intervention on patient/family caregiver reported quality of life at
seven days and 30 days post SNF-PCC in a pilot randomized controlled trial among 80 patients; and 3)
Determine adherence to SNF-PCC recommendations at seven days and 30 days post SNF-PCC. The specific
training objectives that will provide the knowledge and skills to complete the research aims are to: 1) expand
understanding and application of the principles of transitional care, 2) develop and tailor clinical interventions,
3) acquire skills in palliative care clinical trials research, and 4) train in the ethical conduct of research. The
research environment at the University of Pennsylvania features a number of high quality, well-established
resources that will facilitate Dr. Carpenter's development. This proposal will provide the foundation for future
clinical trials that test the effectiveness and implementation of palliative care interventions to enhance the care
and outcomes for older adults with serious illness.

## Key facts

- **NIH application ID:** 9843531
- **Project number:** 5K23NR017663-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Joan Gleba Carpenter
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $123,692
- **Award type:** 5
- **Project period:** 2019-01-01 → 2020-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9843531

## Citation

> US National Institutes of Health, RePORTER application 9843531, Palliative Care Consultations for Persons in the Medicare Skilled Nursing Facility (SNF) Setting (5K23NR017663-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9843531. Licensed CC0.

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