Approximately one in five of all deaths in the United States occurs in a nursing home (1). At the same time, studies of quality of life and family satisfaction with EOL care of nursing home residents reveal a need for improvement in the EOL care provided to dying nursing home residents (2,3). EOL care encompasses both hospice and palliative services. Although the purpose of hospice and palliative care is to alleviate symptoms and provide support, hospice care is for a person with a life expectancy of months, whereas palliative care can be provided at any point in the course of the person’s illness. Although the benefits of hospice and palliative care are clear (4–10)