Dhingra L, et al. - Researchers used federal data from the Minimum Data Set and other sources to determine if Institutional Special Needs Plan (I-SNP) availability has been related to changes in hospice utilization in the United States. This study included all US nursing homes in 2011 (n = 15,750) and 2013 (n = 15,732). Participants were Medicare or both Medicare and Medicaid enrollees who were nursing home residents. Multivariate analyses revealed the link of greater hospice enrollment in nursing homes with the following: having at least one I-SNP enrollee per month; year (2013 higher than 2011); smaller facility size; urban (vs rural) setting; location in the Northeast (vs Midwest); lower average resident mental status; higher average resident mobility; younger residents, on average; and facilities with higher proportions of residents with specific diagnoses (cancer, cirrhosis, and dementia). Following adjustment for resident and nursing home features, the link between monthly I-SNP presence and hospice enrollment was observed only in nursing homes with ≥ 50 beds, and a positive link with increasing size was also noted. Overall, the growth of I-SNPs was related to shifts in hospice utilization, but the associations differed by facility size.