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9%). Residents who received hospice care were in more severe and complex clinical conditions than those who did not receive hospice care. CONCLUSION Only a small proportion of residents in LTCFs received hospice care. Further investigation of standardized assessment of terminal status is needed as accuracy of end-stage diagnosis continues to be challenging and criteria for hospice eligibility are narrow. Special attention should be paid to improve access to hospice care among residents with dementia or other progressive chronic disea