Patients Often Discharged to Nursing Homes with No Information on Quality of Care
A significant number of nursing home residents are shorter-term residents who are recuperating from surgery or illness. A recent study centered on the information provided when patients are discharged from hospitals to nursing homes, and they or their families are tasked with choosing a post-acute care facility.
As a result of regulations and incentives imposed by the Affordable Care Act, hospitals began being held partly accountable for Medicare patients’ care after discharge. However, little information has been available about the process of patients choosing a post-acute care facility.
Study of Availability of Patient Care Information in Choice of Skilled Nursing Facilities
Researchers used a case study approach to determine how patients select a post-acute care facility. The study explored how patients requiring post-acute care decide which skilled nursing facility to select. Further, the study examined the role of hospital staff members in the patients’ decision-making process.
Researchers interviewed 138 staff members of 16 hospitals and 25 skilled nursing facilities, as well as 98 patients in 14 of the skilled nursing facilities. Most patients stated that they received only lists of skilled nursing facilities from hospital staff members, with no other data or information.
Staff members reported not sharing data about facilities’ quality with patients because they believed that patient choice regulations precluded them from doing so. The result was that patients’ choices of a skilled nursing facility following hospitalization were usually not based on quality data that was readily available.
What Can Be Done to Increase Information Provided to Patients?
As proposed by the Centers for Medicare and Medicaid Services (CMS), changes to the Medicare conditions of participation for hospitals, which pertain to discharge planning, could help correct the lack of access to information.
In addition, a less stringent interpretation of Medicare choice requirements may give hospital staff more flexibility in the discharge planning process in terms of providing information to patients about the quality of post-acute care facilities. Medicare’s Nursing Home Compare website provides information about Medicare-certified skilled nursing facilities. Case managers can consider providing patients with information about accessing such information about nursing facilities, without affecting patient autonomy of choice.