Skilled nursing facilities in Rhode Island got the attention of Americans with Disabilities Act advocates when they refused to admit people coming out of hospitals after treatment for opioid addiction, according to a study published in February. The study sounded the alarm on the trend, and was led by Patience Moyo, PhD, an assistant professor of health services, policy and practice at Brown University.
As part of the study, researchers surveyed 27 nursing homes in Rhode Island between 2021 and 2022. The team interviewed 29 leaders including administrators and directors. They included nonprofit and for-profit facilities. The surveys ended after the U.S. Department of Justice made a statement on opioid use treatment and the Americans with Disabilities Act.
“Our study took place before affirmations of anti-discrimination protections became more widely publicized across the country, which may have allowed administrators to give voice to views that they would be more cautious in openly expressing today,” the article said.
One facility said it didn’t admit 110 people referred to them by hospitals based on a person’s psychiatric issues, drug use, suicidality, smoking or opioid treatment.
Not all facilities reported refusals. But some said they refused patients if they knew they were on a medication such as methadone. Along with methadone, buprenorphine is another drug that can wean people off opioids, but most nursing facilities don’t have clinicians there to prescribe the drug. Many facilities don’t have the staff to transport people to methadone clinics, either, the report said. A lot of facilities were already strained financially, and didn’t have the training in place to help people in recovery, Moyo noted.
“In some contexts, those hospitalizations involve serious infections, or procedures that need more time to recover from, or additional rehabilitation, and even mobility issues. Sometimes people lose mobility while they’re hospitalized,” Moyo told the Rhode Island Current. “So these nursing facilities can be a place where people can get a subacute level of care.”
About 30% of patients discharged from hospitals for opioid use disorder are readmitted within 30 days, and about 16% of the people go to a nursing facility, Moyo reported.
There’s some stigma involved in refusing potential residents, too, the report showed. Nursing homes are usually home to older adults and not younger folks with drug use disorders. Some of the people surveyed were concerned about the potential for violence at their facilities if they admitted someone in recovery. There are also sometimes age differences that can make socializing among residents an obstacle, and impact an individual’s mental health, Moyo said.
The news comes as a survey released last month on 772 US adults showed that 38% of people over the age of 55 talk to their healthcare providers about substance abuse.
