Nurse, CNA cares for nursing home resident, woman

Despite caring for a sicker patient population during the pandemic, skilled nursing facilities were able to provide post-acute rehabilitation services on a level comparable to prepandemic care with only a modest decline in intensity, investigators say.

In a new study, researchers from Hebrew SeniorLife and Harvard Medical School in Boston used multistate data representing more than 100,000 short-stay residents across 776 nursing homes. They compared prepandemic care from October 2019 to March 2020 to pandemic services provided October 2020 to March 2021. 

Half-day decrease in rehab

The cohort study examined data for physical, occupational, and speech and language therapies performed. During the pandemic, SNFs admitted patients with a greater burden of cognitive impairment and higher mortality risk than they did prior to the pandemic, the investigators found. 

Rehabilitation services, meanwhile, decreased overall as COVID-19 spread nationwide. But the change represented only about a half day on average across the three therapy disciplines, reported Sarah M. Berry, MD, MPH and colleagues. This amounts to an approximate 10% reduction from prepandemic levels, the study authors noted.

The decrease in therapy may be explained in part by the drop in group therapy during the pandemic, they added. 

A ‘remarkable’ feat

The modest level of decline in rehabilitation intensity and community discharge during the pandemic was “remarkable” considering that high staff turnover left fewer staff to care for sicker residents, the authors wrote.

The results show the resiliency and adaptability of the skilled nursing sector during this difficult time, they concluded.

“During the pandemic we knew that fewer people went to skilled nursing facilities after hospitalizations, and it seemed like the ones that went were overall sicker, with more cognitive impairment and higher risk overall,” lead author Sandra M. Shi, MD, MPH, said in a statement. “This study helps to demonstrate that despite caring for a sicker population with scarce resources, SNFs were still largely able to provide post-acute rehabilitation for patients.”

The study was published in JAMA Health Forum.

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