Nurse dressed in personal protective equipment helps a senior woman at a nursing home
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Skilled nursing facilities were “severely limited” during the early COVID-19 surge after a study found that a Massachusetts hospital referred just 10% of post-acute discharges to SNFs following a stay, according to a new study. 

The findings, published Wednesday in the Journal of the American Geriatrics Society, included data from 836 senior patients hospitalized with COVID-19 during a 12-week surge starting in March 2020. 

Half of the patients (50%) were discharged home, while 31% were sent to post-acute care facilities. Of those, just 10% of the total patients were discharged to SNFs. Seventeen percent were sent to long-term care and 4% were discharged to inpatient rehabilitation.  

“In the final weeks, when fewer patients with COVID-19 were discharged, nearly 60% were discharged [to post-acute care] facilities and no patients were discharged home without [home health agency] services. SNF referrals for all hospitalized patients peaked to an average of 15 referrals per patient from a pre-pandemic average of four,” lead author Jessica O’Neil, M.D., et al. wrote. O’Neil works under the Department of Medicine at the Massachusetts General Hospital in Boston. 

The researchers noted that the surge caused significant challenges within post-acute care, including limited visitor access, staffing shortages, internal outbreaks and lack of personal protective equipment, simultaneous with increased post-acute needs among senior patients. 

“As the pandemic emerged, considerable attention was paid to anticipated acute inpatient needs, however, preparation for [post-acute care] use was less robust. Few facilities accepted patients with COVID-19 initially, and many were unable to operate at capacity,” the authors concluded. 

“Our referral findings suggest that access to SNFs was severely limited during the COVID-19 surge and that this improved over time as auxiliary discharge locations opened. In addition, strict admission requirements to LTAC and IRF were waived to facilitate movement of patients across the care spectrum as seen in our cohort,” they added.