Skilled nursing facilities can safely take on higher levels of care for their residents to avoid the hospital, and they can do so without raising residents’ risk of death.
That’s according to a new study by the RTI International research firm, published in October’s Health Affairs. Researchers there took a closer look at providers involved in the federal government’s Initiative to Reduce Avoidable Hospitalizations among nursing home residents, which ended in 2016. They found that not only did the effort reduce hospitalizations by treating residents at the SNF, but they also did so without greatly risking seniors’ lives.
“Often I’ve heard from my physician colleagues or even family members that they do not have a high trust in the SNF’s capacity to take care of these residents and really do clinical work in their facilities,” Zhanlian Feng, Ph.D., senior research public health analyst at RTI and lead author of the study, told McKnight’s. “That’s the larger context motivating this analysis. We’re asking this question: Yes, it appears as if this is effective, you’re cutting a lot of hospitalizations, but are there any unintended consequences, like mortality?”
The analysis looked at the work of seven different organizations, called Enhanced Care and Coordination Providers, or ECCPs, operating in seven states. Hospitals collaborated with 143 nursing homes, with the aim of identifying residents whose conditions could be managed in the SNF, instead of a hospital. They found success in that regard, with percentage-point reductions of 2.2 to 9.3 in all-cause hospitalizations in 2015, RTI notes.
Mortality rate changes were miniscule, ranging from an 0.8 percentage-point reduction to a 1.5 percentage-point increase. Authors believe this success could be translated to other SNFs.
“With increased clinical care capacity and staffing support in identifying, assessing, monitoring and managing residents’ condition changes on site, this success might also be within the reach of nursing facilities that did not participate in the initiative,” the study concludes.