Implementation of Post‐Acute Rehabilitation at Home: A Skilled Nursing Facility‐Substitutive Model

2020 ◽  
Vol 68 (7) ◽  
pp. 1584-1593 ◽  
Author(s):  
Matthew R. Augustine ◽  
Claire Davenport ◽  
Katherine A. Ornstein ◽  
Mitchell Cuan ◽  
Pamela Saenger ◽  
...  
Keyword(s):  
Skilled Nursing Facility ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Acute Rehabilitation ◽  
At Home

The effects of telehealth use for post-acute rehabilitation patient outcomes

2016 ◽  
Vol 24 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Stephanie A Hicks ◽  
Verena R Cimarolli
Keyword(s):  
Cognitive Functioning ◽  
Patient Outcomes ◽  
Skilled Nursing Facility ◽  
Functional Independence ◽  
Emergency Department Visits ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Rehabilitation Care ◽  
Acute Rehabilitation ◽  
The Impact

Introduction Previous research has shown that home telehealth services can reduce hospitalisations and emergency department visits and improve clinical outcomes among older adults with chronic conditions. However, there is a lack of research on the impact of telehealth (TH) use on patient outcomes in post-acute rehabilitation settings. The current study examined the effects of TH for post-acute rehabilitation patient outcomes (i.e. discharge setting and change in functional independence) when controlling for other factors (e.g. cognitive functioning). Methods For this retrospective study, electronic medical records (EMRs) of 294 patients who were discharged from a post-acute rehabilitation unit at a skilled nursing facility were reviewed. Only patients with an admitting condition of a circulatory disease based on ICD-9 classification were included. Main EMR data extracted included use of TH, cognitive functioning, admission and discharge functional independence, and discharge setting (returning home vs. returning to acute care/re-hospitalisation). Results Results from a regression analysis showed that although TH use was unrelated to post-acute rehabilitation care transition, it was significantly related to change in functional independence. Patients who used TH during their stay had significantly more improvement in functional independence from admission to discharge when compared to those who did not use TH. Discussion Findings indicate that TH use during post-acute rehabilitation has the potential to improve patient physical functioning.

Abstract W P293: Opportunities For Interventions In Stroke-Dizziness Presentations: A Prospective Single Center Surveillance Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Kevin A Kerber ◽  
James F Burke ◽  
Devin L Brown ◽  
TImothy P Hofer ◽  
Eric E Adelman ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Care Center ◽  
Tertiary Care ◽  
Skilled Nursing Facility ◽  
Single Center ◽  
Diagnostic Dilemma ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Neurologic Deficits ◽  
Acute Rehabilitation

Objective: Ischemic stroke can be a diagnostic dilemma in presentations of acute dizziness and increased resources will likely be required to reduce instances of misdiagnosis. To inform the potential value of the deployment of increased resources, we sought to describe opportunities for therapeutic interventions from a series of acute dizziness-stroke patients who had diagnostic uncertainty (i.e., only mild or no general neurologic deficits) on presentation. Methods: Active and passive surveillance methods were used at a tertiary care center to identify acute dizziness patients with nystagmus or imbalance, excluding those with benign paroxysmal positional vertigo, medical causes, or moderate-to-severe neurologic deficits. Stroke was defined as any acute infarction on a clinical or research MRI performed within 14 days of dizziness onset. Results: From November 21, 2009, to March 29, 2013, we identified 26 patients with acute ischemic stroke presenting with dizziness and either mild or no general neurologic deficits. Infarction volume was small (<1cm3) in 19 (73%), moderate (≥1-<10cm3) in 2 (8%), and large (>10cm3) in 5 (19%). The proportion of cases arriving within 3, 4.5, and 6 hours of symptom onset was 38% (10), 38% (10), and 46% (12). Two cases were treated with thrombolysis. Half of all cases were already prescribed a statin medication at the time of presentation and 42% (11) were already prescribed an antiplatelet or anticoagulant. One patient met clinical eligibility for sub-occipital craniectomy. Three patients were discharged to a skilled nursing facility (1) or acute rehabilitation (2), whereas the majority (22; 85%) were discharged home. Conclusion: In this single center study which used rigorous surveillance and imaging-based methods to capture cases of acute dizziness-ischemic stroke with only mild or no general neurologic deficits, we found that a minority of patients met time requirements for acute treatments, nearly half were already on secondary prevention medications, and the majority did not require discharge to a skilled nursing facility or acute rehabilitation.

scholarly journals Skilled Nursing Facility Patients Discharged to Home Health Agency Services Spend More Days at Home

2020 ◽  
Vol 68 (7) ◽  
pp. 1573-1578 ◽  
Author(s):  
Adam Simning ◽  
Jessica Orth ◽  
Jinjiao Wang ◽  
Thomas V. Caprio ◽  
Yue Li ◽  
...  
Keyword(s):  
Skilled Nursing Facility ◽  
Health Agency ◽  
Home Health ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Home Health Agency ◽  
At Home

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

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