Outcomes of post‐acute care in skilled nursing facilities in Medicare beneficiaries with and without a diagnosis of dementia

2021 ◽  
Author(s):  
Robert E. Burke ◽  
Yao Xu ◽  
Ashley Z. Ritter
Keyword(s):  
Acute Care ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Medicare Beneficiaries ◽  
Skilled Nursing ◽  
Diagnosis Of Dementia ◽  
Post Acute Care

scholarly journals Quality of Post-Acute Care in Skilled Nursing Facilities That Disproportionately Serve Black and Hispanic Patients

2018 ◽  
Vol 74 (5) ◽  
pp. 689-697 ◽  
Author(s):  
Maricruz Rivera-Hernandez ◽  
Momotazur Rahman ◽  
Dana B Mukamel ◽  
Vincent Mor ◽  
Amal N Trivedi
Keyword(s):  
Acute Care ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Hispanic Patients ◽  
Post Acute Care

scholarly journals Expectations and Experiences with Physician Care among Patients Receiving Post-Acute Care in US Skilled Nursing Facilities

2020 ◽  
Author(s):  
Kira L Ryskina ◽  
Kierra A. Foley ◽  
Jason H. Karlawish ◽  
Joshua D. Uy ◽  
Briana Lott ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Acute Care ◽  
Nurse Practitioners ◽  
Skilled Nursing Facilities ◽  
Theory Approach ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Individualized Care ◽  
Physician Care ◽  
Post Acute Care

Abstract Background and Objectives: In the US, post-acute care in skilled nursing facilities (SNFs) is common and outcomes vary greatly across facilities. Little is known about the expectations of patients and their caregivers about physician care during the hospital to SNF transition. Our objectives were to (1) describe the experiences and expectations of patients and their caregivers with SNF physicians (or advanced practitioners such as nurse practitioners) in SNFs, and (2) identify patterns that differed between patients with vs. without cognitive impairment.Research Design and Methods: This qualitative study used grounded theory approach to analyze data collected from semi-structured interviews at five SNFs in January-August 2018. Patients admitted for short-term SNF care 5-10 days prior were eligible to participate. Thematic analysis was performed to detect recurrent themes with a focus on modifiable aspects of physician care. Analysis was stratified by patient cognitive impairment (measured by the Montreal Cognitive Assessment at the time of the interview). Results: Fifty patients and six caregivers were interviewed. Major themes were: (1) patients had poor awareness of the physician in charge of their care; (2) they were dissatisfied with the frequency of interaction with the physician; and (3) participants valued the perception of receiving individualized care from the physician. Less cognitively impaired patients were more concerned about limited interactions with the clinicians and were more likely to report attempts to seek out the physician. Discussion and Implications: Patient and caregiver expectations of SNF physicians were not well aligned with their experiences. SNFs aiming to improve satisfaction with care may focus efforts in this area, such as facilitating frequent communication between physicians, patients and caregivers.

scholarly journals Quality of Post-Acute Care in Skilled Nursing Facilities That Disproportionately Serve Hispanics With Dementia

2020 ◽  
Vol 21 (11) ◽  
pp. 1705-1711.e3
Author(s):  
Maricruz Rivera-Hernandez ◽  
Chanee D. Fabius ◽  
Shekinah Fashaw ◽  
Brian Downer ◽  
Amit Kumar ◽  
...  
Keyword(s):  
Acute Care ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Post Acute Care

scholarly journals Expectations and experiences with physician care among patients receiving post-acute care in US skilled nursing facilities

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kira L. Ryskina ◽  
Kierra A. Foley ◽  
Jason H. Karlawish ◽  
Joshua D. Uy ◽  
Briana Lott ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Acute Care ◽  
Skilled Nursing Facilities ◽  
Theory Approach ◽  
Nursing Facilities ◽  
Structured Interviews ◽  
Skilled Nursing ◽  
Individualized Care ◽  
Physician Care ◽  
Post Acute Care

Abstract Background In the US, post-acute care in skilled nursing facilities (SNFs) is common and outcomes vary greatly across facilities. Little is known about the expectations of patients and their caregivers about physician care during the hospital to SNF transition. Our objectives were to (1) describe the experiences and expectations of patients and their caregivers with SNF physicians in SNFs, and (2) identify patterns that differed between patients with vs. without cognitive impairment. Methods This qualitative study used grounded theory approach to analyze data collected from semi-structured interviews at five SNFs in January–August 2018. Patients admitted for short-term SNF care 5–10 days prior were eligible to participate. Thematic analysis was performed to detect recurrent themes with a focus on modifiable aspects of physician care. Analysis was stratified by patient cognitive impairment (measured by the Montreal Cognitive Assessment at the time of the interview). Results Fifty patients and six caregivers were interviewed. Major themes were: (1) patients had poor awareness of the physician in charge of their care; (2) they were dissatisfied with the frequency of interaction with the physician; and (3) participants valued the perception of receiving individualized care from the physician. Less cognitively impaired patients were more concerned about limited interactions with the physicians and were more likely to report attempts to seek out the physician. Conclusion Patient and caregiver expectations of SNF physicians were not well aligned with their experiences. SNFs aiming to improve satisfaction with care may focus efforts in this area, such as facilitating frequent communication between physicians, patients and caregivers.

scholarly journals Expectations and Experiences with Physician Care Among Patients Receiving Post-Acute Care in US Skilled Nursing Facilities

2020 ◽  
Author(s):  
Kira L Ryskina ◽  
Kierra A. Foley ◽  
Jason H. Karlawish ◽  
Joshua D. Uy ◽  
Briana Lott ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Acute Care ◽  
Nurse Practitioners ◽  
Skilled Nursing Facilities ◽  
Theory Approach ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Individualized Care ◽  
Physician Care ◽  
Post Acute Care

Abstract Background and Objectives: In the US, post-acute care in skilled nursing facilities (SNFs) is common and outcomes vary greatly across facilities. Little is known about the expectations of patients and their caregivers about physician care during the hospital to SNF transition. Our objectives were to (1) describe the experiences and expectations of patients and their caregivers with SNF physicians (or advanced practitioners such as nurse practitioners) in SNFs, and (2) identify patterns that differed between patients with vs. without cognitive impairment.Research Design and Methods: This qualitative study used grounded theory approach to analyze data collected from semi-structured interviews at five SNFs in January-August 2018. Patients admitted for short-term SNF care 5-10 days prior were eligible to participate. Thematic analysis was performed to detect recurrent themes with a focus on modifiable aspects of physician care. Analysis was stratified by patient cognitive impairment (measured by the Montreal Cognitive Assessment at the time of the interview). Results: Fifty patients and six caregivers were interviewed. Major themes were: (1) patients had poor awareness of the physician in charge of their care; (2) they were dissatisfied with the frequency of interaction with the physician; and (3) participants valued the perception of receiving individualized care from the physician. Less cognitively impaired patients were more concerned about limited interactions with the clinicians and were more likely to report attempts to seek out the physician. Discussion and Implications: Patient and caregiver expectations of SNF physicians were not well aligned with their experiences. SNFs aiming to improve satisfaction with care may focus efforts in this area, such as facilitating frequent communication between physicians, patients and caregivers.

scholarly journals Expectations and Experiences with Physician Care among Patients Receiving Post-Acute Care in US Skilled Nursing Facilities

2020 ◽  
Author(s):  
Kira L Ryskina ◽  
Kierra A. Foley ◽  
Jason H. Karlawish ◽  
Joshua D. Uy ◽  
Briana Lott ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Acute Care ◽  
Skilled Nursing Facilities ◽  
Theory Approach ◽  
Nursing Facilities ◽  
Structured Interviews ◽  
Skilled Nursing ◽  
Individualized Care ◽  
Physician Care ◽  
Post Acute Care

Abstract Background: In the US, post-acute care in skilled nursing facilities (SNFs) is common and outcomes vary greatly across facilities. Little is known about the expectations of patients and their caregivers about physician care during the hospital to SNF transition. Our objectives were to (1) describe the experiences and expectations of patients and their caregivers with SNF physicians in SNFs, and (2) identify patterns that differed between patients with vs. without cognitive impairment.Methods: This qualitative study used grounded theory approach to analyze data collected from semi-structured interviews at five SNFs in January-August 2018. Patients admitted for short-term SNF care 5-10 days prior were eligible to participate. Thematic analysis was performed to detect recurrent themes with a focus on modifiable aspects of physician care. Analysis was stratified by patient cognitive impairment (measured by the Montreal Cognitive Assessment at the time of the interview). Results: Fifty patients and six caregivers were interviewed. Major themes were: (1) patients had poor awareness of the physician in charge of their care; (2) they were dissatisfied with the frequency of interaction with the physician; and (3) participants valued the perception of receiving individualized care from the physician. Less cognitively impaired patients were more concerned about limited interactions with the physicians and were more likely to report attempts to seek out the physician. Conclusion: Patient and caregiver expectations of SNF physicians were not well aligned with their experiences. SNFs aiming to improve satisfaction with care may focus efforts in this area, such as facilitating frequent communication between physicians, patients and caregivers.

Medicare Bundled Payments for Post-Acute Care: Characteristics and Baseline Performance of Participating Skilled Nursing Facilities

2018 ◽  
Vol 77 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Xi Cen ◽  
Helena Temkin-Greener ◽  
Yue Li
Keyword(s):  
Acute Care ◽  
Market Competition ◽  
Cost Of Care ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Bundled Payments ◽  
Baseline Performance ◽  
Care Improvement ◽  
Post Acute Care

Medicare bundled payment models have focused on post-acute care as a key component of improving the efficiency and quality of health care. This study investigated the characteristics and baseline performance of skilled nursing facilities (SNFs) that participated in Medicare Bundled Payments for Care Improvement Initiative Model 3. As of July 2016, 657 SNFs participated in 7,932 episodes in risk-bearing phase. Our retrospective analyses found that larger facilities, higher occupancy rate, chain affiliation, better five-star overall rating, and higher market competition for SNF care were associated with increased likelihood of enrolling in clinical episodes in Model 3, whereas not-for-profit ownership, higher adjusted staffing levels, higher percentage of Medicaid residents, and rural location were associated with reduced likelihood of participation in Bundled Payments for Care Improvement. Policy makers should consider approaches to encourage participation of post-acute care providers in this voluntary program and evaluate its impact on patient selection, cost of care, and health outcomes.

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