Resident and facility factors associated with high risk of discharge from nursing facilities, 2012-2017: final report
- Collection:
- Health Policy and Services Research
- Author(s):
- Hughes, Kelly, (Of RTI International), author Feng, Zhanlian, author Zheng, Nan Tracy, author Karon, Sarita L., author Oliveira, Iara, author
- Contributor(s):
- United States. Department of Health and Human Services. Office of Behavioral Health, Disability, and Aging Policy, issuing body. RTI International, issuing body.
- Publication:
- [Washington, D.C.] : Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office Of Behavioral Health, Disability, and Aging Policy September 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Nursing Homes Outcome Assessment, Health Care Patient Discharge -- statistics & numerical data Risk Health Facility Closure Patient Transfer United States
- Genre(s):
- Technical Report
- Abstract:
- People can be discharged from nursing homes for many reasons. Discharges may be a positive outcome and reflect an individual’s choice. In other cases, discharges may be at the direction of the facility and against the will of the resident. There are strict rules about when involuntary facility-initiated discharges (FIDs) are allowed. Under federal law, involuntary FIDs are legal only if they are triggered by one of six reasons: the FID is necessary for the resident’s welfare and the resident's needs cannot be met in the facility; the resident no longer needs nursing home care; the safety of other residents is endangered due to the clinical or behavioral status of the resident; the health of others in the facility would be endangered; the resident fails to pay; or, the facility closes (CMS, 2017a). FIDs are unlawful otherwise. The Office of the Inspector General (OIG) is currently investigating the extent to which state survey agencies investigated and took enforcement actions against nursing homes for inappropriate involuntary transfers and discharges (OIG, 2019). FIDs can be unsafe and traumatic for the residents involved and may result in higher costs of care, raising concerns to the public and to Medicare and Medicaid programs, which are the primary sources of payment. In the last few years, news media and Ombudsman programs report that FIDs may be increasing in frequency and as of 2018, were the leading cause of complaints for nursing home residents (Verdana & Pear, 2018). Recently, there has been heightened concern about the rise of FIDs amid the COVID-19 pandemic (Silver-Greenberg & Harris, 2020). This study builds on a recent review of available literature (Lepore, Zepeda & Yuen, 2018), which identified the following characteristics as placing residents at higher risk of potentially unlawful FIDs: transition to Medicaid payor status; Alzheimer’s or other dementia diagnoses; behavioral symptoms; and impairments that require more staff time (e.g., severe functional dependencies and bowel or urinary incontinence). This study was designed to increase understanding of FIDs and their impacts on nursing home residents. It identifies resident characteristics related to increased risk of live discharges and how these relationships vary across time, states, and facility types. It also presents findings on the relationship between live discharges of residents with risk factors and post-discharge outcomes.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (various pagings))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918574081706676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918574081706676