Selecting a skilled nursing facility for postacute care

Abstract

OBJECTIVES: To describe individuals' experiences during the hospital discharge planning and skilled nursing facility (SNF) selection process.

DESIGN: Semistructured interviews focusing on discharge planning and nursing facility selection, including how facilities were chosen, who was involved, and what factors were important in decision-making.

SETTING: 14 SNFs in five cities across the United States.

PARTICIPANTS: Newly admitted, previously community-dwelling SNF residents (N = 98) and their family members.

MEASUREMENT: Semistructured interviews were qualitatively coded to identify underlying themes.

RESULTS: Most respondents reported receiving only a list of SNF names and addresses from discharge planners and that hospital staff were minimally involved. Proximity to home and prior experience with the facility most often influenced choice of SNF. Most respondents reported being satisfied with their placement, although many stated that they would have been willing to travel further to another SNF were it recommended. Many reported feeling rushed and unprepared, stating that they did not know where or how to get help.

CONCLUSION: SNF placement is a stressful transition, occurring when people are physically vulnerable and with limited guidance from discharge planners. Therefore, most people select a facility based on its location, perhaps because they are provided with no other information. Given Centers for Medicare and Medicaid Services' proposed changes to the discharge planning process, this research highlights the value of providing people and family caregivers with quality data and assistance in interpreting it.