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Despite lowers costs, skilled nursing facilities still second to long-term acute care

February 27, 2018
by I Advance Senior Care
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Skilled nursing facilities are less costly for Medicare than long-term acute care (LTAC) facilities, but they can be missed as an option for seniors recovering from hospitalization, according to a new study in JAMA Internal Medicine and a report from Skilled Nursing News.

“Essentially what we found was dramatic variation in LTAC use, and only about a half of the variation, the reason why older adults are transferred to LTACs, is how sick they are,” Dr. Anil Makam, assistant professor of internal medicine at UT Southwestern Medical Center, told Skilled Nursing News.

In a study of 65,525 hospitalized older adults transferred to an LTAC or SNF, 3,093 were transferred to an LTAC, which cares for patients who are stable but require ongoing intensive care. The strongest predictors of transfer to such a facility were receiving a tracheostomy and being hospitalized in close proximity to an LTAC.

Following adjustment for case mix, about half of the variation in LTAC use, or 52.1%, was explained by the differences between patients, the researchers found. The rest were attributable to hospital and regional differences. It’s those last two factors that could end up sending patients who could be cared for in SNFs to LTACs.

“There’s about 420 or so unique LTACs across the country and they are not geographically spread evenly,” Makam explained to SNN. “Some have a lot and other areas have very few. Geography in a way is destiny, so if you’re in a region that has few or none [LTACs], there’s going to be very little LTAC use.”

High use of LTACs was particularly concentrated in the South, notably in Louisiana, Oklahoma and Texas, he observed. By contrast, the Pacific Northwest region, the North and the Northeast had less use of LTACs.

Read the full story at Skilled Nursing News.