Patients Find SNF Selection After a Hospital Stay ‘Crazy’

When it comes to choices about health care, seniors should have as much information as possible to make educated decisions. Yet for the more than 20 percent of Medicare-using seniors who are admitted to skilled nursing facilities following a hospital stay, decisions have to be made quickly and with very limited information, according to a recent study published in the Journal of the American Geriatrics Society.

The study examines the experiences of 98 hospitalized seniors in five cities across the U.S. during the planning period around the time of their hospital discharge. Most said that they felt “rushed and unprepared,” and only received a list of SNF names and addresses to choose from with no guidance, the study reported.

Most of the seniors interviewed reported that they chose a SNF based on proximity to their home or a family member’s home, and they would have been willing to travel further to a SNF that was recommended. Such recommendations are not typically forthcoming because discharge planners and hospital staff are minimally involved in the decision-making process, according to the study.


Past research has found that hospital staff are very involved in this process, but no research has yet been done into patients’ perceptions of the involvement, the study notes. Furthermore, the interviewed seniors reported feeling that hospital staff were not allowed to offer SNF recommendations. The study posits that staff may misinterpret patient choice statutes of Social Security and Medicare Conditions of Participation, and as a result avoid offering input.

Contrary to this misconception, the Centers for Medicare and Medicaid Services (CMS) has proposed that hospitals help patients choose post-acute care providers by supplying information on quality data and measures, the study notes.

It’s a proposal that would be supported by incoming SNF residents, based on feedback researchers received.


“Transitions are largely rushed and chaotic, and healthcare systems do not support patients well in making informed decisions,” the study concludes. “Patients reported selecting facilities for reasons other than quality and described the process as ‘crazy’ and something they were not prepared for.”

Written by Elizabeth Jakaitis

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