14% Uptick in Patients Being Discharged Home From Nursing Homes

An analysis of over 90,000 custodial patients from 517 skilled nursing facilities (SNFs) across the country found a 14% increase between 2019 and 2021 in the number of patients being discharged home, according to recent analysis by care coordination software provider CarePort.

With new referrals still down 20% from their pre-COVID rates for SNFs as of the second quarter of 2021, CarePort Founder and CEO Lissy Hu felt the data showed that patient preferences continue to evolve as more long-term stay residents are now looking for ways to move back home.

“We do around 20 million referrals annually between acute and post-acute care settings and we have a wide lens on some of these trends,” she explained. “We can see the decline in SNF referrals and then the commensurate increase on the home health side. That’s something that we’ve been tracking for a while.”


Patients staying in nursing homes were also returning home more frequently in September 2021 than they were in July 2019.

Still, Hu believes nursing homes remain a critical part of the long-term care continuum.

“Even if we’re talking about a 14% increase, it’s still only about one person per month transitioning to the home, which is a testament to all the services these residents still need,” Hu said. “We’re not talking about short-term rehab patients, these are all patients that stayed at the nursing home for at least 100 days — or custodial residents.”


She said SNFs should look to build partnerships through the care continuum through vertical integration and by the diversification of their service lines. As the home becomes more of the preferred long-term destination for patients, SNFs ability to connect across the continuum to communicate transitions will be crucial moving forward.

“As we look to the future, think about ways to partner with providers across the continuum to facilitate those transitions. That’s certainly a part of it,” Hu said.

Similarly, on the other end, Hu said that when transitioning patients to home health services, SNFs need to find ways to better communicate with home health providers about when their patient visit will be.

“If it’s not going to be scheduled within 48 hours of discharge, then there’s a high chance that that patient who’s going to go home is going to bounce back into the hospital which is going to be your facility in terms of readmission rates,” she added.

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