Older adults who were discharged to skilled nursing facilities after the pandemic received rehabilitation care comparable to the levels of care that were provided before the pandemic, according to research published in the JAMA Health Forum. This, despite a rise in patient acuity during the period.
Researchers said that despite exceptional challenges during the pandemic, SNFs provided post-acute rehabilitation with only a modest decline in intensity, suggesting that SNFs were largely able to adapt and provide post-acute care rehabilitation to older adults.
“During the pandemic we knew that fewer people went to skilled nursing facilities after hospitalizations, and it seemed like the ones that went were overall sicker, with more cognitive impairment and higher risk overall,” said researcher Sandra M. Shi. “This study helps to demonstrate that despite caring for a sicker population with scarce resources, SNFs were still largely able to provide post-acute rehabilitation for patients.”
Researchers studied 108,522 individuals in 776 skilled nursing facilities across the country. They found skilled nursing facilities saw patients with higher cognitive impairment and mortality rates during and after the pandemic, compared to pre-pandemic levels.
“Our goal was to characterize changes in rehabilitation services provided by SNFs during COVID-19”, said researcher Sarah Berry. “Rehabilitation services overall decreased, but only by about a half day on average.”
Researchers wrote that rehabilitation intensity declined modestly by roughly a half-day decrease in therapy, which is approximately a 10% reduction from pre-pandemic levels. Researchers said the finding may be partially explained by a large reduction in group therapy during the pandemic.
“Modest declines in rehabilitation intensity and community discharge during the pandemic were remarkable, as staffing levels decreased with higher turnover, leaving fewer staff present for a sicker patient population,” researchers wrote.
Although group therapy may be making a comeback in skilled nursing facilities, during the pandemic it was prohibited due to infection control protocols.