Making Smarter Decisions About Where to Recover After Hospitalization

Rising stress and confusion often means older adults and their families do not make the best decisions for post-hospitalization recovery, reports Kaiser Health News . A 2018 study from the Medicare Payment Advisory Commission (MedPAC) found nearly 84 percent of Medicare beneficiaries who go to a skilled nursing facility (SNF) following a hospital stay could have chosen a higher-rated provider within a 15-mile radius, while hospitals refer persons needing short-term rehabilitation to 34 SNFs on average. The MedPAC study noted where older adults go is important "because the quality of care varies widely among providers," which impacts how fully people recover, whether they suffer complications, and whether they go home or into a skilled care situation. University of Pennsylvania School of Nursing Professor Kathryn Bowles said definitive guidelines for physicians or discharge planners are lacking, but older adults who have difficulty walking or taking care of themselves, with complex medical conditions and complicated medication regimens, or who require close monitoring or are missing caregiver support, are often considered candidates for such care. Medicare will only cover short-term rehabilitation at SNFs if an older adult has had an inpatient hospital stay of at least three days, or if an older adult needs physical, occupational, or speech/language therapy at least five days a week or skilled nursing care seven days a week.