Nursing Homes & Facilities

Stakeholders, researchers, and policymakers have identified varying nursing home ownership structures and ownership transactions as potentially influencing the quality of care delivered to vulnerable residents.

It is well known that in the early weeks of the COVID-19 pandemic in the United States much of the devastation was concentrated in nursing homes. In addition to the staggering death toll, isolation and suffering from COVID-19 among nursing home residents, the pandemic introduced new challenges for nursing home staff and exacerbated ongoing challenges.

This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.

This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.

People can be discharged from nursing homes for many reasons. Discharges may be a positive outcome and at an individual’s choice. In other cases, discharges may be at the direction of the facility and against the will of the resident. There are strict rules about when involuntary facility-initiated discharges (FIDs) are allowed.

Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment (VBP) programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.

Opioid use was very common among the long-term care (LTC) residents in our sample. Perhaps reflecting their post-acute rehabilitative needs, discharged residents were more likely to have opioid use prior to LTC admission and at the beginning of the LTC stay.

Newly released CMS skilled nursing facilities (SNF) Change of Ownership data (CHOW) data allows for a better understanding of how the nursing home ownership financial structures are changing. A total of 3,258 SNFs have been sold since 2016. Roughly 3.5% of skilled nursing facilities are sold in the US each year since then.

Prescriptions dispensed for antipsychotics in nursing homes and assisted living facilities increased since the beginning of the pandemic, with 20.8 thousand dispensed in 2020 compared to 20.5 thousand in 2019. This represents a 1.5% increase in total prescriptions since the beginning of the pandemic despite lower resident census levels in long-term care facilities (LTCFs).

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