Skilled Nursing Facilities and Post Acute Care

Abstract

The rapid growth in the number of the elderly has created an unprecedented challenge to the current health system. Taking care of the frail elderly continue to face significant barriers achieving the desired and optimal care. The elderly are most vulnerable for higher rate of complications in the post acute care of their illness either due to mental, physical or psychosocial impairments, requiring multiple interventions needed on many fronts. Skilled nursing facilities are an essential part of the post acute geriatric care.Post acute care (PAC) encompasses a wide range of health care services that share the goal of restoring recently hospitalized patients to the highest level of functioning possible. Patients can access PAC services in a wide range of settings, including skilled nursing facilities (SNFs), inpatient rehabilitation facilities, long-term care hospitals, and in their own homes, with services from home health agencies [1] In this brief review, we will focus on key elements in the skilled aspect of the post acute care as a merging factor in the long term nursing facilities. Keywords:Elderly; skilled nursing facilities; nursing home; post acute care; subacute service Aging PopulationThe health care needs for older Americans continue to be a challenge for health care providers as the number of frail elderly continues to rise. Between 2010 and 2050, the United States is projected to experience rapid growth in its older population. In 2050, the number of Americans aged 65 and older is projected to be 88.5 million, more than double its projected population of 40.2 million in 2010. The baby boomers are largely responsible for this increase in the older population, as they will begin crossing into this category in 2011 [2]. Each year, more than 10 million Medicare beneficiaries are discharged from acute care hospitals into postacute care (PAC ) settings , including inpatient rehabilitation facilities, skilled nursing facilities, and homes with services from home health agencies [1]. This demographic transition will create new challenges confronting every sector of the health care system. Increase Health CostHealth care costs have been rising for several years. Expenditures in the United States on health care surpassed $2.3 trillion. In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation's Gross Domestic Product (GDP); this is among the highest of all industrialized countries. Total health care expenditures grew at an annual rate of 4.4 percent in 2008, a slower rate than recent years, yet still outpacing inflation and the growth in national income [3]. It is a widely held belief that the cost of acute hospital care increases with age among older persons [4-6] However, experts agree that aging of the population contributes minimally to the overall high growth rate of health care spending [7]. Hospital spending represents approximately one third of total national health care cost [3]. Health Risks of Hospitalization in The ElderlyElderly individuals with...

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

“…Among Medicare patients, HBSNFs provide care to those who “need short-term” skilled nursing and/or rehabilitation services after a hospital stay of at least 3 days, are not well enough to go home, and need extended medical supervision or nursing services. 8 , 25 - 27 HBSNFs can serve as a potential mechanism for better coordination of patient care through improved access to physicians, nurses, therapists, and ancillary services (such as x-ray and laboratory exams), thereby facilitating the transition from acute to PAC, and ultimately into the community. 28…”