Elders who need nursing homes or assisted living facilities are only given a list of the available facilities, and nothing else.

Patients in U.S. hospitals who need to be transferred to a nursing home are often left to choose a facility without the benefit of important information, suggests a new study.

In many cases, patients only receive lists of nearby facilities, without comprehensive and publicly available information about their quality, researchers found.

“They’re pretty much just given a list of the skilled nursing facilities in the city and expected to pick among them on their own without information about where they could even get that information,” said lead author Denise Tyler, a senior researcher at RTI International in Waltham, Massachusetts.

Tyler and colleagues interviewed 138 staff members at 16 hospitals and 25 skilled nursing facilities in eight states in 2015. They also interviewed 98 patients at 14 skilled nursing facilities. All patients were on Medicare, which is the publicly funded health insurance program for older or disabled people.

While the interviews were spread across several states, the patients provided “strikingly similar comments,” according to the researchers. Patients had received a list of nearby nursing facilities, but not much else.

Only four patients reported receiving any information about nursing facilities’ quality or where to find that information.

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Interviews with staff supported the patients’ reports, the research team wrote in Health Affairs.
Hospitals cited legal restrictions and an emphasis on patient choice as the reasons why they could not supply patients with additional data about nursing facilities.

Tyler said hospitals were taking an “extreme view” of the law protecting patient choice.
“Our take on it is that it’s still possible to provide people with choice, but wouldn’t it be great if they could make an informed choice on information that currently exists?” she added.

Much of that information can be found on Nursing Home Compare, which is run by the U.S. Centers for Medicare and Medicaid Services. The site has detailed information about every Medicare- and Medicaid-certified nursing home in the country, including the facility’s rating, health inspections, staffing and quality measures.

In addition to helping patients make an informed choice about their care, providing more information about nursing home quality is in the hospital’s interest, too, Tyler said.

For example, she noted, payments to the hospital from Medicare are tied to the proportion of patients who return to the hospital after discharge and are readmitted.

Providing the added information to those selecting a nursing facility seems like a “win-win” for both patients and hospitals, said Tyler.

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SOURCE: Health Affairs, online August 7, 2017.