Reference no: EM133635768

Question: Admissions to long-term care facilities such as assisted living or skilled nursing facilities (SNF) require that certain criteria- associated with length of stay, methods of payment, the individual's health and support needs, level of ability, amongst others- be met.

An assisted living community is one designed to give older adults the choice of a healthy social environment with life-enriching activities in a stay-at-home setting; while skilled nursing facilities provide in-patient medical and rehabilitation services to its residents and are staffed with trained medical professionals, according to Senior Services of America (n.d.)

An estimated 1.4 million Americans are residents of the more than 16,000 nursing homes, national, and improving the process of transferring prospective residents from hospitals to SNFs has reportedly become a priority (Baughman et al, 2018.)

Baughman et al (2018) point out that these transfers are being further prioritized by readmission penalties, limited hospital capacity, and continued efforts to decrease patients' hospital length of stay rewarded by quality-of-care and cost incentives for safety and efficiency.

Eligibility for assisted living admission is reportedly based on the care requirement of a potential resident including minimal skilled nursing services, rehabilitation needs, daily assistance with tasks (bathing, eating, etc.,) and medication management needs (seniorservicesofamerica.com, n.d.)

Preadmission Screening and Resident Review (PASRR) assist in ensuring individuals needing long-term care are appropriately placed as part of a federal requirement (umgc.edu, n.d.)

According to Medicaid.gov (2021,) PASRR require that Medicaid-certified facilities evaluate all applicants for "serious mental illness (SMI) and for intellectual disability (ID,)" before offering applicants the most appropriate setting to meet their physical, health and other needs, as well as provide applicants with the services needed in the appropriate setting.

Decisions on home health admissions are significantly reliant on contributions from nurses who provide relevant information on such issues as their client/patient's frequency need for skilled nursing visits, hospitalization, etc., all of which affect patient outcomes (Sockolow et al, 2021.)

The clinical decision-making surrounding home health admissions consider documentation on such things as onset of visit, agency standards, and established patterns in the patient's care that could directly affect timely decision-making; cause delay in care, and impact payment or reimbursement (Sockolow et al, 2021.)

Whether seeking admission in a skilled nursing facility, an assisted living community, or remaining at home and receiving care through an agency, federal and state regulations on the ratio of patients to staff may also have a significant implication, and contribute to being wait-listed, in some instances, due to staff shortage and safety issues.