Long-term care facilities are rejecting more hospital referrals and home-health agencies are not able to pick up the slack, causing patient flow problems, according to a self-funded report from a healthcare technology company.
WellSky’s 2023 “The Evolution of Care” report found that in the year since the company’s last report, referral volume to skilled nursing facilities has increased by 10%. The company attributes that and the accompanying rise in rejected patients to an increase in demand for care and the national staffing crisis hitting long-term and post-acute care facilities. But the analysis also found that rejection rates for home-health agencies were up to 76% in December 2022 from 54% in 2019.
“What’s unique here is having data available that comes from across the continuum — acute and post-acute providers — paints a truer picture of the patient experience,” Lissy Hu, president of connected networks at WellSky, said in an email to McKnight’s Long-Term Care News. “Our cross-continuum data shows the impact on important outcome trends like [length of stay], rejection rates, referral numbers, which are key to improving decision making going forward.”
The American Hospital Association, among others, also has noted that lengths of stay and discharge transitions to post-acute settings have been climbing, according to a Becker’s Hospital Review report Wednesday. It said that, as of December, patient hospital stays grew 19% over the last three years — a figure that soared to 24% when calculating for patients eventually headed to post-acute facilities.
At the same time as referrals and rejections are going up, patients are presenting as sicker. WellSky’s report found that patients are 6% more needy as far as acute-care needs at hospital discharge compared to 2019 averages. The report also noted that providers need to arrange for more post-acute care services, such as behavioral health, medication management and physical therapy. WellSky figures found that the average length of stay before patients were discharged from a hospital to a SNF increased 12% from 2019 to 2022.
“As patient acuity increases, nursing homes and SNFs are a critical piece of the continuum for patients needing to recover,” Hu said. “Not all patients can go home, and using data based on millions of patient trajectories across the continuum can help us understand which patients are appropriate for home versus facility.”
LeadingAge also referenced its statement from the May 18 hearing, and said it agreed with that the workforce crisis in the LTC sector “is very real” The association said it is “incredibly challenging” for nursing homes to have to wait months or years for follow up visits despite quickly correcting deficiencies cited in surveys.
“When the survey and certification process encounters delays, it makes resolving issues that much more challenging and impacts the timeliness and accuracy of the information reported,” an association spokeswoman said in an email to McKnight’s. “Change and improvement to the nursing home survey and inspection process is needed. We ardently believe it is time to forge a new path of collaboration between aging services providers, policymakers, regulators, and consumers that will create a more effective and efficient oversight process for our country’s nursing homes.”
