Study Finds That Hospitalization of the Elderly Followed by Discharge to a Skilled Nursing Facility Increases the Risk of Institutionalization in Long-Term Care

Relevant factors that generally lead to placement of elders into nursing homes or long-term care are advanced age, cognitive dysfunctions, and physical disability. The role of acute care hospitalization is little known but also a significant risk factor for long-term institutionalization of elders.

According to a recent study published in the Journal of Gerontology: MEDICAL SCIENCES in August 2011, titled “Risk of Continued Institutionalization after Hospitalization in Older Adults,” three quarters of new nursing home placements were preceded, and presumably precipitated, by a hospitalization with discharge to a skilled nursing facility (SNF). The analysis of national Medicare data from 1995 to 2008 showed that hospitalized patients for acute illness were almost 10 times more likely to reside in a nursing home 6 months later compared to non-hospitalized control patients. The patients who were transferred home were also less likely to be institutionalized in long-term care than those who were transferred to a SNF on hospital discharge.

Based on the results of this study, the article concludes that “an appropriate time to initiate programs to prevent long-term institutionalization is at hospitalization,” and that “[a]nother point for potential intervention is during an SNF stay, which now occurs in almost two thirds of all patients who go into long-term care after hospitalization.” Therefore, efforts for reductions in institutionalization of the elderly in long-term care should focus on elder patients undergoing this transition from hospitalization to subsequent placement into a SNF.

Due to such link between hospitalization and long-term institutionalization, finding the right SNF is particularly important for elder patients’ well-being. Many factors, especially nursing staff levels, can affect the quality of care and the risk of nursing home injuries. Thus patients and family members should carefully compare and choose a SNF that is in compliance with federal and state regulations and laws and provides high quality skilled nursing services.

Of course, a preferable option, if possible, would be home care with the services of a Home Health Agency. This is often a sacrifice for the family who agrees to take in a loved one who needs 24 hour skilled nursing care. The benefit, however, is that the patient is under close family supervision, in a home environment, which can substantially benefit the patient psychologically. This is not to say that all Home Health Agencies are perfect, and you should study their background carefully as well to ensure their compliance history with state and federal. However, given the alarming rate of elder abuse and neglect in California nursing homes, a home health agency is worth looking into.


If your loved one has suffered any of nursing home injuries in Alameda County, San Leandro, Hayward, Richmond, or Pleasanton, California, or if you believe a nursing home failed to provide adequate care to prevent or treat pressure ulcers (bedsores) or infections, please contact us today so that we can help protect your loved one’s best interests and hold the responsible parties accountable.