The Culture of Medical Information Gaps in Skilled Nursing Facilities

Milta O. Little’s article, “Climbing Out of the Black Hole of Subacute Care”, explores the existence of a medical information gap that is aptly comparable to a black hole in outer space: once a patient is moved out of a hospital and into a subacute care facility, their medical profile ceases to exist to the rest of the health care community. Subacute care is implemented for patients who need health care that can be provided on a long-term basis, and can apply to many medical conditions that require the patient to rely on 24-hour nursing care. As a result, many of the patients who disappear into this ‘black hole’ are the frail and elderly who are neither well enough to live independently at home nor ill enough to continue staying at a hospital.

Much of the information pertaining to a transitioning patient’s current condition is crucial in a nursing home’s ability to truly help the patient through a full recovery while maintaining good health. It is disparaging that vital information needed to fully understand a patient’s needs is often lost or disregarded during a patient’s transition from a hospital to subacute care. As a result, nursing homes often neglect to provide detailed care to patients that need special attention. The loss of that information usually results in the aggravation of a patient’s condition that could have easily been prevented in the first place. Vulnerable patients are also at high risk of reentering a hospital from the facility, thus creating an influx of residents who are constantly being transitioned from the facility to the hospital and back again. This is a situation that is often avoidable if subacute care facilities give the proper amount of attention to their patient’s medical information and employ properly trained nurses. Studies have also shown that constant transitioning between a hospital and a nursing facility is directly harmful to the patient’s health, as patients tend to become despondent. Errors are also more likely to occur as various health providers and care sites become involved in the process.

A large amount of the information loss can be attributed to a lack of communication that is perpetuated and encouraged by the current work environment of nursing facilities. The majority of people who feel that they or their loved ones have suffered from abuse or neglect within the nursing home environment complain that the facility and nurses withhold important information concerning the patient and simply do not communicate any problems or issues that the patient may currently be facing. This lack of communication is an indication of the low quality of care that exists in many nursing homes.

There are many health problems that occur within the nursing home environment that are preventable, given that the nurses and staff are adequately trained and the facility employs the proper amount of staff. When a nursing home is understaffed, a few preventable health issues will start to trend within the facility’s patients. Pressure ulcers, which are sores and bruises that occur on the skin if a patient is not adequately moved around, become a common occurrence, and infections are easily spread from patient to patient through improper handling and poor hygiene on the part of the nurses providing care. Both infections and pressure ulcers are easily preventable and are often signs of elderly neglect.


There should be more accountability on the part of skilled nursing facilities to ensure that unneeded hospital transitions and fatal errors stop playing a large role in the way that patients receive care and treatment. Missing medical information should be a rarity within the medical community, not an every day occurrence. If you believe that you or your loved ones may have suffered a preventable health issue due to a lack of proper care, please contact us for a free consultation regarding your situation.