CMS Study Supports Onsite Acute Care in Nursing Facilities
Providing optimal health care for residents in nursing facilities has always been a priority. A recent Centers for Medicare and Medicaid Services (CMS) study examined the effectiveness of onsite treatment for various medical conditions in nursing facilities. The results highlighted the potential benefits of onsite care in nursing facilities and shed light on the importance of early assessment and treatment for residents.
The study compared care trajectories of nearly 17,000 episodes of onsite nursing facility treatment with 5,907 in-hospital treatment episodes focused on six medical conditions: congestive heart failure, chronic obstructive pulmonary disease, skin infection, dehydration, urinary tract infection and pneumonia.
The study revealed several positive outcomes associated with onsite treatment. Residents treated onsite had lower admission rates and mortality compared to those treated in the hospital. Specifically, only 14% of residents treated onsite were subsequently hospitalized; 8% died within 30 days. In contrast, residents treated in the hospital were more likely to then be admitted (26%) or to die (17%). These findings suggest that on-site treatment may not only be safe but also potentially beneficial for residents.
In addition to improved outcomes, the initiative led to enhancements in the quality of onsite assessments. Participating facilities implemented additional documentation and clinical pathway tools, resulting in more consistent follow-up tests and treatments. Moreover, nursing home staff received training and practice in administering intravenous antibiotics, which contributed to their skill development. The special focus on the six medical conditions and the added support and education provided during the initiative played a crucial role in enhancing staff capabilities.
Treating residents on-site not only improved outcomes but also supported continuity of care. Residents were able to remain in a stable, familiar environment, which is crucial for their well-being. The study also noted that onsite treatment could reduce the stress and anxiety associated with hospitalization, which can be particularly challenging for older adults. By providing care in a familiar setting, nursing facilities can enhance the overall quality of life for residents.