Hospitals have incentives to ensure patients seek high-quality post-acute care, and quality data exist for skilled nursing facilities (SNFs). But new research finds those same hospitals typically fail to provide that quality information to patients when the time comes for them to choose a facility.
Only four of the 98 patients at 14 skilled nursing facilities interviewed for the study reported that they received guidance from the discharging hospital regarding the quality of nearby skilled nursing facilities, according to a study in Health Affairs.
“They’re pretty much just given a list of the skilled nursing facilities in the city and expected to pick among them on their own without information about where they could even get that information,” the study’s lead author, Denise Tyler, a senior researcher at RTI International in Waltham, Massachusetts, told Reuters Health.
Given that hospitals face pressure to reduce readmission rates, one might expect staff members to steer patients toward higher quality facilities. But hospital staff members believe any guidance they provide patients beyond a list of nearby facilities could unduly influence their choices, according to the study. In other words, patients wind up getting less guidance than is readily available to make a decision, all in the name of greater patient choice.
The authors point out that while federal law is clear on patients’ rights to choose their own providers, “nothing in these statutes precludes hospitals from helping patients make an informed choice.” They also highlight the fact that guidelines from the Centers for Medicare and Medicaid Services include explicit permission to direct patients to the Nursing Home Compare website, which provides quality data.
While the efficacy of penalizing hospitals for readmission rates has come under fire lately, the study notes that hospitals should have other incentives to provide quality data to patients. In fact, some hospitals have formed provider networks with nursing facilities, but researchers saw no evidence they made any effort to steer their patients toward facilities in those networks.
Moreover, patients are frustrated with the lack of information, a situation the authors believe is untenable. “A system based on quality reporting and competition for patients cannot succeed if patients do not have the data necessary to make an informed choice,” they write.