Geriatric healthcare occurs at a variety of levels of care, some of which include skilled nursing facilities (SNF), assisted living facilities (ALF), personal care homes (PCH), and home and community based services (HBC). The COVID-19 pandemic highlighted many problems in long term care facilities. We sought to examine the impact of the COVID-19 pandemic on levels of long term geriatric care by examining the disposition of patients at the time of closure of a SNF in Pittsburgh, Pennsylvania at the end of 2020.
Charles Morris Nursing and Rehab (CMNRC) was a non-profit 93-bed NH affiliated with the Jewish Association on Aging. Like many SNFs, the long term financial problems with Medicaid payment were exacerbated by the pandemic. The decision to close was made in November 2020. At this time there were 56 long term residents, and Social Work assisted with disposition of these patients. The transition between levels of care was tracked.
71% of patients were female, and the average age was 87 years old. 63% were Medicaid, 23% were private pay, and 14% were Medicaid/Community Life. 43/56 (77%) were transitioned to the same level of care at other local SNFs. 5/56 (9%) were transitioned to ALFs. 4/56 (7%) were transitioned to PCHs. 4/56 (7%) were transitioned to HBCs.
At the close of CMNRC, not all patients were transitioned to the same level of long term care. Many of these transitions were impacted by restrictions and limitations due to the COVID-19 pandemic. 23% of patients were transitioned to a lower level of care. This may suggest that ALF, PCH, and home based services may serve as potential substitutes for patients who have greater financial resources and strong family support. The COVID-19 pandemic has provided an opportunity to re-evaluate the role of long term care for older adults.
All authors have stated there are no financial disclosures to be made that are pertinent to this abstract.
© 2022 Published by Elsevier Inc.