What is Post-Acute Care?
Acute care is medical terminology for the type of health care provided to a patient with a life threatening condition. The treatment often involves life support or other intensive care services. When a patient no longer requires intensive emotional, cognitive or medical treatment in a traditional hospital setting, but is not well enough to return home, the medial team may recommend transitioning the patient to a post-acute care facility.
Each year, three million hospital patients require post-acute care, according to U.S. Department of Health and Human Services figures. In some cases, post-acute care is provided only until the patient is well enough to go home. In other cases, the care is required for the remainder of the person’s life.
Some traditional hospitals have post-acute care or long-term care units in-house, or a patient may be transferred to an off-site skilled nursing facility. Patients who require longer care or a longer stay in the hospital usually receive long-term acute care. Returning home with the under the care of a home health nurse may also be an option. In any case, the type of care a patient receives involves assistance in performing daily routines, such as eating, personal grooming and dressing, monitoring the patient’s progress such as vital signs, and administering medications. Some patients require more specialized care, such as rehabilitation for wound care, voice therapy, head trauma, or recreational therapy, to name just a few.
Patients and their caregivers should be included in the decision to move to a new post-acute care site. It’s a big decision so how do you chose a facility that is right for the patient, where his or her needs are best served?
Finding the Right Post-Acute Care Facility
One consideration in choosing a new facility is if the hospital has a strategic partnership with the post-acute care facility? If so, the hospital has likely pre-screened the facility and knows its medical director and the quality of care the facility gives patients.
Important questions to ask are:
• What are the facility’s clinical transition measures?
• How many patient falls with injury does the facility have?
• What is the facility’s hospital readmission rate?
• What is the patient satisfaction rate for pain management? With their overall care?
• Are line-associated infections common at the facility?
• What percentage of pressure ulcers does the facility see?
• Does the care facility have available rehabilitation services on site?
• Can a patient transfer from the facility into home care if they desire?
A strategic partnership is more likely to mean better communication between the hospital and care facility, so essential clinical patient information gets to the post-acute provider. It is becoming more common these days for hospital staff to visit the post acute care facility onsite and participate in rounds for an added level of integration in patients’ care continuum.
While post-acute care is necessary for recovery and avoiding re-hospitalization for many patients is expensive. The average cost of a semi-private room in 2006 was $192 per day, according to the U.S. Dept. of Health and Human Services. Rules about Medicare and Medicaid coverage for this type of care are transitioning. Check the official Medicare website for the latest information at http://www.medicare.gov/longtermcare/static/home.asp
Helpguide.org has more information on post-acute care facilities at http://helpguide.org/elder/nursing_homes_skilled_nursing_facilities.htm
Medical Dictionary (accessed online at http://medical-dictionary.thefreedictionary.com/acute+care)
National Institute of Neurological Disorders and Stroke Rehabilitation Fact Sheet, accessed at: http://www.ninds.nih.gov/disorders/stroke/poststrokerehab.htm
U.S. Department of Health and Human Services figures via Agency for Healthcare Research and Quality, National Quality Measures Clearinghouse. Accessed at: http://www.qualitymeasures.ahrq.gov/content.aspx?id=8252
American Hospital Association. Trend Watch November 2010. Maximizing the Value of Post-acute Care. Accessible at http://www.aha.org/research/reports/tw/10nov-tw-postacute.pdf