Nursing Home Staffing Shortages Making it Harder for Hospitals to Discharge Elderly Patients: Report

Nursing home staffing shortages are making it harder for hospitals to discharge recovering patients, straining their patient capacity and services, according to new findings.

Since the COVID-19 pandemic emerged more than three years ago, there have been ongoing problems with nursing home understaffing, and facilities continue to struggle to maintain sufficient staffing levels to provide proper care to residence.

A 2022 report indicated three quarters of U.S. nursing homes may eventually close due to staffing shortages, and the problems are not only impacting existing residents at the facilities, but also hospitalized patients who are ready for discharge, but can not safely return to their home.

Hospital Referrals Increasing Amid Nursing Home Staffing Shortages

According to a recent report released by the software company CarePort Health, hospitals have referred nearly twice as many patients to nursing homes and home health agencies in early 2023, compared to earlier years. However, the referral rejection rates are also increasing amid continuing staffing shortages.

Researchers from the health tech company highlights how a lack of staffing at nursing homes has resulted in hospitals keeping patients longer, reducing their own capacity to take in patients in need of more intensive care.

Previous research has also warned that a nationwide lack of nursing home staff is placing elderly citizens who need long-term care at risk. Nursing home understaffing is often a factor in nursing home neglect lawsuits alleging facilities failed to provide adequate care to residents, leading to nursing home abuse, falls, bed sores and other injuries, including death.

In this new CarePort Health report, researchers examined their internal data on 2,000 hospitals and 130,000 post-hospital care providers, including nursing homes.

As of January 2023, the average number of hospital referrals to nursing homes or home health care increased by 118%, compared to monthly numbers dating back to 2019, the data indicates.

The researchers linked the increased number of referrals to an overall aging U.S. population suffering from more severe illnesses. These more numerous, and more severely ill, older patients require more intensive care after being discharged than in years before, they noted.

The data suggested that an overall rise in the senior population led to patients admitted to hospitals with more severe illnesses, thus requiring more intensive post-discharge care.

Nursing Homes Refusing New Patients

Researchers found that more than 61% of nursing homes restricted new admissions during January and February of 2023. In addition, home health agencies reported rejecting 76% of hospital referrals during that same time period.

The report indicates the restrictions and rejections are leaving hospitals to have to care for those patients until a spot opens up in a nursing home or in home health care. Since 2019, hospital stays have been about 12% longer for patients eventually discharged to a nursing home, they determined.

Longer hospital stays increase costs and lead to longer wait times for new patients, as well as reduce the overall capacity of the hospital, the report noted.

The researchers warned that nursing home staffing shortages are putting many hospitals over capacity, endangering patient care. To combat this, the health care industry needs to provide elderly patients with more long-term care options that do not rely on nursing homes, they recommended.

“Providers need to arrange more services post-discharge, such as physical therapy, behavioral health, and medication management,” the researchers concluded. “These factors can make it more challenging to manage care and ensure a safe and successful transition.”