Postacute Care: Case Study, Strategies, and Tools

​A case study in the December 2013 edition of the Agency for Healthcare Research and Quality’s (AHRQ) online case study review, WebM&M, “highlights the pressure on SNFs skilled nursing facilities to manage sicker patients,” states a commentary on the case. On admission to a SNF after a long hospitalization for small-bowel obstruction, acute kidney failure, and deep-vein thrombosis, the 88-year-old patient was on 14 medications and had mild delirium. SNF staff felt that the patient needed a higher level of care but were told that the patient “didn’t meet inpatient criteria any longer.” The SNF physician saw the patient on her first day, communicating with the nursing staff by phone thereafter. Staff continued to voice concerns because she could not take all her medications, and the family was concerned as well.