Hospitals may want to be on the lookout for a drop in the number of patients discharged to skilled nursing facilities (SNFs) and a related increase in the number of patients discharged to home health care, a trend that has gained steam with the COVID-19 pandemic, a case management expert says.

It played out that way at Loma Linda University Health in California, said Paul Arias, assistant vice president of care coordination. He attributes the drop in SNF discharges and the rise in home health admissions to managed Medicare and Medicaid plans dragging their feet in authorizing SNF admissions. That keeps patients in hospital beds longer, which is undesirable for hospitals and patients, Arias said. The shift to home health also correlates to more readmissions, he said. “We believe managed Medicare and Medicaid plans are shifting patients to home health to save money, but it’s impacting patient outcomes because of an increase in readmission rates,” he said.