Nursing Home Guide Could Save U.S. Millions of Dollars

nursing home, nursing home guide, health care

This guide will serve as an essential tool to help nursing home residents and their family members engage in informed discussions on a number of important and challenging topics related to their care.

By gisele galoustian | 8/8/2017

Thinking “outside-the-box,” a researcher from the Christine E. Lynn College of Nursing at Florida Atlantic University has developed an innovative yet simple and inexpensive approach that could have a dramatic impact on health care cost savings, morbidity and quality of life for residents in nursing homes across the country.

Using a guide developed for nursing home residents and their families, FAU’s College of Nursing, Barry University in Miami Shores, and The Larkin Health System in Miami have joined forces to launch a pilot program in seven South Florida nursing homes for a much-needed initiative to help avoid unnecessary hospital readmissions.

Hospital readmissions cost the U.S. health care system up to $14 billion year, even though it is estimated that almost half of them can be avoided. While there are many quality improvement programs designed to reduce the number of potentially preventable hospitalizations of nursing home residents, they do not adequately address one of the most difficult to control reasons for these hospitalizations – a resident or family member insists on going to the hospital.

With the support of a $677,000 grant from The Patient Centered Outcomes Research Institute (PCORI), Ruth Tappen, Ed.D., R.N., FAAN, Christine E. Lynn Eminent Scholar in Nursing in FAU’s College of Nursing and her team developed a hospital transfer guide, “Go to the Hospital or Stay Here? A Decision Guide for Patients and Families.”

Prior to development of this guide, little attention was paid to the role residents and their families play in avoiding potentially preventable hospital transfers. Studies have shown that their insistence on going to the hospital accounts for as much as 15 to 18 percent of these admissions. Furthermore, it is commonplace that medical providers will not refuse to transfer the nursing home resident to the hospital if the resident or a family member insists.  

This guide provides residents and families with vital information to help them make informed decisions about whether or not a transfer to the hospital is necessary. Explaining the risks and benefits of treatment in long-term care versus transfer to the hospital, this guide was developed based on interviews with 271 residents, family members and care providers.

“This project will provide participating nursing homes with the opportunity to utilize a new evidence-based tool in the continuing effort to reduce unnecessary readmissions back to the hospital,” said David G. Wolf, Ph.D., associate professor of health services administration at Barry University and co-principal investigator of this project.   

The seven participating nursing homes are: Arch Plaza Rehabilitation and Nursing Center in North Miami; East Ridge Retirement Village at Cutler Bay; Hialeah Shores Nursing & Rehabilitation Center; The Rehabilitation Center at Hollywood Hills in Hollywood; Riverside Care Center in Miami; South Pointe Plaza Rehabilitation & Nursing Center in Miami Beach; and West Gables Healthcare Center in Miami. 

“We are honored to be part of this important collaboration with Florida Atlantic University and Barry University,” said Jack Michel, M.D., president of Larkin Health System. “This initiative is especially timely and has the potential to save our nation’s health care system billions of dollars annually in preventable hospital readmissions. Our collaboration will not only result in savings for unnecessary hospital readmissions but also in reducing morbidity and mortality associated with preventable medical errors associated with hospital admissions.” 

Grace Franco, coordinator, and Adrien Rivero, outreach coordinator director, both with the Larkin Health System, are coordinating this effort between the collaborating institutions and the seven nursing homes. 

“There are so many things that the general public does not understand about aging and long-term care. Unless you have been through a situation like this before with a loved one, navigating through the process is like a complex maze,” said Marlaine Smith, Ph.D., dean of FAU’s College of Nursing. “Whether we like it or not we are all going to have to address this reality at some point in our lives. This guide will serve as an essential tool to help nursing home residents and their family members engage in informed discussions on a number of important and challenging topics related to their care.”

The guide is copyrighted by FAU, but is available free at in English and Spanish, as well as Creole, French, Chinese and Tagalog (Filipino). Printed copies may be ordered from MED-PASS, Inc. at 800-438-8884 (item #: MP57-GD for the decision guide booklet and item #: MP57-BR for the trifold version).