title: Cardiac rehabilitation in skilled nursing facilities: a missed opportunity.
abstract: BACKGROUND
  After hospitalization for a cardiac event, older adults are frequently discharged to a skilled nursing facility (SNF) for postacute care. The American Association of Cardiopulmonary Rehabilitation recommends that cardiac care be integrated into procedures at SNFs.
  
  
  OBJECTIVE
  We undertook this research to describe the characteristics of patients in SNFs after a cardiac event and the cardiac care delivered at SNFs.
  
  
  METHODS
  A dual approach included (1) a retrospective medical record review of consecutive patients admitted to 2 hospital-based SNFs after a cardiac event (n = 80), and (2) surveys from healthcare professionals (n = 21) working in these facilities.
  
  
  RESULTS
  Thirty-two percent of patients were not candidates for cardiac rehabilitative interventions because they had been rehospitalized, discharged to long-term care facilities, or manifested contraindications to exercise. No standard assessment of exercise tolerance was evident, and although 70% of patients were discharged home, cardiac-specific discharge education was seldom evident. Healthcare professionals in SNFs reported that standard procedures for cardiac care services were lacking.
  
  
  CONCLUSIONS
  The integration of cardiac care into SNFs is important to ensure the safety of therapy and improve the transition of patients from SNFs to outpatient cardiac rehabilitation programs.
authors: Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106, USA. mary.dolansky@case.edu
authors: Mary A
authors: MA
authors: Dolansky
authors: Melissa D
authors: MD
authors: Zullo
authors: Salwa
authors: S
authors: Hassanein
authors: Julie T
authors: JT
authors: Schaefer
authors: Patrick
authors: P
authors: Murray
authors: Rebecca
authors: R
authors: Boxer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D009741:Nursing Staff, Hospital / Q000592:standards*; D010351:Patient Discharge / Q000639:trends; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States