title: Transitions to and from nursing facilities.
abstract: Many nursing home transition barriers are manmade and avoidable. PPACA is encouraging improvement and reduced unnecessary hospitalizations through incentives and penalties. Providers are responding through a variety of internal and collaborative models. The resulting communication, technology, education, and emphasis can improve the quality of life for the people served.
authors.affiliation: Lutheran Services for the Aging, Lutheran Family Services in the Carolinas, Salisbury, NC 28145, USA. tgoins@lsanc.net
authors.forename: Ted W
authors.initials: TW
authors.lastname: Goins
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000639:trends; D004282:Documentation / Q000592:standards / Q000639:trends; D057286:Electronic Health Records / Q000592:standards / Q000639:trends; D006739:Hospital Administration / Q000592:standards* / Q000639:trends; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D033183:Interdisciplinary Communication; D007373:Interinstitutional Relations; D008508:Medication Errors / Q000517:prevention & control*; D009657:North Carolina; D009722:Nurse Practitioners / Q000458:organization & administration / Q000639:trends; D009735:Nursing Homes / Q000458:organization & administration* / Q000639:trends; D010359:Patient Readmission / Q000592:standards / Q000639:trends; D010360:Patient Transfer / Q000592:standards / Q000639:trends