title: Heart Failure Among Older Adults in Skilled Nursing Facilities: More of a Dilemma Than Many Now Realize.
abstract: Post-acute care, encompassing long-term care hospitals, home health, inpatient rehabilitation, and skilled nursing facilities, is increasingly employed as an integral part of management for more complicated patients, particularly as hospitals seek to maintain costs and decrease length of stay. Skilled nursing facilities (SNFs) in particular are progressively utilized for patients with complex medical processes, including today's growing population of older hospitalized heart failure (HF) patients who pose a prominent challenge due to their high risks of mortality, 30-day readmissions, and substantial aggregate cost burden to the healthcare system. Publications to date have largely grouped post-hospitalized HF patients together when reporting demographic or outcome data, without differentiating those at SNFs from those at traditional nursing homes or other post-acute care settings. SNF patients suffer distinctive vulnerabilities and needs, and understanding these distinctions has implications for determining goals of care. In this review we evaluate HF patients referred to SNFs, and discuss the characteristics, outcomes, and management challenges associated with this particular population.
authors.affiliation: Division of Cardiology and the Cardiovascular Center, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA; Post-Acute Cardiology Care, LLC, Wellesley, MA 02481, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Orr
authors.affiliation: Section of Geriatric Cardiology, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Suite 500, Pittsburgh, PA 15213, USA; Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Forman
authors.affiliation: Department of Medical Sciences, Division of Internal Medicine and Angiology, Catholic University of Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Matteis
authors.affiliation: Department of Medical Sciences, Division of Internal Medicine and Angiology, Catholic University of Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gambassi
keywords: Heart failure; Long-term care; Nursing home; Post-acute care; Skilled nursing facility