Patient management in the subacute unit

Social and economic forces have driven the health care industry to devise new venues and models of care for the growing number and medical complexity of elderly patients. One such venue is the subacute unit in skilled nursing facilities, which was designed to provide comprehensive, interdisciplinary, and skilled nursing, medical, and rehabilitative care to the elderly patient with potential for return to his or her previous level of function. The challenges in these units are to prevent iatrogenic consequences and prolonged, expensive stays for the patient. Gerontologic nurse practitioners with their advanced clinical skills and knowledge of geriatric primary care are uniquely suited to meet these challenges. This article describes the process of care in the subacute unit and the role of the nurse practitioner to lead the interdisciplinary team in achieving effective and timely outcomes for this fragile population.