Factors in the admission decision: skilled nursing facilities in New York State

Little is known about the policies, practices, or procedures that affect the selection of applicants for nursing home admission. Results of a study of skilled nursing facilities (SNFs) in the state of New York revealed that fewer than 5% of the respondents viewed their goal as merely keeping patients comfortable; about half of the facilities reported their goal as preventing further decline. More than 70% of the respondents stated that skilled nursing beds were in short supply in the area served by their facility, while 91% of the respondents reported that their geographic area had a backlog of patients in acute care hospitals awaiting placement in SNFs. The authors discuss the study results in terms of the respondents' type of facility--public, proprietary, or voluntary. They also discuss admissions personnel, multidisciplinary teams, information collection, family involvement, and other factors that influence admission (eg, philosophy of care). The authors conclude that further research is needed to help coordinate the medical and social needs of patients and their families with the administrative needs of the facility.