Effects of a fast-track closing on a nursing facility population

Sixty-nine patients in a nursing facility were subjected to sudden, forced relocation to other nursing facilities when the facility they were in failed to meet conditions for participation in the Medicaid program. A retrospective study was conducted to examine the effects one year after transfer. Comparisons between those returned following recertification of the facility and those not returned demonstrated dramatic differences; 65 percent of the first group suffered deterioration or death, compared with 19 percent of the second group. Other factors found to be associated with high death rates or worsening of condition one year later were being male, severe physical or mental impairment, and lack of social support. Findings verify that serious adverse effects occur when unprepared patients are suddenly relocated and suggest that return to the facility of origin can mitigate those effects. Implications for policy and practice are discussed.