Higher Proportion of COVID-19 Patients Discharged to Hospice, SNFs

More patients suffering from the COVID-19 virus have been discharged from the hospital to hospice or skilled nursing facilities this year compared to typical Medicare fee-for-service patients.

A report from the data analytics firm HealthPivots compared hospital discharge numbers from the U.S. Centers for Medicare & Medicaid Services (CMS) using inpatient claims information. Researchers examined COVID-19 discharge data against overall patient mortality as well as those from two principal diagnosis groups: circulatory and respiratory.

“Compared to the circulatory and respiratory diagnosis groups, a higher portion of inpatients with a COVID-19 diagnosis were discharged, live, directly to skilled nursing facilities (SNF) or hospice, while a lower portion were discharged to home or home health,” the report indicated. “These data indicate COVID-19 inpatients were discharged to advanced care (SNF) and hospice more often compared to an average Medicare FFS live discharge.”

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Inpatient mortality for all Medicare fee-for-service in patient discharges reached 3% in 2019. Specifically for those with respiratory or circulatory conditions mortality was 3.7% and 3.3% respectively.

Thus far in 2020, inpatient mortality among COVID-19 patients was more than nine times the rate for all inpatients. Close to 30% of those patients were discharged to skilled nursing facilities, compared to 19.9% of all live discharges.

About 7.4% were discharged to hospice, compared to 3.3% of all live discharges, 3.1% for patients with circulatory conditions and 4.2% of those with a respiratory illness.

Overall, 37.5% of COVID patients were discharged to their homes, compared to nearly 47% of all patients discharged alive from a hospital.

“The findings on SNF and hospice are consistent with the other data released by CMS showing that COVID-19 inpatients were older and had high prevalence of chronic conditions,” according to the report. “Pre-existing health conditions, advanced age, the effects of COVID-19, and outbreaks in nursing homes are all likely to contribute to these differences. The specific challenges of care for COVID-19 patients, such as [personal protective equipment] shortages, quarantine requirements, and increased demand for some services may also play an important role.”

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