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At least 19 recordsLinked to original sources
PubMed2000

The future of subacute care.

Subacute care is a program of care for individuals with recent or current illness or injury. Currently, the services received by patients in subacute care vary considerably among sites, partly because these sites may specialize in certain treatments and partly because providers often define subacute care according to their own areas of expertise. Certain approaches to patient care, however, are universal regardless of diagnosis, and care that is given should be based on essential geriatric principles. In setting a standard for care in the subacute care setting, certain parameters must be clarified, including (1) defining subacute care, including what it is and what it is not; (2) selecting the right patient to receive subacute care; (3) making sure that care is centered on patients rather than sites or providers; and (4) ensuring that care is reimbursed adequately and appropriately. These issues are addressed, and guidelines on how to accomplish the goal of standardizing subacute care are provided.

Acute Disease↗
PubMed1995

Getting started with subacute care.

Subacute care programs serve patients who require less intensive care than traditional acute care, but more intensive care than traditional nursing home care. For hospitals, skilled nursing facilities, and other facilities, subacute care programs may be a means to better serve patients along the continuum of care while cutting costs and enhancing payment. Before launching a subacute care program, healthcare executives must determine potential benefits; payment mechanisms; equipment, space, and staffing requirements; and financial risks. With this knowledge, executives can make an informed decision about whether to develop a subacute care program.

Aged↗
PubMed1998

Nutrition support for patients in long-term acute care and subacute care facilities.

Long-term acute care and subacute care facilities (also transitional care facilities) have evolved from the need to decrease costs associated with acute care in the hospital. As the length of stay in many medical centers has been reduced, patients are admitted to transitional care facilities to continue recovery and rehabilitation. Rehabilitation and recovery can be enhanced with the provision of optimal medical nutrition therapy. Nutrition screening is essential in identifying patients who are at risk of malnutrition or are malnourished. Nutrition assessment verifies the risk or presence of malnutrition followed by the development, implementation, and monitoring of nutrition intervention. Nutrition screening and intervention promote recovery from illness, minimize morbidity and mortality, and enhance quality of life. The goals of nutrition support are to prevent starvation-associated malnutrition, preserve lean tissue mass, support metabolic functions, and improve clinical outcomes. Oral nutrition is the preferred method of nourishment; however, specialized nutrition support is considered for patients unable to meet their nutrient requirements adequately. Enteral nutrition support is recommended when providing nutrition support however, parenteral nutrition support is used when the gastrointestinal tract can not be safely used. With appropriate intention, administration, and monitoring, nutrition support can be safely administered.

Acute Disease↗
PubMed1996

Accreditation, managed care and subacute care.

Accreditation promotes continuous quality improvement of systems that affects the quality of patient care delivered, attains desirable clinical and financial outcomes and strategically positions the subacute care provider in the rapidly changing health care delivery system. Thus, as consumers and purchasers of health care plans continue to demand quality care with the best possible outcomes at significant cost savings, accreditation may become the panacea of the future.

Accreditation↗
PubMed1993

New directions in long term care. The emergence of subacute care.

Health care providers are entering an era of change. While the national system of health care delivery undergoes radical reform, the demographics of the American public are changing. So are their care needs. In the wake of these changes, long term care providers are reassessing their role in the care continuum and carving out new niches to fill the diverse needs of the people they serve. Explains Paul Willging, executive vice president of the American Health Care Association (AHCA), "To solve the health care crisis and to curb spiraling health care costs, providers must participate more fully in the continuum--from providing less sophisticated to heavy skilled care." Subacute care and assisted living, relative newcomers to long term care, are likely to become mainstays of the continuum for frail and elderly Americans.

Activities of Daily Living↗
PubMed1996

The phases of managed care: where does subacute care fit?

There are four phases of development in managed care based on their degree of market penetration: Phase I = up to 10%; Phase II = 11% to 30%; Phase III = 31% to 50%; and Phase IV = 50%+ of the market. Negotiation strategies vary according to the phase the market is in.

Continuity of Patient Care↗
PubMedDate not supplied

Outcomes system implementation for subacute care.

The emergence of subacute care, seen as a cost-effective alternative to other, more expensive settings, is an important option for case managers. The current, rapid growth of subacute care, the diversity of subacute programs, the differences in patient types, and the lack of consistent standards to define subacute care illustrate the critical need for the case manager's role in balancing quality and cost. The lack of solid clinical outcomes data for patients treated in subacute care make it difficult for case managers to assess quality. Outcomes data, as a measurable dimension of quality, may include clinical effectiveness measures, associated costs, and patient/family satisfaction. Outcomes data can be used as a tool by the case manager to facilitate the coordination of patient care. Although there is an increased consumer interest in outcomes across all health care modalities, there is limited outcomes research available to document the efficacy of subacute care. As the pressure increases for outcomes data on subacute care by consumers and payers, efforts toward facility implementation of outcomes systems to assess subacute care are growing. The unique challenges to outcomes implementation in a skilled nursing facility-based setting are discussed, and strategies for successful implementation are presented. Basic subacute outcomes implementation issues of organizational support, staff participation, and data collection are reviewed. Ideas for case management involvement with facility implementation are discussed.

Case Management↗
PubMed1997

Business strategies in subacute care.

To increase market share in a managed care environment, subacute care providers must confront several issues: business strategies, information technology and human resource management. The backbone of the subacute care facility is its human resources, its link to the world is information technology and its foundation is the business plan.

Commerce↗
PubMed2000

The Life Care Center of St. Louis experience with subacute care.

The Life Care Center of St. Louis is a 100-bed, freestanding, subacute care facility. The major differences between subacute care facilities and nursing homes are described. The problems associated with dealing with medically complex conditions in a subacute care facility are stressed. The center's approach to rehabilitation is reviewed in detail. The utility of the Functional Independence Measure in subacute care settings is discussed. Common conditions seen in subacute care facilities are briefly reviewed.

Activities of Daily Living↗
PubMedDate not supplied

Developing clinical program guidelines for subacute care.

Providers of subacute care are now faced with the reality of demonstrating their claims that they offer cost-effective programs. Developing internal standards or guidelines from an organizational and clinical perspective can help to assure and validate quality service delivery.

Cost-Benefit Analysis↗
PubMed1995

Is subacute care feasible?

As healthcare executives attempt to control costs and enhance revenue in an increasingly competitive market, many are considering converting acute care units into subacute care units (Medicare-certified skilled nursing units). Such a conversion can help control costs by providing care in a less expensive setting that is appropriate for patients who require less intensive care than traditional acute care. In addition, converting an acute care unit into a subacute care unit can optimize reimbursement for Medicare patients. A detailed feasibility analysis that addresses clinical, regulatory, space, and financial considerations should be conducted before healthcare executives decide to convert acute care beds into subacute care beds. Only after a feasibility analysis is performed can healthcare executives determine whether creating a subacute care unit is a realistic, beneficial option.

Bed Conversion↗
PubMed1995

Managing financial pressures with subacute care.

Many healthcare organizations have found that converting acute care beds to subacute care beds has enabled them to control costs, enhance payments, and better serve patients along the full continuum of care. Conversion to subacute care, however, requires careful planning and sufficient resources. Healthcare executives contemplating converting an acute care unit to a subacute care unit must determine the cost of conversion, the types of services to be offered, licensing requirements, the types of patients to be served, and reimbursement implications.

Bed Conversion↗
PubMed1996

JCAHO accreditation: a challenge for subacute care providers.

Clearly, subacute care providers who are JCAHO accredited have a competitive edge over those who are not. As Medicare and Medicaid continue to shift to managed care plans and as employers' groups become more familiar with subacute care providers, those that can get accredited within 2 years will be in an excellent position to capture a large share of the market. The challenge, then, is how to prepare for a successful accreditation process.

Accreditation↗
PubMed1994

Unleashing the potential of subacute care.

The emergence of subacute care as a legitimate setting for certain patients is attracting the attention of payers and providers in local delivery systems. The author suggests that incorporating subacute care within the continuum of services can have specific and immediate payoffs for payers and providers alike. The article explores alternative ways in which hospitals can provide subacute care and proposes an approach that involves the formation of a hospital subacute care organization with a long-term care provider.

Cost-Benefit Analysis↗
PubMed1996

The changing marketplace: are subacute care providers ready?

In 1995, subacute care providers focused much attention on program development, marketing, managed care contracting and outcomes measurements. As the move to balance the federal budget continues to occupy center stage in the health care arena, subacute care providers need to rapidly shift gears and develop a blueprint for managing the changing marketplace. Without such a blueprint, subacute care providers may find themselves struggling for survival in the years ahead, instead of strategically positioned to remain competitive.

Health Facility Merger↗