Heart Failure and Skilled Nursing Facilities: Review of the Literature

Background: Almost one-fourth of older adults hospitalized with heart failure (HF) are discharged to skilled nursing facilities (SNFs). The purpose of this review was to evaluate knowledge about HF patients discharged to SNFs to provide a foundation for future studies. Methods and Results: A search was conducted of Medline, CINAHL, PubMed, and Google Scholar. Key words were heart failure, congestive heart failure, skilled care, skilled nursing care, skilled nursing facilities, nursing home, postacute care, postacute services, and subacute care. Publications (n = 37) were reviewed and categorized into case studies, editorials, clinical care, evaluation projects, and data-based publications. Of 29 data-based publications, 6 were focused on factors associated with hospital readmission from postacute settings, 3 on trends in hospitalizations, 12 on hospital discharge to postacute services, 5 on rehabilitation services in postacute settings, I on cost, and 2 on interventions. Patients discharged to SNFs were at high risk for mortality and multiple hospitalizations. No HF-specific care or guidelines were found at SNFs. Only 1 study evaluated quality of life at SNFs. Conclusions: Prospective studies are needed to evaluate the clinical condition of HF patients discharged to SNFs and the interventions they receive. (J Cardiac Fail 2012;18:854-871)