Residency numbers continue to decline in skilled nursing, with recent reports citing occupancy as low as 81.7 percent. Operators who want to thrive in this market are having to rethink their approach to virtually all aspects of their operation and innovate to create opportunities. One often overlooked area that can be instrumental in differentiating facilities is their approach to medication management at discharge.
Nonadherence to medications can exacerbate medical conditions or result in adverse events that can lead to hospitalizations. That’s why medication adherence following discharge from a facility is critical to achieving optimal clinical outcomes. But it can often be challenging for the elderly to comply, especially when they have experienced a change in their health that necessitated skilled nursing care and new drugs that mean a change in their home medicines. Their new regimen can prove difficult to remember, and the consequences of a lapse can be extreme, even resulting in hospitalizations. In fact, a recent study from APhA found that 26% of potentially preventable readmissions were medication-related, with the leading cause nonadherence.
To help with compliance, the skilled nursing facility can make it part of their process to provide outgoing residents with a supply of their medications that will get them through up to the first 30 days at home, either by taking what remains in the cart or ensuring a sufficient quantity is filled before they leave. This simple step can eliminate the chance that a resident will fail to fill one or more new prescriptions, a common problem for many going home since, at discharge, there’s a lot to consider.
Changes in their lives like equipment, routine, or caregivers can be so overwhelming when residents return to their residences that they neglect to fill their prescriptions. Or they don’t believe they need a medication after discharge and opt not to pick it up. For some, the lack of easy access to a pharmacy, particularly in rural areas, can be enough of a barrier to delay or even prevent some residents from getting necessary drugs. Even those who stop at the pharmacy may face factors beyond their control, such as poor stock management at the site that block them from getting the medications they need.
Whatever the reason, studies show that nearly a third of patients fail to fill first-time prescriptions.
In addition to providing a supply of medications, another action facilities can take to improve adherence is to place a follow-up phone call within the first month after discharge. This effort can be crucial since approximately 50 percent of medications are not taken at the appropriate time, frequency, dose, or duration. While some simple and inexpensive interventions to improve medication adherence post-discharge are common, such as the use of a pillbox or chart that can help remind patients it’s time to take their pills correctly, personal outreach has been deemed particularly effective.
During a call, the skilled nursing pharmacies or facilities can ask about the resident’s medication use to determine if any issues are preventing compliance. Sometimes even telling the residents before discharge that they’ll be contacted and asked about their experiences with their medications can be enough indirect pressure to help boost adherence. Callers should also ask the residents whether they’ve scheduled a visit with their primary care physician, who will monitor their medication use and side effects and make any adjustments to their regimens for the best outcomes.
With regulations and payment systems penalizing poor rehospitalization rates, better-than-expected numbers can generate a reputation that elevates a facility’s competitive position in the market. As hospitals increasingly create formal networks of high-quality facilities, they will seek out these select partners who meet their standards and provide services to help reduce avoidable hospitalizations.
When working with hospital discharge teams, a facility can share how its specialized care offerings, like a comprehensive discharge planning process that helps ensure residents take medications appropriately, can lower their risks. With these types of programs, facilities can set themselves apart and increase referrals that can be converted into admissions.
In the battle for occupancy, services like DischargeRx can improve medication management at discharge to help you meet your census goals. Contact PharMerica at firstname.lastname@example.org or 800-564-1640 to learn more.