APPROPRIATE PLACEMENT OF NURSING-HOME RESIDENTS IN LOWER LEVELS OF CARE

Too often individuals with long-term-care needs are placed in nursing homes when they might well be better served at a lower level of care. The uneven distribution of residents across settings stems from intera cting factors of supply and demand: clinical need; lack of consensus a mong physicians about what constitutes the best setting for their pati ents; regulations restricting services in personal care homes. Three s ets of clinical criteria identify nursing-home residents according to their appropriateness for lower levels of care. Factors like cost and ability of the patient's family to make informed decisions affect plac ement as well. Policies for shifting patients to lower levels of care muse be carefully designed in order to save costs and ensure that qual ity of care is retained.