EFFECTS OF A FAST-TRACK CLOSING ON A NURSING FACILITY POPULATION

Sixty-nine patients in a nursing facility were subjected to sudden, fo rced relocation to other nursing facilities when the facility they wer e in failed to meet conditions for participation in the Medicaid progr am. A retrospective study was conducted to examine the effects one yea r after transfer. Comparisons between those returned following recerti fication of the facility and those not returned demonstrated dramatic differences; 65 percent of the first group suffered deterioration or d eath, compared with 19 percent of the second group. Other factors foun d to be associated with high death rates or worsening of condition one year later were being male, severe physical or mental impairment, and lack of social support. Findings verify that serious adverse effects occur when unprepared patients are suddenly relocated and suggest that return to the facility of origin can mitigate those effects. Implicat ions for policy and practice are discussed.