Background: Following a hospitalization, older adults, their caregivers, and clinicians caring for them face a complex decision regarding post-acute care (PAC). The purpose of PAC, delivered by a skilled nursing facility (SNF) or home health (HH), is to support the recovery of patients after hospital discharge. However, the transition to PAC is a vulnerable time […]

Background: The VA, like many health care systems, seeks to meet the needs of a rapidly growing older adult population. The transition from hospital to post-hospital care – particularly in older adults- is increasingly common, but unfortunately is high-risk and low-value. Further, 85% of older adults choosing a skilled nursing facility had a higher-quality facility […]