What are the best practices for optimizing transitions from hospital to skilled nursing facilities for older adult patients, with specific regard to adapting hospital medication regimens to the skilled nursing facility setting?

Medication errors and discrepancies are well known to lead to adverse drug events during transitions of care, as well as rehospitalization. The standard of care that has emerged over the last twenty years or so is rigorous medication reconciliation. Medication reconciliation is defined as comparing a list of the patient's inpatient medications and then reconciling them with their outpatient medications, checking them for accuracy, and documenting any changes.

That said, the devil is in the detail...

In addition to the answers already given, I like the 5 categories of errors presented in this article for thinking about transitions from hospital to SNF (Kuye et al., PMID 37783978).

Here is the summary from the article:

1. Medication reconciliation: Examples of errors within medication reconciliation included missing medications in the medication list, inappropriate or inaccurate end times, or conflicting information within the discharge summary text and medication list.
2. Post-hospitalization foll...

As a geriatrician/palliative care physician with experience in both inpatient and nursing home settings, I’d like to share a few practical considerations for medication transitions that are often overlooked during hospital discharge planning.

1. Understand Medicare Coverage: SAR vs. LTC

It’s crucial to distinguish between subacute rehabilitation (SAR) stays and long-term care (LTC) in nursing homes, as Medicare coverage differs significantly.

• During a SAR stay, Medicare Part A covers the cost o...