Skilled Nursing Facilities Struggle with High Referral Rejection Rates Due to Staffing Shortages

The COVID-19 pandemic has caused a significant impact on the healthcare industry, especially skilled nursing facilities (SNFs) and home health agencies. Although many SNFs have looked to rebuild hospital referrals as a way to recover from the loss of census during the pandemic, referral rejection rates have now hit a two-year high due to staffing shortages.

According to an analysis by Careport, a WellSky company, there is high demand for post-acute services, but finding the staff to supply it has become the biggest challenge. The data revealed that in January 2022, referral rejections reached 65% in SNFs and 58% in home health, the highest levels since early in the pandemic.

Staffing Shortages Cause High Referral Rejection Rates

The CEO of Burgess Square Healthcare and Rehabilitation Centre, John Vrba, believes that the high rejection rates for SNFs are due to staffing shortages. The sector has lost approximately 400,000 caregivers since the beginning of the pandemic, resulting in workforce levels hitting a 15-year low. More than half of nursing homes have limited new admissions, and hospitals have been overwhelmed with Omicron surges.

Moreover, long-term care facilities have limited their new admissions since the COVID-19 pandemic began. As a result, finding nursing home beds to send patients to continues to hold up the care continuum. Even when patient referral volume to SNFs reached within 3% of pre-COVID numbers, finding enough caregivers to accommodate those patients was a challenge.

High Demand for Post-Acute Care Soars

The data reveals that overall demand for post-acute care is high right now, with SNFs experiencing a surge in demand for post-acute care services. Although the labor shortage exists across other healthcare settings, the challenge is most pronounced for the long-term care industry.

The staffing shortage problem creates a significant challenge from a safety perspective. The average total resident census rebounded to 1.13 million in Q3 2021, up 2.5% from the previous quarter and 5.5% since Q1 2021, while staffing levels dropped nearly 8%. It has also resulted in a longer hospital length of stay, with patients staying in hospitals for longer periods before being discharged to SNFs.

Conclusion

Skilled nursing facilities and home health agencies have faced significant challenges during the COVID-19 pandemic. While rebuilding hospital referrals is one way SNFs have looked to recover census loss, staffing shortages have led to high referral rejection rates. The high demand for post-acute care services further highlights the need for adequate staffing in the long-term care industry.