Post-Acute Care Use Made Big Shift Away From SNFs During the Pandemic

December 15, 2021

During the pandemic, there was a significant shift in post-acute care use, with fewer patients entering nursing homes. A new study in the December issue of JAMDA details how both hospital discharges to skilled nursing facilities (SNF) and SNF spending have dropped.

In Trends in Post-Acute Care Utilization During the COVID-19 Pandemic, the authors studied and summarized post-discharge use of the SNF and spending from January 2019 through October 2020. They found that the percentage of patients discharged from the hospital to home or inpatient rehabilitation did not change significantly during the pandemic. However, discharges to SNFs declined 5%.

While spending slowed in each setting during the study period, SNFs saw the biggest decline at 55%. This compares to a 41% drop in home health and a 32% dip in inpatient rehab spending. As a percentage of all post-acute care spending, expenditures for SNFs declined from 39% to 31%. At the same time, the percentage of post-acute care spending on home health and inpatient rehab both increased.

The authors observed that trends moving away from institutional post-acute care, especially nursing homes, started before COVID hit. They said, “With the pandemic, we documented an acceleration in these trends, particularly in SNFs, likely due to concerns about COVID-19 rates in nursing homes.”

These changes in post-acute care utilization, the authors concluded, “have important implications for patients, families, and caregivers.” They noted that while shifting post-discharge care to the home is often consistent with patient preferences, this may increase the burden on family members and other unpaid caregivers; and it may negatively affect the ability to provide sufficient care.

This study was conducted by researchers at Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA.

Get more information on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email




JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit for more information.

About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.