Case management in a COVID-19 surge: A single-institution study of disposition and access to post-acute care

Patients hospitalized with coronavirus disease 2019 (COVID-19) have demonstrated significant care needs after discharge, particularly among older adults and those with preadmission frailty.1 Characteristics and outcomes of patients hospitalized with COVID-19 have been well described,2 but few studies have examined patterns in post-acute care (PAC) utilization over the course of a COVID-19 surge.3 Evaluating these trends may inform planning for future surges.

During the initial COVID-19 surge, PAC facilities and resources were limited due to lack of personal protective equipment, internal COVID-19 outbreaks, and staffing shortages. To address these shortages in Boston, Massachusetts, PAC sites for patients with COVID-19 were created, including Boston Hope Field Hospital4 and dedicated units at skilled nursing facilities (SNFs) in the community.5 We describe patterns in PAC utilization, including placement in PAC facilities (SNFs, long-term acute care [LTAC], and inpatient rehabilitation [IRF]) and referral to home health agencies (HHAs) among patients aged 50 years or older with COVID-19 at a tertiary care, 1043-bed, hospital in Massachusetts...