In a 2004 report in which the OIG presented the findings of its analysis of consecutive stays that included at least one inpatient stay and one skilled nursing facility stay that year, it developed several recommendations. One of these was a call for greater involvement by Quality Improvement Organizations (QIOs) in transitioning Medicare beneficiaries between inpatient and skilled nursing facilities (SNF). To this end, the National Transitions of Care Coalition (NTOCC) was formed to bring together thought leaders and health care providers from various care settings to address improving the quality of care coordination and communication when patients are transferred from one level of care to another. In addition to being a member of this Coalition, AMDA members have identified issues with transitions of care over the past decade, prompting work on the 3-day requirement, the development of a universal transfer form and cooperation through the AMA. This panel includes perspectives held by the various stakeholders in the complexities of transitions in care. A dialogue between panelists and the audience will reveal the positions and proposed initiatives targeting this important issue.
Chair Department of Geriatrics,
Florida State University, College of Medicine