Skilled Nursing Facility At Home Trial

University of Massachusetts, Worcester

Status: Enrolling

Conditions: Rehabilitation; Home Based Care; Skilled Nursing Facility

Treatments: Other: Sub-Acute Rehab at Home

Study type: Interventional

Funder types: Other

Identifiers

NCT06547645

STUDY00001862

Details and patient eligibility

About

Skilled Nursing Facility at Home is a multicenter randomized control trial that aims to evaluate a home-based model of providing post-acute care (PAC). We will enroll 650 hospitalized patients who require rehabilitation and/or skilled-nursing support upon discharge and randomly assign them to an intervention (home-based PAC) or control arm (facility-based PAC). Our design includes two different health systems in Massachusetts: Baystate Health and UMass Memorial Health. We will perform 1:1 randomization between the intervention and control arm using a permuted block design, with stratification by clinical site and payor group. The primary outcome of the trial will be the difference in hospital readmission and mortality rates from the time of enrollment to 30 days after enrollment. Secondary clinical, functional, and cost outcomes include length of stay in PAC, difference in health-related quality of life (HRQoL), and healthcare cost and utilization.

Enrollment: 650 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18 or older
• Admitted to an inpatient unit OR receiving home health and requiring an escalation to skilled-nursing facility care
• Require post-acute care in a skilled nursing facility based on the clinical inpatient team's assessment (or, if the participant is coming from home, based on the home health team's assessment)
• Pass the home readiness assessment
• Reside within Greater Worcester or Greater Springfield

Exclusion criteria

• Inability to return to a home residence where care can be provided
• Inability for patient or their proxy to provide informed consent for the study
• Requires long-term care
• Requires palliative or hospice care
• On active chemotherapy
• Post-transplant surgery
• Requires hemodialysis
• Requires radiation therapy
• Requires two-person assist or mechanical lift
• Expresses unwillingness to be randomized to SNF OR SNF at Home care
• Considered clinically inappropriate by SNF at Home clinical team

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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650 participants in 2 patient groups

Facility-based

No Intervention group

Description:

Facility based post acute care at a skilled nursing facility, as is the standard care model.

Home-based

Active Comparator group

Description:

Home-based Post-Acute Care

Treatment:

Other: Sub-Acute Rehab at Home