Staff Perceptions of Involuntary Nursing Home Closure and Relocation Processes

Primary author: Raven Weaver
Co-author(s): Karen Roberto; Nancy Brossoie; Pamela Teaster

Primary college/unit: Agricultural, Human and Natural Resource Sciences
Campus: Pullman

Abstract:

Involuntary nursing home closures occur infrequently, but when they occur, they impact residents, their family members, and facility staff. Residents’ care needs are of primary concern, yet few studies have examined the centrality of and relationship between actions of staff to residents’ relocation adjustment. We interviewed 18 administrators and 44 staff working at 27 facilities to explore the relocation process for residents from two facilities that lost Medicaid certification because of low quality performance. Our research questions were: 1) What are the issues and challenges faced by facilities who accepted residents from decertified facilities? 2) How did relocation affect the lives of residents and their families? Using content analysis, we identified challenges that hindered relocation and affected resident/family experiences. Receiving facility staff perceived undue distress and hardship on residents/families because of inadequate notification about the situation. Limited, untimely, and poor communication led to residents being unprepared for moving. The efficiency and effectiveness of the resident discharge process was also viewed as unacceptable. Minimal documentation in residents’ charts hampered coordinating resident moves. Receiving facility staff offered recommendations for decertified facilities and receiving facilities to improve the relocation experience, including the need for open communication, thoughtful and early engagement in the process, and transparent and timely interactions. Findings suggest that resident-centered policies are needed to improve the involuntary relocation process and give voice to remaining/receiving staff, both integral to residents’ support system. We offer evidence-based recommendations for policy and practice to improve processes to ensure the well-being of residents facing involuntary relocations.