Hospitals expect backlog of patients awaiting transfers to other treatment will worsen this winter

The hefty backlog of patients waiting to be discharged from hospitals and transferred to other treatment settings is expected to grow this winter, health leaders warned Monday.

About 750 patients were stuck in acute or post-acute care hospitals on any given day in November as they waited to receive additional care at skilled nursing or rehabilitation facilities, as well as from home health agencies, according to the latest report from the Massachusetts Health and Hospital Association.

Just over 200 patients waited 30 days or longer to be discharged to a skilled nursing facility, the association said.

"Based on data trends, the backups are expected to worsen in the coming months," the group added in its weekly newsletter. "The December 2022 to March 2023 winter totals, taken from a smaller sample of hospitals during the height of flu/COVID/RSV season, showed the numbers of patients stuck in acute hospitals beds totaling more than 1,000 per month."

State public health data show about 16% of the roughly 67,200 emergency department visits during six days in mid-December were tied to acute respiratory disease.

The hospital backlogs are caused by obstacles including administrative barriers from insurance companies, inadequate insurance coverage, and staffing and capacity constraints at post-acute care facilities, the hospital association said.

The association described the backups as a "persistent problem" in the state's health care system that "remains unresolved," even as hospitals try to find solutions like coordinating admissions with skilled nursing facilities over the weekends.

"Hospitals and their partners across the post-acute care continuum are also strengthening hospital-to-home programs, seeking additional reimbursement for MassHealth patients who need specialized post-acute care, addressing the challenges of patients with psychiatric diagnoses who require skilled nursing facility care, and working to highlight the need to recruit more individuals to serve in roles of guardians and conservators for patients who require assistance with decision-making needs," the association said.

"Caregiver shortages are also a great problem that the healthcare system hopes to further address in 2024."