Residents’ and Family Perspectives of Involuntary Healthcare Facility Closure and Relocation

Abstract

Older adults who receive care in a healthcare facility certified by the Centers for Medicare and Medicaid Services receive services mandated and regulated by state and federal policy to ensure that basic quality and safety standards are met. Termination of certification due to ongoing care deficiencies results in the involuntary relocation of residents receiving Medicare or Medicaid services to another healthcare facility. If a facility ultimately closes, all residents are displaced. Facility decertification happens infrequently, but when it does occur, it affects both residents and their families. Few studies have examined resident input and the role that family plays in the relocation process. The purpose of this study was to explore residents’ and families’ perceptions of the relocation process and its effect on residents’ health and wellbeing. The study sample included 27 residents and 93 family members from two facilities that lost their certification. Semi-structured, audio-recorded interviews conducted with participants either in-person or by telephone focused on perceptions of relocation processes, relocation challenges and stressors, and physical and mental effects on residents. Interviews were transcribed verbatim and analyzed using an open coding process to identify common themes and patterns in the data. Four interrelated, overarching themes emerged from the analysis: 1) awareness of need to relocate; 2) notification of need to relocate; 3) involvement in relocation decisions; and 4) relocation stressors. Neither residents nor families were satisfied with the re-location process and offered multiple suggestions to guide policy and practice to improve their involuntary relocation experiences.