# Skilled Nursing Facility Care and Outcomes After Hospitalizations Involving Opioid Use Disorder

> **NIH NIH R21** · BROWN UNIVERSITY · 2022 · $197,452

## Abstract

PROJECT SUMMARY
Opioid use disorder (OUD) is increasing in older adults (≥65 years) and among younger people with disabilities
who are enrolled in Medicare. Increased opioid-related hospitalizations and emergency department visits have
also been reported in this population. Comprehensive post-acute care (PAC) for people with OUD (PWOUD)
should address the care needs for both OUD treatment and other medical issues. As existing initiatives to prevent
and treat OUD primarily target community-based residents, much is still unknown about when and how PWOUD
interact with institutional settings for post-acute and long-term care such as skilled nursing facilities (SNFs).
There are also knowledge gaps about whether OUD represents a barrier to admission to higher quality SNFs,
the outcomes of PWOUD who enter SNFs, and about the capacity to deliver OUD treatment in these settings.
Yet, SNFs which are a dominant setting for institutional post-acute care SNFs are receiving more referrals for
PWOUD. The long-term goal of this research is eventual partnership with SNFs to improve the willingness and
capacity to provide medications for OUD (MOUD) for PWOUD in post-acute and long-term care settings. The
objective of this application, the first step toward this long-term goal, is to examine the quality of SNFs that admit
PWOUD, survival and health care trajectories after OUD-related hospitalization, and elicit provider perspectives
on strategies to improve access to MOUD in SNFs. The two-pronged study rationale is to address knowledge
gaps on SNF use and outcomes for PWOUD, and encourage better integration of addiction treatment with
gerontologic and post-acute care services. We will analyze 2015-2019 inpatient hospital claims for 100% fee-
for-service Medicare beneficiaries linked to or combined with other data (e.g., enrollment, Nursing Home
Compare, Minimum Data Set, Part D, Omnicare PAC pharmacy data and SNF electronic medical records). Our
Specific Aims are to: 1) Assess receipt of post-acute care by Medicare beneficiaries with OUD, including the
attributes of SNFs they enter, health care use and survival trajectories, and availability of providers for OUD
treatment in neighborhoods where SNFs are located. 2) Identify and describe barriers and facilitators for the
placement of PWOUD in nursing homes, and best practices for providing access to OUD treatment by eliciting
the views of nursing home personnel. In Aim 2, we will conduct semi-structured telephone interviews with nursing
home administrators, admissions coordinators, and direct care staff to obtain rich contextual information about
the mechanisms that shape post-acute SNF use and outcomes for PWOUD. The interviews will also provide
preliminary data to inform the design and potential feasibility of interventions to improve OUD treatment in SNFs.
Both aims will also examine whether SNF use and outcomes differ between younger and older adults with OUD.
Developing this evidence will enhance efforts to des...

## Key facts

- **NIH application ID:** 10371281
- **Project number:** 1R21DA053518-01A1
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Patience Moyo Dow
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $197,452
- **Award type:** 1
- **Project period:** 2022-04-15 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10371281

## Citation

> US National Institutes of Health, RePORTER application 10371281, Skilled Nursing Facility Care and Outcomes After Hospitalizations Involving Opioid Use Disorder (1R21DA053518-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10371281. Licensed CC0.

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