As part of the Atrius Health offering of coordinated care, we have carefully selected and secured a network of local, quality-driven skilled nursing facilities. The selected facilities all have a 3-star CMS rating or higher. You are welcome to evaluate the facility by visiting the CMS Care Compare website.

The Atrius Health skilled nursing facility preferred network, also known as the extended care facility (ECF) program, has registered nurse (RN) case managers assisting to coordinate the care provided to Atrius Health patients. The RN case managers are there to support you, the patient, and your family in returning home and avoiding potential returns to the hospital by:

• Communication and collaboration with your primary care provider and other Atrius Health specialists as needed.
• Their expertise in managing complex care events, including medication management.
• Their involvement at family and team meetings to support your goals.
• Their close work with you, your family, and the facility in your transition of care.

We strongly recommend that you select one of these ECF facilities. If you select an extended care facility that is not staffed by one of our Atrius Health RN case managers, it will be more difficult to assist you with your transition of care during your stay and to support you in achieving your goals.

When clinically appropriate, payers allow Atrius Health to admit directly to our preferred ECF facilities.  This allows our patients to be admitted to facilities without the requirement of a hospital stay first.  Patients can avoid unnecessary hospital admissions and begin their skilled care in the ECF sooner.

Skilled nursing facilities provide a high level of care outside of a hospital setting. These facilities are certified by the Massachusetts Department of Public Health (DPH) and the Centers for Medicare & Medicaid Services (CMS). Skilled nursing facilities provide a multidisciplinary approach, including, but not limited to:

• An attending physician and nurse practitioner or physician assistant
• Inpatient rehabilitation, such as physical, occupational, and speech therapy; and some provide respiratory therapy
• 24/7 skilled nursing services
• Medication management
• Social services
• Activities & dining programming
• Discharge planning services