Neurology-Forward Care Reduces Hospitalization & ED Visits

Crown Point, IN, Sept. 30, 2025 – New research published by GuideStar Eldercare reports that a neurology-based integrated clinical care program significantly reduced acute inpatient psychiatric and emergency department (ED) admissions for residents with dementia. These two key measures, defined and documented by CMS, are key indicators of residents’ clinical status.

For hospitalization, the incidence rate was 0.76 per 1000 patient days, significantly lower than the national average of 1.79. ED visits decreased from 1.43 to 0.70 per 1000 patient days.

The markedly improved outcomes result from a collaborative initiative with a client skilled nursing facility (SNF) operator to develop LTC Centers of Excellence for individuals with severe behavioral and psychological symptoms of dementia (BPSD) and/or associated neuropsychiatric conditions. These specialized buildings were serving a combined average census of 250 residents.

“CMS research has already identified that LTC residents commonly experience potentially avoidable ED and acute hospital transfers,” note the authors. “These residents are especially vulnerable to the risks and negative outcomes associated with ED and hospital admissions and transitions between nursing facilities and hospitals.” Hospitalization can exacerbate BPSD and cause further cognitive decline for people with dementia, note the authors.

The neurology-forward care model incorporates neurology, psychiatry, psychology, primary care, pharmacy, nursing, and social work, using the best available evidence and publication-based standards of care. The approach was designed to improve the overall clinical status and quality of life for LTC residents living with dementia, helping them remain in their living environments and reducing the negative impact of hospitalization and care transfers.

The research article, “Reduction in Acute Psychiatric and Emergency Department Admissions in a Long-Term Care Population Through Use of a Neurology-Based Clinical Paradigm,” appears in Annals of Long-Term Care, Sept. 26, 2025.