Skilled Nursing FacilitiesNCT04263779
Repisodic & Skilled Nursing Facility Preferred Provider Networks
A study testing Order of Options and Default Option in people with Skilled Nursing Facilities and Behavioral Economics, run by Geisinger Clinic at 1 site in United States.
Trial summary
This study tests whether changing the relative order of presentation of post acute care skilled nursing facilities (SNFs) in the Repisodic application, i.e., presenting preferred SNFs (P-SNFs) first, increases selection of, and discharges to, P-SNFs and decreases lengths of stay (LoS) for Geisinger patients discharged… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Skilled Nursing Facilities, Behavioral Economics
- What is being tested?
- Order of Options and Default Option
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 5,581 participants
- Where
- 1 siteUnited States
- Study dates
- 28 May 2021to 2 Jan 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Discharging units at Geisinger (e.g., Geisinger Medical Center, Geisinger Wyoming Valley Medical Center, and Geisinger Community Medical Center)
- Patients placed on adult medical/surgical wards
- Patients selected for discharge to a SNF
- Case managers using Repisodic to discharge patients (under the criteria above) to a SNF
- Discharge date occurs after pandemic alleviation benchmark has been met (see Study Description for further details)
Who cannot join
- Discharges in which the full list presented to the case manager contains no P-SNFs.
- Note: If a patient consistent with the above criteria has a caretaker that is interacting with the Repisodic application for the patient's post-acute care decision, the caretaker's behavior will be used.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Post-acute Care Preferred Provider Network Skilled Nursing Facility Selection as a Function of Repisodic Mobile Application Settings
This study tests whether changing the relative order of presentation of post acute care skilled nursing facilities (SNFs) in the Repisodic application, i.e., presenting preferred SNFs (P-SNFs) first, increases selection of, and discharges to, P-SNFs and decreases lengths of stay (LoS) for Geisinger patients discharged to SNFs. Along with the order of P-SNFs, the study also assesses whether a short video reviewing the benefits of care coordination in P-SNFs increases patient election to transfer to one.
Read the detailed description
Patients in acute-care facilities (hospitals) who are being discharged to post-acute care skilled nursing facilities (SNFs) currently struggle, in the absence of decision aids, to obtain practical information about SNFs to which the patients must be discharged. The same difficulties affect the attending case managers, social workers, and discharge planners. Moreover, although preferred SNF (P-SNF) networks offer patients the potential for improved coordination of care over non-preferred SNFs (NP-SNFs)-via shared staff across facilities and electronic sharing of information-this aspect of SNF selection is not highlighted or shared with patients according to any established protocol in the post-acute care setting.
The Repisodic application is a technology platform, accessed via laptop, smart phone, or tablet, intended to provide a user-friendly approach to rapid SNF facility identification and selection, with information provided on facility amenities and details, quality ratings, distance, and fit for the patient's needs. It functions in a manner analogous to online consumer search/sort/filter/quality applications, allowing the discharge planner to build a curated list of discharge options matched to each patient's needs.
The purpose of the current study is to test whether highlighting and changing the organization of, or information about, P-SNFs in the Repisodic app increases the selection of, and placements in, P-SNFs, while decreasing length of stay (LoS) at the discharging Geisinger acute care hospital. Our hypothesis is that presenting the P-SNF options at the top of the list (for case managers) and as the only options on the first screen or default map (for patients) will increase selection of and placement in P-SNFs, compared with the default ranking of SNFs (according to fit) in Repisodic. Note that patients presented P-SNF options on the first screen will always have the ability to expand the list to see all options they have been given, thus preserving choice. We also hypothesize that the P-SNF focused presentations will reduce LoS thanks to easier coordination between Geisinger hospitals and P-SNFs. An introductory video describing the SNF selection and discharge process to patients, will be available for optional viewing by patients across conditions. The optional link to the video will be further highlighted and the video will include sections describing the advantage of P-SNFs for care coordination, in the P-SNF focused (patient) conditions. The video, when viewed, may therefore further enhance the appeal of P-SNFs to patients in the conditions in which P-SNFs are highlighted. Secondarily, we hypothesize an overall reduction in LoS (at the acute care hospital) due to the quicker decision making, selection, and transmission processes facilitated by the Repisodic application. In a proportion of cases, patients and/or their caregivers may only have access to the SNF list via paper printout, in which case all relevant SNFs and their key characteristics will be included in the printout, but the map and video will not be available.
The cluster-randomized trial study design will randomize case managers to one of two conditions (Default List vs. P-SNF Top-Sorted List) and patients to one of two conditions (Full List/Full Map/Default Video vs. P-SNF List/P-SNF Map/P-SNF Video). Primary outcomes include P-SNF selection and P-SNF placement (post-introduction of Repisodic) and LoS (i.e., the change in LoS from prior to Repisodic to post-Repisodic introduction). Secondary outcomes include patient time spent selecting a SNF on Repisodic. Generalized linear mixed models will be used to examine outcomes as a function of the conditions, accounting for patients nested within case managers and controlling for potential covariates and moderators at the patient, case manager, and discharging unit level. The findings will enhance our understanding of how patients' informed choice, as facilitated by a bedside decision tool, affects SNF choice.
Note: random assignment of case managers to conditions will occur upon launch of the application (anticipated: January, 2021) and any patients will be randomly assigned starting at that time. However, due to the COVID-19 pandemic, SNFs are experiencing aberrant operational issues and bed availabilities. Furthermore, many patients who would be discharged to SNFs under normal circumstances are being sent home instead. In order to improve generalizability of the present study to post-pandemic circumstances, formal data collection to assess the impact of the intervention on primary outcomes will begin after a "pandemic alleviation" benchmark has been met. This benchmark specifies 25 or fewer average cases per 100,000 over a contiguous two-week period in the top 12 volume counties of Geisinger's catchment area (Centre, Mifflin, Juniata, Perry, Cumberland, Union, Snyder, Northumberland, Montour, Columbia, Luzerne, and Lackawanna).
- Conditions
- Skilled Nursing Facilities, Behavioral Economics
- Being tested
- Order of Options, Default Option
- Keywords
- Default Options, Order of Options, Choice Architecture, Video, Decision Aid, Mobile Application
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Order of OptionsBehavioural
Also called Choice Architecture
Relevant providers who are part of the Geisinger preferred provider network will be presented at the top of the otherwise ranked list of SNFs.
Default OptionBehavioural
Also called Order of Options, Choice Architecture
Both the list and the map will present only the P-SNFs, with a button allowing patients to view all results only if they opt to do so. The optional P-SNF advantage video will be included and the link to it highlighted.
| Study group | Role | What they receive |
|---|---|---|
| Default List (case manager level) | No intervention | In this condition, all SNF options will be presented to case managers in Repisodic in rank order according to Repisodic's algorithm that weights dimensions such as Centers for Medicare \& Medicaid Services (CMS) quality metric ratings, distance, and the match between SNF features and specific patient need. The list only includes SNFs that accept the patient's insurance. |
| P-SNF Top-Sorted List (case manager level) | Experimental | This condition is the same as the Default List, except that relevant providers (i.e., those meeting patient needs and located within a threshold distance to be determined per hospital) who are part of the Geisinger preferred provider network will be presented at the top of the otherwise ranked list of SNFs.
Situations in which there are no relevant P-SNFs will be flagged yet still assigned to this condition, in an intent-to-treat analysis; the default algorithm-based rank-ordered approach will be applied to all non-preferred providers. Receives: Behavioral: Order of Options |
| Full List/Full Map/Default Video (patient level) | No intervention | All SNF options, both P-SNFs and NP-SNFs (up to a maximum of 10 by default) that case managers preselected for patients will be presented to patients in rank order (according to Repisodic's algorithm, as described above). Patients will also have the option of viewing the default Repisodic map, which will show the SNFs on the list, and patients will be provided the link to an introductory video presenting the SNF selection and discharge process. When only a paper printout is available, the same SNF sorting order will be presented on paper. |
| P-SNF List/P-SNF Map/P-SNF Video (patient level) | Experimental | This is the same as the Full List condition, except that both the list and the map will present only the P-SNFs, with a button allowing patients to view all results only if they opt to do so. Moreover, the link to viewing the optional introductory video will be highlighted, and the video will include sections describing the advantage of P-SNFs for care coordination. When only a paper printout is available, the same SNF sorting order will be presented on paper, with only the P-SNFs presented on the first page. Receives: Behavioral: Default Option |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall LoS (system/case manager level)
Difference in LoS (in days) for patients as a function of case manager study condition.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
P-SNF placement (system/case manager level)
Difference in proportion of discharges of patients to P-SNFs (out of P-SNFs + NP-SNFs) as a function of case manager study condition.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
P-SNF pre-selection (case manager level)
Number of P-SNFs selected by case managers for inclusion in the patients' lists, to assess the direct impact of Repisodic changes on case manager behavior; this is the first decision in the process, before patients' selections and SNF availability factor into the final discharge decision and placement.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
P-SNF selection (case manager level)
Number of P-SNFs selected by patients to help assess the downstream impact of Repisodic changes on patient behavior following case manager pre-selection, again omitting the influence of SNF availability.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
P-SNF percent selected (case manager level)
Percentage of patients who selected at least one P-SNF, to help assess the downstream impact of Repisodic changes on patient behavior following case manager pre-selection.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
LoS (patient/caretaker level)
LoS for patients (in days).
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
P-SNF placement (patient/caretaker level)
Patient was discharged to a P-SNF: yes/no.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
P-SNF selection (patient/caretaker level)
Patient selected a P-SNF for discharge: yes/no. This is a more direct reflection of patient behavior, not yet moderated by bed availability and other real-world considerations that affect Outcome 7.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Secondary outcomes (2)
Time to pre-select a SNF (case manager level)
Time to pre-select a SNF/SNF list in Repisodic (in minutes), from the time that the case manager first signs into the iPad to when the case manager saves the list to send to the patient. This measure excludes cases in which the task was not completed.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Time to select a SNF (patient/caretaker level)
Time to select a SNF in Repisodic (in minutes), from the time that the patient first signs or is signed into the iPad to when the patient clicks to send the list to the case manager. This measure excludes cases in which the task was not completed.
Measured: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Feb 2020
- Study start28 May 2021
- Primary completion2 Jan 2023
- Study completion2 Jan 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Skilled Nursing FacilitiesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Factorial
- Model description
- Case managers (\~145) will be randomly assigned to conditions in a cluster-randomized trial design: 1. Default List: all eligible SNF options presented in Repisodic in rank order. 2. P-SNF Top-Sorted List: same as Default List, except relevant P-SNFs will be shown at the top of the otherwise ranked list. Patients (\~5,000) will independently be randomized to conditions and tracked: 1. Full List/Full Map/Default Video: all SNF options preselected by case managers will be presented to patients ordered by Repisodic's ranking algorithm. A map will present SNFs on the list if selected, and a link to an introductory video on SNF selection and discharge will be available. 2. P-SNF List/P-SNF Map/P-SNF Video: same as Full List, except that both the list and map will present only the P-SNFs, with an opt-in button allowing patients to view all results. Moreover, the link to view the optional SNF video will be highlighted and the advantage of P-SNFs for care coordination will be presented.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 5,581 participants (actual)
Sponsor and investigators
- Lead sponsor
- Geisinger Clinic
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Amir Goren, Geisinger Clinic
- Investigators
- Amir Goren, PhD, Principal investigator, Geisinger Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04263779
- Sponsor's protocol ID
- 2019-1101
- Status last verified
- Feb 2023
- First submitted
- 7 Feb 2020
- Last updated
- 2 Mar 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings.
Study at a glance
From the registry record, last updated by the sponsor on 2 Mar 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Post-acute Care Preferred Provider Network Skilled Nursing Facility Selection as a Function of Repisodic Mobile Application Settings
- ClinicalTrials.gov ID
- NCT04263779
- Acronym / sponsor ID
- 2019-1101
- Conditions
- Skilled Nursing Facilities, Behavioral Economics
- Keywords
- Default Options, Order of Options, Choice Architecture, Video, Decision Aid, Mobile Application
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 5,581 participants (actual)
- Lead sponsor
- Geisinger ClinicUniversity, hospital or other
- Study start
- 28 May 2021 (actual)
- Primary completion
- 2 Jan 2023 (actual)
- Study completion
- 2 Jan 2023 (actual)
- First posted
- 11 Feb 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study tests whether changing the relative order of presentation of post acute care skilled nursing facilities (SNFs) in the Repisodic application, i.e., presenting preferred SNFs (P-SNFs) first, increases selection of, and discharges to, P-SNFs and decreases lengths of stay (LoS) for Geisinger patients discharged to SNFs. Along with the order of P-SNFs, the study also assesses whether a short video reviewing the benefits of care coordination in P-SNFs increases patient election to transfer to one.
Detailed description
Patients in acute-care facilities (hospitals) who are being discharged to post-acute care skilled nursing facilities (SNFs) currently struggle, in the absence of decision aids, to obtain practical information about SNFs to which the patients must be discharged. The same difficulties affect the attending case managers, social workers, and discharge planners. Moreover, although preferred SNF (P-SNF) networks offer patients the potential for improved coordination of care over non-preferred SNFs (NP-SNFs)-via shared staff across facilities and electronic sharing of information-this aspect of SNF selection is not highlighted or shared with patients according to any established protocol in the post-acute care setting.
The Repisodic application is a technology platform, accessed via laptop, smart phone, or tablet, intended to provide a user-friendly approach to rapid SNF facility identification and selection, with information provided on facility amenities and details, quality ratings, distance, and fit for the patient's needs. It functions in a manner analogous to online consumer search/sort/filter/quality applications, allowing the discharge planner to build a curated list of discharge options matched to each patient's needs.
The purpose of the current study is to test whether highlighting and changing the organization of, or information about, P-SNFs in the Repisodic app increases the selection of, and placements in, P-SNFs, while decreasing length of stay (LoS) at the discharging Geisinger acute care hospital. Our hypothesis is that presenting the P-SNF options at the top of the list (for case managers) and as the only options on the first screen or default map (for patients) will increase selection of and placement in P-SNFs, compared with the default ranking of SNFs (according to fit) in Repisodic. Note that patients presented P-SNF options on the first screen will always have the ability to expand the list to see all options they have been given, thus preserving choice. We also hypothesize that the P-SNF focused presentations will reduce LoS thanks to easier coordination between Geisinger hospitals and P-SNFs. An introductory video describing the SNF selection and discharge process to patients, will be available for optional viewing by patients across conditions. The optional link to the video will be further highlighted and the video will include sections describing the advantage of P-SNFs for care coordination, in the P-SNF focused (patient) conditions. The video, when viewed, may therefore further enhance the appeal of P-SNFs to patients in the conditions in which P-SNFs are highlighted. Secondarily, we hypothesize an overall reduction in LoS (at the acute care hospital) due to the quicker decision making, selection, and transmission processes facilitated by the Repisodic application. In a proportion of cases, patients and/or their caregivers may only have access to the SNF list via paper printout, in which case all relevant SNFs and their key characteristics will be included in the printout, but the map and video will not be available.
The cluster-randomized trial study design will randomize case managers to one of two conditions (Default List vs. P-SNF Top-Sorted List) and patients to one of two conditions (Full List/Full Map/Default Video vs. P-SNF List/P-SNF Map/P-SNF Video). Primary outcomes include P-SNF selection and P-SNF placement (post-introduction of Repisodic) and LoS (i.e., the change in LoS from prior to Repisodic to post-Repisodic introduction). Secondary outcomes include patient time spent selecting a SNF on Repisodic. Generalized linear mixed models will be used to examine outcomes as a function of the conditions, accounting for patients nested within case managers and controlling for potential covariates and moderators at the patient, case manager, and discharging unit level. The findings will enhance our understanding of how patients' informed choice, as facilitated by a bedside decision tool, affects SNF choice.
Note: random assignment of case managers to conditions will occur upon launch of the application (anticipated: January, 2021) and any patients will be randomly assigned starting at that time. However, due to the COVID-19 pandemic, SNFs are experiencing aberrant operational issues and bed availabilities. Furthermore, many patients who would be discharged to SNFs under normal circumstances are being sent home instead. In order to improve generalizability of the present study to post-pandemic circumstances, formal data collection to assess the impact of the intervention on primary outcomes will begin after a "pandemic alleviation" benchmark has been met. This benchmark specifies 25 or fewer average cases per 100,000 over a contiguous two-week period in the top 12 volume counties of Geisinger's catchment area (Centre, Mifflin, Juniata, Perry, Cumberland, Union, Snyder, Northumberland, Montour, Columbia, Luzerne, and Lackawanna).
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Single blind (participant)
- Number of arms
- 4
- Model description
- Case managers (~145) will be randomly assigned to conditions in a cluster-randomized trial design: 1. Default List: all eligible SNF options presented in Repisodic in rank order. 2. P-SNF Top-Sorted List: same as Default List, except relevant P-SNFs will be shown at the top of the otherwise ranked list. Patients (~5,000) will independently be randomized to conditions and tracked: 1. Full List/Full Map/Default Video: all SNF options preselected by case managers will be presented to patients ordered by Repisodic's ranking algorithm. A map will present SNFs on the list if selected, and a link to an introductory video on SNF selection and discharge will be available. 2. P-SNF List/P-SNF Map/P-SNF Video: same as Full List, except that both the list and map will present only the P-SNFs, with an opt-in button allowing patients to view all results. Moreover, the link to view the optional SNF video will be highlighted and the advantage of P-SNFs for care coordination will be presented.
| Arm | Type | Receives |
|---|---|---|
| Default List (case manager level) | No intervention | –In this condition, all SNF options will be presented to case managers in Repisodic in rank order according to Repisodic's algorithm that weights dimensions such as Centers for Medicare \& Medicaid Services (CMS) quality metric ratings, distance, and the match between SNF features and specific patient need. The list only includes SNFs that accept the patient's insurance. |
| P-SNF Top-Sorted List (case manager level) | Experimental | Behavioral: Order of OptionsThis condition is the same as the Default List, except that relevant providers (i.e., those meeting patient needs and located within a threshold distance to be determined per hospital) who are part of the Geisinger preferred provider network will be presented at the top of the otherwise ranked list of SNFs. Situations in which there are no relevant P-SNFs will be flagged yet still assigned to this condition, in an intent-to-treat analysis; the default algorithm-based rank-ordered approach will be applied to all non-preferred providers. |
| Full List/Full Map/Default Video (patient level) | No intervention | –All SNF options, both P-SNFs and NP-SNFs (up to a maximum of 10 by default) that case managers preselected for patients will be presented to patients in rank order (according to Repisodic's algorithm, as described above). Patients will also have the option of viewing the default Repisodic map, which will show the SNFs on the list, and patients will be provided the link to an introductory video presenting the SNF selection and discharge process. When only a paper printout is available, the same SNF sorting order will be presented on paper. |
| P-SNF List/P-SNF Map/P-SNF Video (patient level) | Experimental | Behavioral: Default OptionThis is the same as the Full List condition, except that both the list and the map will present only the P-SNFs, with a button allowing patients to view all results only if they opt to do so. Moreover, the link to viewing the optional introductory video will be highlighted, and the video will include sections describing the advantage of P-SNFs for care coordination. When only a paper printout is available, the same SNF sorting order will be presented on paper, with only the P-SNFs presented on the first page. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Discharging units at Geisinger (e.g., Geisinger Medical Center, Geisinger Wyoming Valley Medical Center, and Geisinger Community Medical Center)
- Patients placed on adult medical/surgical wards
- Patients selected for discharge to a SNF
- Case managers using Repisodic to discharge patients (under the criteria above) to a SNF
- Discharge date occurs after pandemic alleviation benchmark has been met (see Study Description for further details)
Key exclusion criteria (2 listed)
- Discharges in which the full list presented to the case manager contains no P-SNFs.
- Note: If a patient consistent with the above criteria has a caretaker that is interacting with the Repisodic application for the patient's post-acute care decision, the caretaker's behavior will be used.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Order of OptionsAlso: Choice ArchitectureRelevant providers who are part of the Geisinger preferred provider network will be presented at the top of the otherwise ranked list of SNFs. | Behavioural | P-SNF Top-Sorted List (case manager level) |
| Default OptionAlso: Order of Options, Choice ArchitectureBoth the list and the map will present only the P-SNFs, with a button allowing patients to view all results only if they opt to do so. The optional P-SNF advantage video will be included and the link to it highlighted. | Behavioural | P-SNF List/P-SNF Map/P-SNF Video (patient level) |
Primary outcome
Overall LoS (system/case manager level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Difference in LoS (in days) for patients as a function of case manager study condition.
P-SNF placement (system/case manager level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Difference in proportion of discharges of patients to P-SNFs (out of P-SNFs + NP-SNFs) as a function of case manager study condition.
P-SNF pre-selection (case manager level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Number of P-SNFs selected by case managers for inclusion in the patients' lists, to assess the direct impact of Repisodic changes on case manager behavior; this is the first decision in the process, before patients' selections and SNF availability factor into the final discharge decision and placement.
P-SNF selection (case manager level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Number of P-SNFs selected by patients to help assess the downstream impact of Repisodic changes on patient behavior following case manager pre-selection, again omitting the influence of SNF availability.
P-SNF percent selected (case manager level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Percentage of patients who selected at least one P-SNF, to help assess the downstream impact of Repisodic changes on patient behavior following case manager pre-selection.
LoS (patient/caretaker level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
LoS for patients (in days).
P-SNF placement (patient/caretaker level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Patient was discharged to a P-SNF: yes/no.
P-SNF selection (patient/caretaker level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Patient selected a P-SNF for discharge: yes/no. This is a more direct reflection of patient behavior, not yet moderated by bed availability and other real-world considerations that affect Outcome 7.
2 secondary outcomes
Time to pre-select a SNF (case manager level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Time to select a SNF (patient/caretaker level)
Time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Mar 2023.
- Individual participant dataSharing planned: Yes. Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Amir Goren, PhD principal investigator
Geisinger Clinic
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Order of Options and Default Option in people with Skilled Nursing Facilities and Behavioral Economics, run by Geisinger Clinic at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall LoS (system/case manager level) (time frame: 24 months or as long as it takes to reach N=5,000, whichever occurs first). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Mar 2023; AzTrials last refreshed its copy on 28 Oct 2026.