SHM Converge Scientific Abstract ePoster Gallery-Age-Friendly Care on Hospitalization at Home: Home Is Where the 4Ms Are

Pdf Summary

This poster examines whether Hospitalization at Home (HaH) delivers age-friendly care aligned with CMS’s new 4Ms framework: what matters, medications, mentation, and mobility. The study used a retrospective chart review of 140 randomly selected patients age 65 or older admitted directly from the emergency department to Mount Sinai’s HaH program.<br /><br />The authors reviewed documentation and care processes across the four domains. In the “what matters” domain, code status was documented in 100% of cases and healthcare proxy/surrogate identification in 76%, but goals-of-care discussions were recorded in only 9%. In the “medications” domain, medication reconciliation was completed in 96% of patients, though 30% had unintended discrepancies and 45% of those were high-risk. For “mentation,” mental status assessment was documented in 96% of patients, and 20% had dementia. In “mobility,” 94% received a mobility assessment, while only 29% had PT/OT evaluation.<br /><br />All reviewed admissions had at least one completed element in each of the 4Ms domains, indicating consistent attention to age-friendly principles. The cohort was demographically diverse and medically complex, including substantial proportions of non-White, Hispanic/Latino, non-English-speaking, and Medicaid-insured patients.<br /><br />The authors conclude that HaH is a scalable model for delivering age-friendly care and can successfully incorporate CMS 4Ms priorities across varied patient populations. They suggest future work should identify which HaH practices drive strong performance and how similar approaches might be translated into traditional inpatient hospital settings.

Asset Subtitle

Sofia Yunez

Meta Tag

Author List Irina Zaretsky, Jeffrey D. Epstein, Jung Eun Ha, Kathryn Cole, Lisa Schwartz, Sofia Yunez, Tuyet-Trinh Truong

Category Research

Concept Home-Based Acute Care

Concept CMS 4Ms Age-Friendly Care Framework

Concept 4Ms

Concept Medication Reconciliation

Concept Mobility

Distinguished Non-Finalist

Presenter Organization Mount Sinai Hospital

Presenting Author Sofia Yunez

Track Outcomes Research

Keywords

Hospitalization at Home

Age-friendly care

CMS 4Ms framework

What matters

Medication reconciliation

Mentation

Mobility assessment

Older adults

Emergency department admissions

Retrospective chart review

Home-Based Acute Care

CMS 4Ms Age-Friendly Care Framework

4Ms

Medication Reconciliation

Mobility