How does InterRAI LTCF support transitions of care (e.g., admission, discharge, transfer)?

• A. Provides standardized data to inform care planning across settings and ensure continuity of care
• B. It maintains separate records with no cross-setting use
• C. It delays information sharing
• D. It replaces clinical judgment

Answer: (A)

Cross-setting continuity of care is supported by standardized data that can be shared across settings during admissions, transfers, and discharges. InterRAI LTCF provides consistent, portable assessment information so all members of the care team—from hospitals to home care to long-term care facilities—can quickly understand a resident’s current needs, risks, and plans. This enables informed care planning across settings, improves communication, and reduces information gaps and duplicative assessments, which are essential for a smooth transition. Keeping records separate, delaying data sharing, or replacing clinical judgment would hinder continuity and patient safety, not support it.