Another Option in Reducing Hospital Readmissions From Skilled Nursing Facilities: Project RED (ReEngineered Discharge)

2013 ◽  
Vol 14 (10) ◽  
pp. 717
Author(s):  
Eric G. Tangalos
Keyword(s):  
Hospital Readmissions ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing

Rehabilitation Intensity and Patient Outcomes in Skilled Nursing Facilities in the United States: A Systematic Review

2021 ◽  
Author(s):  
Rachel A Prusynski ◽  
Allison M Gustavson ◽  
Siddhi R Shrivastav ◽  
Tracy M Mroz
Keyword(s):  
United States ◽  
Systematic Review ◽  
Patient Outcomes ◽  
Hospital Readmissions ◽  
The United States ◽  
Skilled Nursing Facilities ◽  
Functional Improvement ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
The Relationship

Abstract Objective Exponential increases in rehabilitation intensity in skilled nursing facilities (SNFs) motivated recent changes in Medicare reimbursement policies, which remove financial incentives for providing more minutes of physical therapy, occupational therapy, and speech therapy. Yet there is concern that SNFs will reduce therapy provision and patients will experience worse outcomes. The purpose of this systematic review was to synthesize current evidence on the relationship between therapy intensity and patient outcomes in SNFs. Methods PubMed, Medline, Scopus, Embase, CINAHL, PEDro, and COCHRANE databases were searched. English-language studies published in the United States between 1998 and February 14, 2020, examining the relationship between therapy intensity and community discharge, hospital readmission, length of stay (LOS), and functional improvement for short-stay SNF patients were considered. Data extraction and risk of bias were performed using the American Academy of Neurology (AAN) Classification of Evidence scale for causation questions. AAN criteria were used to assess confidence in the evidence for each outcome. Results Eight observational studies met inclusion criteria. There was moderate evidence that higher intensity therapy was associated with higher rates of community discharge and shorter LOS. One study provided very low-level evidence of associations between higher intensity therapy and lower hospital readmissions after total hip and knee replacement. There was low-level evidence indicating higher intensity therapy is associated with improvements in function. Conclusions This systematic review concludes, with moderate confidence, that higher intensity therapy in SNFs leads to higher community discharge rates and shorter LOS. Future research should improve quality of evidence on functional improvement and hospital readmissions. Impact This systematic review demonstrates that patients in SNFs may benefit from higher intensity therapy. Because new policies no longer incentivize intensive therapy, patient outcomes should be closely monitored to ensure patients in SNFs receive high-quality care.

Skilled Nursing Facilities Modify the Relationship Between Depressive Symptoms and Hospital Readmissions but Not Health Outcomes Among Older Adults

2021 ◽  
pp. 089826432110131
Author(s):  
Leah R. Abrams ◽  
Geoffrey J. Hoffman
Keyword(s):  
Depressive Symptoms ◽  
Hospital Readmissions ◽  
Positive Association ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Health Rehabilitation ◽  
The Relationship ◽  
Health Hospital ◽  
Retirement Study

Objectives: Despite detrimental effects of depressive symptoms on self-care and health, hospital discharge practices and the benefits of different discharge settings are poorly understood in the context of depression. Methods: This retrospective cohort study comprised 23,485 hospitalizations from Medicare claims linked to the Health and Retirement Study (2000–2014). Results: Respondents with depressive symptoms were no more likely to be referred to home health, whereas the probability of discharge to skilled nursing facilities (SNFs) went up a half percentage point with each increasing symptom, even after adjusting for family support and health. Rehabilitation in SNFs, compared to routine discharges home, reduced the positive association between depressive symptoms and 30-day hospital readmissions (OR = 0.95, p = 0.029) but did not prevent 30-day falls, 1-year falls, or 1-year mortality associated with depressive symptoms. Discussion: Depressive symptoms were associated with discharges to SNFs, but SNFs do not appear to address depressive symptoms to enhance functioning and survival.

Trends of 30-Day Hospital Readmissions Among Patients Discharged to Skilled Nursing Facilities From an Academic Practice

2017 ◽  
Vol 25 (6) ◽  
pp. 21-26 ◽  
Author(s):  
Anupam Chandra ◽  
Paul Takahashi ◽  
Gregory J Hanson ◽  
Amelia Sneve ◽  
Parvez Rahman ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Day Hospital ◽  
Skilled Nursing ◽  
Academic Practice

scholarly journals READMISSION RISK BY INSURANCE TYPE FOR PATIENTS WITH HEART FAILURE IN SKILLED NURSING FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S645-S645
Author(s):  
Andrea E Daddato ◽  
Edward A Miller ◽  
Pamela Nadash ◽  
Denise Tyler ◽  
Rebecca S Boxer
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Controlled Trial ◽  
Hospital Readmissions ◽  
Skilled Nursing Facilities ◽  
P Value ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Care Plans ◽  
Insurance Type

Abstract Heart failure (HF) is a leading cause of potentially preventable hospital readmissions for Medicare beneficiaries from skilled nursing facilities (SNFs). This research seeks to determine if a HF patient’s insurance type (Medicare Fee-for-Service (FFS) vs. Medicare Advantage (MA)) influences their risk for readmission within 30 days of hospital discharge to a SNF. MA beneficiaries receive benefits through managed care plans with restricted networks, but typically expanded benefits. This research is particularly timely in light of CMS’ new penalties under the Protecting Access to Medicare Act (PAMA) directed at SNFs for 30-day rehospitalizations. Outcomes data on readmissions from a randomized controlled trial of HF Disease Management in SNFs conducted from 2014-2017 were used to evaluate the risk of readmission. Patients with HF receiving SNF care were enrolled and followed for 30 days from SNF admission. Patients were recruited from 29 primarily for-profit (93%) SNFs that contracted with an average of 4.07 (±5.48) MA plans. Of the 340 study participants followed, 62% had FFS Medicare coverage (n=212) and 38% had MA (n=128). In total, 23% (n=79) of patients experienced at least one readmission within 30 days of hospital discharge. FFS patients had a higher risk of rehospitalization within 30 days of hospital discharge than MA patients (25% vs. 20%), but the association between insurance type and rehospitalization was not statistically significant (p-value=0.177). Findings suggest that insurance type may be an important risk factor for rehospitalizations for patients with HF from SNF; however, a larger sample will need to confirm this relationship.

scholarly journals Reducing Hospital Readmissions Through Preferred Networks Of Skilled Nursing Facilities

2017 ◽  
Vol 36 (9) ◽  
pp. 1591-1598 ◽  
Author(s):  
John P. McHugh ◽  
Andrew Foster ◽  
Vincent Mor ◽  
Renée R. Shield ◽  
Amal N. Trivedi ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing
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