The Association Between Skilled Nursing Facility Care Quality and 30-Day Readmission Rates After Hospitalization for Heart Failure

2014 ◽  
Vol 30 (3) ◽  
pp. 205-213 ◽  
Author(s):  
Owolabi Ogunneye ◽  
Michael B. Rothberg ◽  
Jennifer Friderici ◽  
Mara T. Slawsky ◽  
Vijay T. Gadiraju ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skilled Nursing Facility ◽  
Care Quality ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing

Disease management partnership with skilled nursing facility improves heart failure 30-day readmission rates

Heart & Lung ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 556
Author(s):  
Tasha Beck Freitag ◽  
Sandra Young ◽  
Macall Perez ◽  
Dan Altland ◽  
Tamela Sterner
Keyword(s):  
Heart Failure ◽  
Disease Management ◽  
Skilled Nursing Facility ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing

scholarly journals Skilled Nursing Facility Referral and Hospital Readmission Rates after Heart Failure or Myocardial Infarction

2012 ◽  
Vol 125 (1) ◽  
pp. 100.e1-100.e9 ◽  
Author(s):  
Jersey Chen ◽  
Joseph S. Ross ◽  
Melissa D.A. Carlson ◽  
Zhenqiu Lin ◽  
Sharon-Lise T. Normand ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Hospital Readmission ◽  
Skilled Nursing Facility ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Hospital Readmission Rates

scholarly journals Association of Partner Status and Disposition With Rehospitalization in Heart Failure Patients

2012 ◽  
Vol 21 (3) ◽  
pp. e65-e73 ◽  
Author(s):  
Jill Howie-Esquivel ◽  
Joan Gygax Spicer
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Older Patients ◽  
Skilled Nursing Facility ◽  
Age Group ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Discharge Disposition ◽  
Patients With Heart Failure

Background Sociodemographic variables that are predictors of rehospitalization for heart failure may better inform hospital discharge strategies. Objectives (1) To determine whether sociodemographic variables are predictors of hospital readmission, (2) to determine whether sociodemographic or laboratory variables differ by age group as predictors of readmission, and (3) to compare whether patients’ discharge disposition differs by age group in predicting readmission. Methods Retrospective chart review of hospitalized patients with heart failure admitted in 2007. Results Mean age was 68 (SD, 17) years for the 809 patients, with slightly more than one-third (n = 311, 38%) reporting a legal partner. Fewer than half (n = 359, 44%) were white. Almost one-third (n = 261, 32%) were rehospitalized within 90 days. Multivariable analysis revealed that patients younger than 65 years old and not partnered were at 1.8 times greater risk for being readmitted 90 days after discharge (P = .02; 95% CI, 0.33–0.92). Patients who were 65 years and older and not partnered were at 2.2 times greater risk for readmission (P = .01; 95% CI, 0.25–0.85) after creatinine level and discharge disposition were controlled for. For older patients discharged to home or to home with home services, the risk of readmission was 2.6 times greater than that for patients discharged to a skilled nursing facility (P = .02; 95% CI, 1.20–5.56). Conclusions The absence of a partner was predictive of readmission in all patients. Older patients with heart failure who were discharged to a skilled nursing facility had lower readmission rates. The effect of partner and disposition status may suggest a proxy for social support. Strategies to provide social support during discharge planning may have an effect on hospital readmission rates.

scholarly journals RACIAL DISPARITIES IN 30-DAY READMISSION RATES AMONG MEDICARE PATIENTS DISCHARGED TO SKILLED NURSING FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S780-S780
Author(s):  
Maricruz Rivera-Hernandez ◽  
Maricruz Rivera-Hernandez ◽  
Momotazur Rahman ◽  
Vincent Mor ◽  
Amal N Trivedi
Keyword(s):  
Skilled Nursing Facility ◽  
Ethnic Disparities ◽  
Fee For Service ◽  
Nursing Facilities ◽  
Readmission Rates ◽  
Value Based Purchasing ◽  
Nursing Facility ◽  
Data Set ◽  
Skilled Nursing ◽  
American Health Care

Abstract The 30-Day All-Cause Readmission Measure is part of the Skilled Nursing Facility Value-Based Purchasing (SNFVBP) beginning 2019. The objective of the study was to characterize racial and ethnic disparities in 30-day rehospitalization rates from SNF among fee-for-service (FFS) and Medicare Advantage (MA) patients using the Minimum Data Set. The American Health Care Association risk-adjusted model was used. The primary independent variables were race/ethnicity and enrollment in FFS and MA. The sample included 1,813,963 patients from 15,412 SNFs across the US in 2015. Readmission rates were lower for whites. However, MA patients had readmission rates that were ~1 to 2 percentage points lower. In addition, we also found that African-Americans had higher readmission rates than whites, even when they received care within the same SNF. The inclusion of MA patients could change SNF penalties. Successful efforts to reduce rehospitalizations in SNF settings often require improving care coordination and care planning.

scholarly journals Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

2019 ◽  
Vol 56 ◽  
pp. 004695801881799
Author(s):  
Shivani Gupta ◽  
Ferhat D. Zengul ◽  
Ganisher K. Davlyatov ◽  
Robert Weech-Maldonado
Keyword(s):  
Hospital Readmission ◽  
Fixed Effects ◽  
Skilled Nursing Facility ◽  
Health Resources ◽  
Estimating Equation ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
American Hospital ◽  
American Hospital Association

Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potentially preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days of discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented to reduce readmission rates. Prior research has shown that coordination of care could play a significant role in lowering readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving care for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association with hospitals’ readmission rates. This study seeks to examine the association between HBSNFs and hospitals’ readmission rates. Data sources included 2007-2012 American Hospital Association Annual Survey, Area Health Resources Files, the Centers for Medicare and Medicaid Services (CMS) Medicare cost reports, and CMS Hospital Compare. The dependent variables were 30-day risk-adjusted readmission rates for acute myocardial infarction (AMI), congestive heart failure, and pneumonia. The independent variable was the presence of HBSNF in a hospital (1 = yes, 0 = no). Control variables included organizational and market factors that could affect hospitals’ readmission rates. Data were analyzed using generalized estimating equation (GEE) models with state and year fixed effects and standard errors corrected for clustering of hospitals over time. Propensity score weights were used to control for potential selection bias of hospitals having a skilled nursing facility (SNF). GEE models showed that the presence of HBSNFs was associated with lower readmission rates for AMI and pneumonia. Moreover, higher SNFs to hospitals ratio in the county were associated with lower readmission rates. These findings can inform policy makers and hospital administrators in evaluating HBSNFs as a potential strategy to lower hospitals’ readmission rates.

scholarly journals Care transition to skilled nursing facility – A model and a case study

2019 ◽  
Vol 8 (3) ◽  
pp. 38 ◽  
Author(s):  
Mohan Tanniru ◽  
Jacqueline Jones ◽  
Samer Kazziha ◽  
Michelle Hornberger
Keyword(s):  
Patient Care ◽  
Nurse Practitioners ◽  
Skilled Nursing Facility ◽  
Care Quality ◽  
Care Transition ◽  
Care Providers ◽  
Post Discharge ◽  
Nursing Facility ◽  
Skilled Nursing

Background: Healthcare providers have focused on improving patient care transitions to reduce unanticipated readmission costs, improve patient care quality post-discharge and increase patient satisfaction. This is especially true in US since the introduction of the Affordable Care Act. While there are several practices and evidence-based programs discussed in the literature to address care transition post-discharge, the key challenge remains the same – how to structure the care transition program to influence its effectiveness. In this paper, we focus on modeling one particular care transition – moving a patient from a hospital to a skilled nursing facility (SNF) – and discuss how improved capacity building and use of intermediaries such as advanced nurse practitioners have shown promise in reducing patient readmissions.Method: The methodology proposed here uses service dominant (SD) logic research to inductively derive a model for service exchanges between the two provider ecosystems. This model is then used to analyze service gaps and look for opportunities to innovate within an SNF and improve its capacity to deliver care. Use of intermediation that expands the service model with the addition of more care providers besides the hospital and SNF is also discussed to reduce patient readmissions.   Results: The study demonstrates that a number of actors have to work collaboratively to make care transition effective in meeting the patient and provider goals. Specifically, when two care facilities, hospital and SNF, are involved in care transition, opportunities exist to improve their internal capacity to address care within and across facilities.    Conclusion: The paper makes two important contributions. It shows the role of SD Logic in identifying opportunities for service innovations in support of care transition, and it shows the role of actors in provider-customer ecosystems to make the transition effective.    

Abstract P387: Length of Stay Among Medicare Beneficiaries Hospitalized with Heart Failure

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Emily B Levitan ◽  
Melissa K Van Dyke ◽  
Ligong Chen ◽  
Meredith L Kilgore ◽  
Todd M Brown ◽  
...  
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Systolic Dysfunction ◽  
Skilled Nursing Facility ◽  
The United States ◽  
Demographic Characteristics ◽  
Hospital Length Of Stay ◽  
Medicare Beneficiaries ◽  
Nursing Facility ◽  
Skilled Nursing

Background: Heart failure (HF) is among the most common reasons for hospitalization in the United States. Hospital length of stay (LOS) is a driver of cost and disease burden. Objectives: To examine factors associated with LOS of HF hospitalizations. Methods: Medicare beneficiaries with fee-for-service and pharmacy coverage who had HF hospitalizations (inpatient claims with ≥1 overnight stay/2 hospital days with HF as the primary discharge diagnosis, discharged alive) between 2007 and 2011 were identified in the Medicare national 5% sample. The median and interquartile range (IQR) LOS was calculated by demographic characteristics, comorbidities, and discharge status based on Medicare claims data with the Kruskal-Wallis test to compare distributions in the overall population with HF (n = 45,584) and in the subpopulation with documented systolic dysfunction (n = 10,256). Results: The median LOS was 5 days (range 2-255, IQR 4-8 days) in the overall HF population and 5 days (range 2-204, IQR 4-8 days) in those with systolic dysfunction. Across most demographic characteristics and comorbidities, the median LOS was 5 days but was higher among nursing home residents and individuals with malnutrition in both groups and with chronic kidney disease in those with systolic dysfunction ( Figure ). All comorbidities were associated with a shift in the distribution toward longer LOS in the population with systolic dysfunction and all but coronary heart disease in the overall population (p < 0.001). HF patients discharged to a skilled nursing facility had longer LOS (median 7 days, IQR 5-10 days) versus other discharge statuses (median 5 days, IQR 3-7 days, p < 0.001) in both populations. Conclusions: In patients hospitalized for HF, the median LOS was 5 days across most comorbidities and other characteristics, but comorbidities were associated with a shift in the upper tail of the distribution toward longer LOS. Worse functional status (nursing residence or discharge to a skilled nursing facility) was associated with a higher median LOS.

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