The Role of Ownership and Chain Affiliation in Skilled Nursing Facility Length of Stay

2013 ◽  
Author(s):  
John R. Bowblis ◽  
John Horowitz ◽  
Christopher Scott Brunt
Keyword(s):  
Length Of Stay ◽  
Skilled Nursing Facility ◽  
Nursing Facility ◽  
Skilled Nursing

scholarly journals The Role of Wound Care in 2 Group A Streptococcal Outbreaks in a Chicago Skilled Nursing Facility, 2015‒2016

2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Sana S Ahmed ◽  
Kasey E Diebold ◽  
Jacob M Brandvold ◽  
Saadeh S Ewaidah ◽  
Stephanie Black ◽  
...  
Keyword(s):  
Group A Streptococcus ◽  
Wound Care ◽  
Skilled Nursing Facility ◽  
Prevention Measures ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Group A ◽  
Care Practices ◽  
Transmission Factors

Abstract Two consecutive outbreaks of group A Streptococcus (GAS) infections occurred from 2015–2016 among residents of a Chicago skilled nursing facility. Evaluation of wound care practices proved crucial for identifying transmission factors and implementing prevention measures. We demonstrated shedding of GAS on settle plates during care of a colonized wound.

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.

Role of ADL Independence in Postacute-Care Rehabilitation Service Needs in the Elderly Abdominal Surgery Population

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512500062p1-7512500062p1
Author(s):  
Erika Dobson ◽  
Rebecca Julian ◽  
Hailey Zanette
Keyword(s):  
Abdominal Surgery ◽  
Skilled Nursing Facility ◽  
The Elderly ◽  
Rehabilitation Service ◽  
Rehabilitation Services ◽  
Service Needs ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Postacute Care

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. More than half of all surgical patients are age 65 and older, and research suggests that a majority of these patients will require postacute-care (PAC) rehabilitation services. Despite the growing costs, characteristics related to requiring PAC in the elderly abdominal surgery population are not well studied. This project aims to describe discharge trends, as well as factors related to requiring placement at a skilled-nursing facility in the elderly abdominal surgery population. Primary Author and Speaker: Erika Dobson Contributing Authors: Rebecca Julian, Hailey Zanette

scholarly journals A Cluster of Group A Streptococcal Infections in a Skilled Nursing Facility-the Potential Role of Healthcare Worker Presenteeism

2016 ◽  
Vol 64 (12) ◽  
pp. e279-e284 ◽  
Author(s):  
Miwako Kobayashi ◽  
Meghan M. Lyman ◽  
Louise K. Francois Watkins ◽  
Karrie-Ann Toews ◽  
Leon Bullard ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Potential Role ◽  
Skilled Nursing Facility ◽  
Streptococcal Infections ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Group A

scholarly journals Comprehensive Hip Fracture Care Program: Successive Implementation in 3 Hospitals

2019 ◽  
Vol 10 ◽  
pp. 215145931984605 ◽  
Author(s):  
Kelly Jackson ◽  
Mary Bachhuber ◽  
Dawn Bowden ◽  
Katherine Etter ◽  
Cindy Tong
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Skilled Nursing Facility ◽  
Care Program ◽  
Fracture Repair ◽  
Mean Difference ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Fracture Care ◽  
Time To Surgery

Introduction: Hip fractures are common and costly in the elderly population, often contributing to loss of function and independence. Prompt, coordinated surgical care may improve clinical and economic outcomes for this population. Materials and Methods: We created an interdisciplinary care program focused on minimizing time spent immobilized awaiting surgery and streamlining the care pathway for hip fracture. Patients older than 65 years with any hip fracture type including hip fracture repair Diagnosis-Related Group codes (MS-DRG 480, 481, or 482) and MS-DRG 469 and 470 with a hip fracture diagnosis were included in the study. The Hip Fracture Care program (HFCP) was implemented on a staggered basis in 3 hospitals in the HonorHealth system. Time to surgery, length of stay, and discharge location (home/skilled nursing facility) were compared pre- and post-intervention, utilizing an interrupted time series analysis to account for background trends. Results: More than 2000 patients across the 3 facilities received HFCP care; demographics were similar for the 826 patients serving as the pre-implementation comparison group. Mean (standard deviation [SD]) length of stay decreased from 5.6 (4.0) to 4.7 (2.9) days (mean difference 0.9 days; P < .05). Mean (SD) time from admission to the operating room decreased from 30.8 (21.1) to 25.6 (20.5) hours (mean difference 5.2 hours; P < .05). There was no change in the proportion of patients discharged to home versus skilled nursing facility. Discussion: Optimal care of this vulnerable population can significantly reduce the time to surgery and length of stay. Conclusions: Length of stay was reduced by nearly 1 day with implementation of a multifactorial program for hip fracture care.

scholarly journals Improving Orthopedic Care Delivery Through Digital Engagement

Iproceedings ◽  
10.2196/16305 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e16305
Author(s):  
Lisa Biernat ◽  
Carly E Milliren ◽  
Jon Rauen ◽  
Bill Lindsay ◽  
Betsy Weaver ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hip Replacement ◽  
Skilled Nursing Facility ◽  
Patient Activation ◽  
Hospital Length Of Stay ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Total Hip ◽  
Total Knee ◽  
Ed Visits

Background Patient activation has been hypothesized to improve medical and surgical outcomes by increasing patient involvement in the care plan. We tested this hypothesis by utilizing a patient activation tool in a population of adults having total hip or total knee replacement. We hypothesized that patient activation would be associated with increased discharge to home as opposed to a skilled nursing facility, reduced hospital length of stay, decreased inpatient readmissions, and decreased emergency department (ED) visits. Objective Using an email patient activation tool, we sought to increase patients’ involvement in their care before and after total joint replacement. Outcomes examined included day of surgery cancellation, length of hospital stay, discharge to home vs discharge to a skilled nursing facility, any ED visit within 30 days of discharge, and any inpatient readmission within 30 days of discharge Methods This was a quasi-experimental design comparing Jan-Jun 2017 to Jan-Jun 2018. We instituted an email patient activation tool for all patients with total knee or total hip replacement surgery beginning in January 2018. This tool was integrated with the electronic medical record system during the six month study period and patients could opt out at anytime if they desired. The tool was designed to prepare patients both educationally and emotionally for their operation with multiple easy-to-read emails starting from the time they were scheduled for surgery through six months postop. Percent of emails opened and clicked were used as measures of engagement for the intervention participants. Results Of the 2,027 TJR patients included, 720 were hip patients and 1,307 were knee patients. Pre- and postintervention groups were similar in gender and age. For hip replacement patients, length of stay was nearly 1/4 day lower in the postintervention group (β=-0.23; P=.001) after adjusting for gender, age and insurance; ED visits were lower among the postintervention group (OR=0.45; P=.05) after adjusting for gender, age and insurance; and postintervention patients were less likely to have day of surgery cancellation, any revisit (ED or readmission), and were more likely to be discharged home. However, these associations did not reach statistical significance. Conclusions Among patients who received the intervention, higher engagement was significantly associated with positive changes in almost all outcomes. Use of the digital patient activation tool demonstrated significant savings in length of stay and reduced ED visits among hip replacement patients. Although just under 50% of patients in the intervention group were enrolled to use the tool, these findings were still significant even when non-participants were included in the postintervention group.

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