PRACTITIONER APPLICATION: The Hospital Readmissions Reduction Program's Impact on Readmissions from Skilled Nursing Facilities

By Sales, Susan A. | Journal of Healthcare Management, May/June 2019 | Go to article overview

PRACTITIONER APPLICATION: The Hospital Readmissions Reduction Program's Impact on Readmissions from Skilled Nursing Facilities


Sales, Susan A., Journal of Healthcare Management


Smith, English, Naidoo, and Whitman have selected a topic that hospitals and skilled nursing facilities (SNFs) have struggled with for years. Both types of entities have been challenged to reduce readmissions, improve communication, smoothen patient transitions, maintain margin, and reduce Medicare expenditures. Thus, the authors' review of clinical, operational, and fiscal systems for hospitals and SNFs is timely.

Since the mid-2000s, hospitals have focused on reducing the length of stay for patients, while SNFs have worked to increase the clinical capabilities of staff. Some practitioners suggest that hospitals may be getting their patients out quicker and sicker to SNFs, but I see an evolution of the healthcare system to serve patients in the most appropriate setting.

This study includes data from 2011 through 2015 for 14,666 SNFs in the United States. During this period, I oversaw a hospital-based SNF; currently, I am the administrator of a medium-sized urban not-for-profit SNF. The authors note that hospital-based and not-for-profit SNFs have improved their performance in the reduction of readmissions. In my experience, proximity of the hospital to an emergency department (ED) facilitates familiarity and ease of conversation among the acute care providers on the capabilities of the SNF, thus helping to avert hospitalization following an ED visit. I also have participated in the Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents, which the Centers for Medicare & Medicaid Services (CMS) launched in 2012. …

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