Reduction in Hospitals' Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Academic Article


  • Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potential preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented 1 reduce readmission rates. Prior research has shown that coordination of care could play a significant role in loweri readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving cai for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association wi hospitals’ readmission rates. This study seeks to examine the association between HBSNFs and hospitals’ readmissic rates. Data sources included 2007-20I2 American Hospital Association Annual Survey, Area Health Resources Files, th Centers for Medicare and Medicaid Services (CMS) Medicare cost reports, and CMS Hospital Compare. The dependei variables were 30-day risk-adjusted readmission rates for acute myocardial infarction (AMI), congestive heart failur and pneumonia. The independent variable was the presence of HBSNF in a hospital (I = yes, 0 = no). Control variable included organizational and market factors that could affect hospitals’ readmission rates. Data were analyzed usir generalized estimating equation (GEE) models with state and year fixed effects and standard errors corrected fc clustering of hospitals over time. Propensity score weights were used to control for potential selection bias of hospita having a skilled nursing facility (SNF). GEE models showed that the presence of HBSNFs was associated with low∣ readmission rates for AMI and pneumonia. Moreover, higher SNFs to hospitals ratio in the county were associated wi lower readmission rates. These findings can inform policy makers and hospital administrators in evaluating HBSNFs as potential strategy to lower hospitals’ readmission rates.
  • Digital Object Identifier (doi)

    Pubmed Id

  • 24668514
  • Author List

  • Gupta S; Zengul FD; Davlyatov GK; Weech-Maldonado R
  • Start Page

  • 1
  • End Page

  • 13
  • Volume

  • 56