The Hospital Readmissions Reduction Program's Impact on Readmissions From Skilled Nursing Facilities

Hospital readmissions have long served as an indicator of patient recovery and the effectiveness of care. The present study examines the Hospital Readmissions Reduction Program's (HRRP's) impact on hospital readmissions from skilled nursing facilities (SNFs) and the characteristics of SNFs...

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Bibliographic Details
Published in:Journal of healthcare management 2019-05, Vol.64 (3), p.186-196
Main Authors: Smith, Todd Brenton, English, Thomas MacAndrew, Naidoo, Jef, Whitman, Marilyn V
Format: Article
Language:English
Subjects:
Beneficiaries
Cost control
Fines & penalties
Health administration
Health facilities
Hospital costs
Hospitalization
Hospitals
Medicaid
Medical research
Medicare
Nursing
Patient admissions
Patients
Physical restraints
Prospective payment systems
Reimbursement
Studies
Urban areas
Variables
Citations: Items that this one cites
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Summary:Hospital readmissions have long served as an indicator of patient recovery and the effectiveness of care. The present study examines the Hospital Readmissions Reduction Program's (HRRP's) impact on hospital readmissions from skilled nursing facilities (SNFs) and the characteristics of SNFs that were predictive of lower readmission rates. Adjusted 30-day readmission rates among 14,666 SNFs in the United States from 2011 through 2015 were examined using linear regression with generalized estimating equations to determine the relationship of the HRRP mandate to readmission rates from SNFs. Findings indicate a significant downward trend in adjusted 30-day readmission rates over time, decreasing 1.4% from 2011 to 2015. Furthermore, lower readmission rates were associated with SNF characteristics including location in a hospital facility, rural designation, higher registered nurse-to-nurse ratios, and not-for-profit status. We found a substantial decrease in SNF-related readmissions associated with HRRP, which may limit the impact of the Protecting Access to Medicare Act. Policy-makers may consider these systemic and structural differences before drafting future legislation targeting hospital readmission from SNFs. In addition, acute care facility operators who do not have an SNF may consider adding one to their facility and/or consider partnering with SNFs to ensure that high-quality programs in these SNFs are in place to reduce 30-day readmissions to the acute care facilities.
ISSN:1096-9012
1944-7396
DOI:10.1097/JHM-D-18-00035