SNF Attributes and Readmissions: A Weak Linkage

Grace C. Huang, MD

Quality indicators and characteristics of skilled nursing facilities do not have strong associations with readmission rates.

One in five Medicare beneficiaries is readmitted within 30 days of hospital discharge. Could choosing the right skilled nursing facility (SNF) influence readmission rates? Researchers identified more than 1.5 million patients from Medicare databases and used publicly reported SNF measures (from Nursing Home Compare) to determine whether certain SNF characteristics were associated with lower readmission rates.

In adjusted analyses that were controlled for patient factors, SNFs with higher site-inspection ratings (i.e., 1-star to 5-star ratings, determined by on-site evaluators who assess whether nursing homes meet Medicare quality requirements) were associated significantly with lower readmission rates. Not-for-profit status, smaller size, and lower proportion of patients covered by Medicare or Medicaid also were associated with fewer readmissions. However, the absolute difference in the composite outcome of death or readmissions between facilities with the lowest and highest site-inspection ratings was only 0.7%.

Citation(s):

Neuman MD et al. Association between skilled nursing facility quality indicators and hospital readmissions. JAMA 2014 Oct 15; 312:1542.