Reducing Skilled Nursing Facility Readmission Rates

Skilled nursing facilities (SNFs) use various metrics to determine the effectiveness of care. Readmission rates are a way for these centers to understand performance and how they can advance care initiatives to improve outcomes. Lowering readmission rates is essential for SNFs to deliver better care and align with value-based care initiatives established by the Centers for Medicare & Medicaid Services (CMS).

At your skilled nursing facility, readmission rates may still be higher than you’d prefer. The good news is that care coordination can be a helpful solution for reducing these rates.

Key Statistics on Readmission Rates

Data on readmission rates shows that nearly 25% of patients admitted to SNFs are readmitted to the hospital within 30 days — and this only captures an average across patient populations. Readmission rates can be higher for some populations, like lower-income adults who are dually eligible for Medicare and Medicaid. Readmission to the hospital can also lead to an increased mortality rate, up to quadruple the rate of those who are not readmitted.

Readmission does more than impact patients’ lives — it has financial implications for skilled nursing centers. Readmissions can cost SNFs as much as $15,000 per patient depending on the diagnosis. Additionally, the push for value-based care from CMS means these centers are penalized for a lower quality of care. Readmission is one of the signifiers of low-quality care.

Impact of Readmission Rates on Revenue

When a patient needs to be readmitted to your center, there are various financial implications. The direct financial losses of readmission are the lost revenue caused by reduced CMS reimbursement rates. As a means of driving value-based care, CMS reimburses SNFs based on the quality of care. Readmissions signify a lower quality of care and are penalized as a result.

These lower reimbursement rates are a direct loss for SNFs, but your revenue is also affected indirectly. Readmission requires more resources and operational expenses, leading your center to spend more than it would’ve with a single admission. These costs can vary widely based on the severity of the patient case.

Beyond operational costs, frequent readmissions can lead to more long-term losses as a result of a damaged reputation. When families and patients see people commonly readmitted to your SNF, they see a lower quality of care. Occupancy rates can decline as a result and reduce your center’s overall profitability.

The Role of Care Coordination in Reducing Readmission Rates

Care coordination is the organization of a patient’s care with various providers and caregivers to ensure a patient’s needs are met effectively. The main benefits of care coordination include:

• Improved communication: A resident at your SNF likely relies on multiple providers. Between physicians, nurses, nutritionists, and therapists, care needs have to be well-communicated. Care coordination creates a collaborative environment among all providers to ensure every participant understands the next steps in a patient’s care. This improved communication helps ensure consistent care strategies across different providers.
• Enhanced engagement: To involve patients in their care, each provider can offer education for their specific area and how it supports larger goals. Higher engagement can also increase satisfaction levels.
• Better chronic condition management: Chronic conditions often have complex care needs. Care coordination ensures all providers are on the same page as well as helps patients understand their responsibilities in managing their condition.

With these factors combined, care coordination can help your SNF reduce readmission rates. Discharge planning — a portion of care coordination — has been shown to reduce readmission rates by up to 15%.

Strategies for Implementing Care Coordination

With the many advantages of care coordination, your SNF needs to take steps to implement it. Strategies include:

• Take an interdisciplinary approach: Interdisciplinary collaboration involves working with healthcare professionals from various disciplines to deliver care. This approach is a core aspect of care coordination. Every provider should be involved in decisions related to a resident’s care, from medication decisions to discharge timing. Holding regular meetings with a patient’s care team is an excellent way to implement an interdisciplinary approach.
• Rely on technology: Technology tools are an excellent way to keep providers connected. Include detailed notes in an electronic health record (EHR) for easy data sharing and real-time updates. Technology can also be used to make appointments more accessible to your patients following discharge. Offer telehealth to make it easier for patients to follow through with their care plans.
• Create a post-discharge plan: While your care coordination efforts are valuable during a resident’s stay, they also play a role post-discharge. Your SNF can use post-discharge plans to establish goals and habits for residents once they leave your center. Create comprehensive care instructions for each patient about medication, diet, and exercise, and establish follow-up appointments before discharge. Care transition practices like this can help reduce readmission by up to 9%.
• Assess program effectiveness: Care coordination is an ongoing process that demands regular assessment to understand effectiveness. Once you’ve implemented your care coordination strategy, establish a series of key metrics to gauge progress. Core areas to look at include patient satisfaction scores and readmission rates.

Improve Care Coordination With First Docs

When your SNF readmission rates are high, your patients’ care outcomes may suffer as a result. Implementing care coordination strategies can be the solution to your high readmission rates, and with the help of First Docs, these strategies become more accessible. Our physicians are more present at your facility than community physicians, and they facilitate communication between providers to support interdisciplinary care.

Contact us today to learn more about how First Docs helps to improve care coordination and reduce readmission rates for your SNF.