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).
Readmission rates, patient outcomes, and SNF revenue are closely connected. Key statistics and their impact demonstrate the importance of developing reduction strategies.
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. When a patient needs readmission, the direct financial cost is 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.
While these lower reimbursement rates are a direct loss, there are also indirect impacts on revenue. 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 due to a damaged reputation. When families and patients see higher readmissions, they see a lower quality of care. Occupancy rates can subsequently decline and lessen your center’s overall profitability.
The good news is there are several effective solutions for reducing readmission rates. A comprehensive approach can help SNFs improve patient outcomes and achieve value-based care goals. Here are seven key areas that SNFs should focus on to tackle readmissions.
Readmission risk rises between 3% and 35% daily without active physician care after entering a SNF — as a result, regular and consistent physician access is key to lowering readmission rates. Having physicians present on-site daily enables early identification and management of emerging health issues, reducing the likelihood of hospital transfers and readmissions.
The SNFist model at First Docs places skilled physicians in your center up to five days a week, ensuring patients are treated in place and minimizing unnecessary hospitalizations.
Proactively evaluating new admissions and providing timely treatment plans helps prevent complications that lead to readmissions. First Docs physicians are hospitalist-trained and have expertise in identifying early signs of decline, addressing acute issues quickly, and stabilizing patients within the center to minimize hospital transfers.
Strong care coordination between physicians, nurses, and other providers is crucial for reducing readmissions.
Implement interdisciplinary care team meetings, where providers share real-time updates and develop a cohesive strategy for each resident’s care. Doing so helps improve communication and creates a collaborative environment where every participant understands the next steps in a patient’s care. First Docs physicians facilitate this collaboration, ensuring seamless communication and comprehensive care management.
Patients with chronic conditions, such as heart failure, COPD, or diabetes, are at a higher risk of readmissions since these conditions often have complex care needs. A customized plan involving regular monitoring, medication management, and patient education can help mitigate risks. First Docs physicians are experienced in managing complex chronic diseases for personalized care that aligns with best practices.
A well-structured SNF post-discharge plan reduces the chance of readmissions by ensuring patients continue receiving appropriate care at home or in outpatient settings. Research shows that effective post-discharge planning can decrease readmission rates by up to 15%.
Your SNF can use post-discharge plans to establish goals and habits for residents with comprehensive care instructions for each patient. Establish follow-up appointments with Primary Care Physicians or specialists, and provide clear instructions on medication, diet, and physical activity.
The First Docs approach includes creating robust post-discharge plans that focus on preventing complications. Care transition practices like this can help reduce readmission by up to 9%.
Reducing unnecessary transfers to the hospital is crucial for lowering readmission rates. The First Docs SNFist model ensures prompt, on-site acute medical care, avoiding hospital transfers unless absolutely necessary. This approach enhances patient outcomes and limits exposure to hospital-acquired infections or other complications.
Data analytics empowers you to drill down into your unique SNF, resident, and readmission information. Spot trends faster and refine your care strategies as a result for better outcomes. First Docs physicians collaborate with SNFs to assess and interpret key metrics like readmission rates in real time. This partnership helps improve care quality and supports value-based care approaches while enabling data-backed decisions.
When your SNF readmission rates are high, your patients’ care outcomes and bottom line may suffer as a result. Implementing readmission-reduction strategies can counteract high 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. They also partner with SNFs to develop proactive, comprehensive care plans based on unique resident requirements and readmission data.
Contact us today to learn more about how First Docs helps to improve resident care and reduce readmission rates for your SNF.