Reduce Hospital Readmissions With Effective SNF-to-Home Transitions

April 15, 2019

New data shows that patients discharged from a skilled nursing facility to home face the highest risk of readmission in the first two days after SNF discharge.


Readmissions are a key financial and quality metric for hospitals.

New data shows that a quarter of heart failure patients discharged from a hospital to a skilled nursing facility then to home are readmitted to a hospital.

Best practices for the SNF-to-home transition are likely similar to the best practices of the hospital-to-SNF transition.

Efforts to reduce hospital readmissions should include effective SNF-to-home transitions and appropriate skilled nursing facilitylength of stay, new research indicates.

For hospitals across the country, readmissions have become a crucial metric with quality and financial dimensions. A hospital's readmission rate is a key indicator of care quality and the effectiveness of discharge planning. Since 2012, Medicare has been penalizing hospitals financially for readmissions linked to several targeted conditions such as pneumonia.

The new research, which was published in the Journal of the American Medical Directors Association, features Medicare claims data collected from more than 67,000 heart failure hospitalizations in which patients where discharged to a SNF then to home.