By: Avinash Kumar  May. 10, 2019
CMS recently instituted a program to evaluate and incentivize skilled nursing facilities (SNF) based on Hospital 30 day readmissions. For example, if a patient is discharged from a hospital to a SNF on Jan 15th 2019 and is readmitted back to a hospital on Jan 27 2019, then this would be counted as part of the measure for SNF Hospital 30 Day readmissions. Dexur analyzed Medicare claims (Oct 2015 to Mar 2018) for three separate skilled nursing facilities to understand the role of Atrial Fibrillation (AFib) on the overall readmissions for these SNFs.
The selected SNFs in the analysis were across the country and are:
To make the calculations clear in the above chart, there were 3233 SNF Stays at Nuvista from Medicare patients who were discharged from a hospital. Of the 3233 SNF Stays, 497 were readmitted back to a hospital within 30 days, thereby getting a readmission rate of 15.3% (497 / 3233). Further, of the 3233 SNF Stays, there 804 patients who had AFib and of these 804 patients, 169 patients were readmitted back to the hospital for a rate of 21.02% (169/804). Therefore, AFib was present in 34% (169/ 497) of all readmitted patients.
Total 30 day Hospital readmissions for these SNFs ranged from 15.2% (Minnesota Masonic) to 16.1% (Whitehall). Patients that had AFib were readmitted at higher rate of 16.3% (Minnesota Masonic) to 21.2% (Whitehall). However, when we looked at only the patient population that were readmitted, we find that patients with AFib were 25% (Deerfield) to 34% (Nuvista) of all readmissions.
The analysis shows that coordination across the hospital and SNF for the long term care of the patient needs to be managed at the condition level to improve hospital 30 day readmissions. For example, the top three hospital sources for patients with AFib for the Nuvista facility are JFK Medical Center in Atlantis, FL, Bethesda Hospital in Boynton Beach, FL and Wellington Regional Medical Center in Wellington, FL. Improvement in readmissions for AFib patients would need a concerted effort by Nuvista across all these hospital sources.