Coordinated care between hospitals and nursing homes is essential to reduce readmissions. Nursing homes can improve performance and reduce readmissions by increasing registered nursing homes. Further, communities can work together to create cross-continuum care teams comprised of hospitals, nursing homes, patients and their families, and other community-based service providers to reduce unplanned readmissions.

We evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients used data from the Centers for Medicare & Medicaid Service from 2010 to 2012. Our final sample included 2,855 communities that covered 4,140 hospitals with 6,751,713 patients, 13,060 nursing homes with 1,250,648 residents, and 7,613 home health agencies providing services to 35,660 zipcodes. Based on a mixed effect model, we found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases of 0.25% (95% CI 0.17–0.34) and 0.60% (95% CI 0.33–0.83), respectively, in community-level risk-standardized readmission rates.

Given the predicted need for continued SARS-CoV-2 diagnostic testing, as well as the evolving availability and types of diagnostic tests, off-site COVID-19 testing centers (OSCTC) leaders need timely guidance to ensure they are meeting the needs of their unique populations. This research discusses the challenges and offers considerations for healthcare organizations and others when setting up and running OSCTCs. It also provides a springboard to engage policy makers and leaders in the healthcare community in a discussion about emergency preparedness, and how to better respond to testing needs going forward.

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