National Trends in 30-Day Re-hospitalization Rates of Skilled Nursing Facilities with Disproportionate Shares of Racial Minorities and Dual Eligibles

Ghosh, Arnab Kumar; Jung, Hye–Young; Ibrahim, Said A.; Unruh, Mark Aaron

doi:10.1007/s11606-019-05521-6

Cited by 2 publications

(5 citation statements)

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“…African American older adults may avoid SNFs because they frequently are admitted to poor quality SNFs far from their community 34–37. Studies demonstrated that race/ethnic minority patients have greater hospital readmission rates than White patients after a SNF admission 38,39. We only identified significant race/ethnic differences in any hospital admission and not in the number of hospitaliztions.…”

Section: Discussionmentioning

confidence: 71%

“…[34][35][36][37] Studies demonstrated that race/ethnic minority patients have greater hospital readmission rates than White patients after a SNF admission. 38,39 We only identified significant race/ethnic differences in any hospital admission and not in the number of hospitaliztions. Previous studies have shown that readmission rates decrease with higher SNFs' quality; however, readmission rates are still significantly greater among Hispanics and African Americans at all quality levels.…”

Section: Sociodemographic Factorsmentioning

confidence: 81%

“…Medicare-Medicaid dual eligibility determines which health care services are available to the beneficiary. Previous studies found that dual-eligible beneficiaries were more often admitted to SNFs with low nurse-to-patient ratio41 and of low quality38,42; furthermore, they more often experience hospital readmissions 38,41. A recent study showed that Medicare-Medicaid dual eligibility was the strongest predictor of being admitted to a low-quality SNF 37.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies found that dual-eligible beneficiaries were more often admitted to SNFs with low nurse-to-patient ratio 41 and of low quality 38,42 ; furthermore, they more often experience hospital readmissions. 38,41 A recent study showed that Medicare-Medicaid dual eligibility was the strongest predictor of being admitted to a low-quality SNF. 37 These factors may influence dual-eligible beneficiaries' decision to seek care at SNF after a hospitalization.…”

Section: Sociodemographic Factorsmentioning

confidence: 98%

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Risk Factors of Skilled Nursing Facility Admissions and the Interrelation With Hospitalization and Amount of Informal Caregiving Received

et al. 2022

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Background: The correlations between skilled nursing facility (SNF) admissions, number of hospitalizations, and informal caregiving hours received after adjusting for physical and cognitive function and sociodemographic covariates are not well understood. Objective: The objective of this study was to better understand risk factors for SNF admissions and the interrelation with hospitalizations and amount of informal caregiving received, this study applied a novel joint modeling analysis to simultaneously explore the correlation and shared information between the 3 outcomes. Research Design: This was an observational follow-up study. Subjects: Data from 4836 older Americans included in the 2011–2015 rounds of the National Health and Aging Trends Study were linked with Centers for Medicare & Medicaid Services. Measures: We jointly modeled SNF admission, hospital admissions, and informal caregiving hours received while accounting for possible risk factors. We addressed missing values by multiple imputation with chained equations. Results: SNF admission evidenced a strong positive correlation with hospital admission, and SNF admission evidenced a weak positive correlation with the informal caregiving hours received after adjustment for important risk factors. Non-Hispanic White race/ethnicity, living alone, not being Medicaid eligible, Alzheimer disease and related dementias diagnosis, activities of daily living disabilities, and frailty were associated with increased risk of SNF admissions and any/number of hospital admission. Lower educational level was also associated with the latter. Medicaid eligibility was the only factor not associated with any nor numbers of informal caregiving hours received. Conclusions: Sociodemographic and health factors were important for predicting SNF admissions. After adjustment for important risk factors, SNF evidenced a strong positive correlation with the number of hospitalizations and a weak positive correlation with the hours of informal caregiving received.

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Section: Discussionmentioning

confidence: 71%

Section: Sociodemographic Factorsmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Sociodemographic Factorsmentioning

confidence: 98%

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Risk Factors of Skilled Nursing Facility Admissions and the Interrelation With Hospitalization and Amount of Informal Caregiving Received

et al. 2022

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“…Facilities that serve predominantly minority resident populations also are more likely to have lower NHC quality ratings, indicating that minority residents may receive poorer quality care compared to white residents (Campbell et al, 2016; Rivera-Hernandez et al, 2019b). These staffing and care quality concerns for racial and ethnic minority residents may result in more hospital transfers (Ghosh et al, 2020; Li et al, 2011; Rivera-Hernandez et al, 2019a).…”

Section: Introductionmentioning

confidence: 99%

Implementation of a CMS Nursing Facility Initiative: Differences by Racial Minority Resident Population

et al. 2022

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Objectives: The CMS Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents: Payment Reform (NFI 2) provided billing opportunities to incentivize participating facilities to keep long-stay residents onsite for acute care, rather than hospitalizing them. We examined cross-facility differences in NFI 2 implementation by racial composition of facility resident populations. Methods: We analyzed Medicare claims in conjunction with in-person and telephone interviews among facility staff to assess NFI 2 engagement in relation to racial minority resident population. Results: Participating facilities with larger racial minority resident populations faced additional barriers to NFI 2 implementation. These facilities submitted fewer NFI 2 claims, reported more challenges engaging resident families, and experienced greater facility staff and leadership instability, compared to facilities with predominantly white resident populations. Discussion: Addressing structural differences within facilities with larger populations of racial minority residents may encourage future development of targeted programs to support diverse nursing facilities.

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National Trends in 30-Day Re-hospitalization Rates of Skilled Nursing Facilities with Disproportionate Shares of Racial Minorities and Dual Eligibles

Cited by 2 publications

References 4 publications

Risk Factors of Skilled Nursing Facility Admissions and the Interrelation With Hospitalization and Amount of Informal Caregiving Received

Risk Factors of Skilled Nursing Facility Admissions and the Interrelation With Hospitalization and Amount of Informal Caregiving Received

Implementation of a CMS Nursing Facility Initiative: Differences by Racial Minority Resident Population

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