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The importance of home health data to SNF administrators

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James M. Spencer,  RKL Senior Living
James M. Spencer, RKL Senior Living

Skilled nursing facility administrators are facing occupancy challenges. According to an article published in McKnight's on September 15, 2017, “Skilled nursing occupancy dropped to 81.7% - its lowest point in five years.” The statistic was based on a report released by the National Investment Center for Seniors Housing & Care.

What is driving this occupancy slump? As we see the industry landscape changing, it comes down to two key factors: More prospective residents are electing to stay home and receive care in the residential setting, and average lengths of stay are dropping as Medicare pushes value-based payment models in lieu of fee-for-service models.

The first issue is tough for SNF administrators to address. People naturally want to remain in the familiar setting of their homes as they age, but not everyone is able to do so. The SNFs that remain viable are those that can find ways to be competitive and partner with referral sources.

This is where length of stay comes into play. For Medicare residents who are at a SNF for short-term rehabilitation from a hospital visit, the length of stay is dropping as a result of pressure to achieve better outcomes at a lower cost. In the past, a 30+ day average length of stay was typical and gave residents time to rehab. Current average lengths of stay have dropped below 20 days as residents are moved to the lowest cost of care as quickly as possible.

This leaves administrators asking: What happens to the residents after they leave the SNF? Most are discharged to the community and many receive home health in their homes. Since, as we all know, 30-day readmissions to the hospitals result in reimbursement penalties imposed on the hospitals, SNF administrators need to be concerned about the care of a resident who is being discharged to their facility from the hospital. Since the average length of stay for the SNF Medicare cohort is under 20 days, SNF administrators need to be confident that when discharged to the home, the resident will receive high quality care in that setting to prevent hospital readmissions.

SNF administrators may wonder how they can evaluate the home health provider that will be caring for a resident upon discharge. Home Health Compare data provide information about the quality of care for Medicare Certified Home Health agencies. The Home Health Compare information, which is available online through the Centers for Medicare & Medicaid Services, provides data related to care, best practices and resident survey responses about their experiences with providers.

Analysis of this data can assist SNF administrators in identifying relationships to partner with the best Home Health providers available. Key information that can be gained from such data analysis includes:

  • Quality and provision of care provided;
  • Resident outcomes;
  • Resident experience; and
  • Readmission rates.

The key here is not only to understand outcomes of residents once they are discharged from the SNF, but also to leverage the information for talking points with hospitals when seeking preferred provider relationships or bundled payment arrangements. Empirical data that clearly illustrate outcomes throughout an episode of care to hospital discharge planners can set an SNF apart from the competition and will help keep those coveted Medicare resident beds full.

James M. Spencer, CPA, MBA, is a manager at Senior Living Services Consulting Group, RKL LLP

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