Rehospitalization measure a 'strong predictor' for hospitals seeking SNF partnerships, study confirms

The rehospitalization rate measure recently added to Nursing Home Compare provides valid predictions of which skilled nursing facilities are likely to have residents readmitted to the hospital, according to a study published Friday.

The study, led by researcher Momotazur Rahman, Ph.D., of Brown University's Department of Health Services Policy and Practice, aimed to figure out if the rehospitalization rates posted on Nursing Home Compare “reflect true quality or are merely the result of favorable selection.” Determining the ratings' true relevance is especially important for hospitals looking to succeed under the Centers for Medicare & Medicaid Services' Hospital Readmission Reduction Program.

“If the published rates are the result of selection (low hospital readmission rates are due entirely to the admission of healthier patients to the SNF), then sending patients to SNFs with low rates will not improve the readmission rate to that hospital; the information will be misguided,” Rahman wrote.

Researchers used Medicare data from 2009 through 2012 to calculate skilled nursing facilities' risk-adjusted rehospitalization rates, which were then used to estimate possible rates for 2013. Results of the researchers' calculations showed that patients in facilities that experienced an increase in rehospitalizations between 2009 and 2012 were more likely to be readmitted to a hospital in 2013.

The results are promising, researchers said, since they show Nursing Home Compare's rehospitalization rates reflect true differences in quality between skilled nursing facilities and not purely differences in patient severity.

“Based on our finding, hospitals should encourage their patients to select SNFs that have lower risk-adjusted rehospitalization rates through such strategies as quality ratings and patient education,” Rahman wrote. “Because of the high rate of rehospitalizations from the SNF relative to other settings, shifting patients to a low-rehospitalization SNF can significantly reduce the likelihood of being penalized under CMS's Readmission Reduction Program.”

Results of the study appear online in Health Services Research.