While skilled nursing facility (SNFs) occupancy rates are slowly increasing, they are still 20% lower than before the COVID-19 pandemic, with many SNFs still struggling to fill beds. A CarePort report found that more patients prefer to receive post-acute care at home instead of in nursing homes and SNFs. According to a recent National Investment Center for Seniors Housing and Care (NIC) survey, one-fifth of nursing care respondents anticipate that occupancy levels will not return to the pre-pandemic rate until 2025 or beyond.
As an SNF operator, one strategy to rebuild occupancy and increase revenues is to partner with a local hospital and become part of its SNF-preferred network. This partnership can help secure referrals and stimulate cash flow, especially when taking on highly complex patients.
As hospitals increasingly move toward value-based care models, which prioritize high-quality and cost-effective care, they realize the need to partner with SNFs to ensure the best patient outcomes and reduce readmissions. Many hospitals are establishing preferred SNF networks to refer their patients for continued care.
Increase patient volume
“The reason to be in a preferred network, from an SNF’s perspective, is pure volume [of patients],” said Phyllis Wojtusik, RN, Executive Vice President of Health System Solutions for Real Time Medical Systems, during a Relias webinar. In the SNF sector, “Margins are razor thin, and they have been hit extremely hard over the last couple of years with COVID. So volume is very important to them.”
Wojtusik shared key factors that hospital systems should look for when they establish their preferred SNF network:
- Type of cases the facility takes on
- The volume of patients in the facility
- The average length of stay in the facility
- Readmission rates
- Patient satisfaction level
- Centers for Medicare and Medicaid Services (CMS) Five-Star Quality Rating System
Currently, about 50% of the discharges go to a hospital’s preferred SNF network, Wojtusik said. She encouraged hospital providers to increase the amount to 80%-90%. “Patients always have a choice,” she noted. But it is important for hospital case managers to explain that they’re working with those facilities to manage their cases and ensure they meet standards of care.
The CMS Hospital Readmissions Reduction Program reduces payments to acute care facilities with a high 30-day readmission rate. One approach that hospital officials are using to manage the readmission risk and avoid Medicare penalties is establishing a preferred SNF network. Hospital and SNF providers and clinicians then work closely to manage post-acute care and improve patient outcomes after discharge.
A study published in Health Affairs in 2017 found that hospitals that developed preferred SNF networks reduced readmission rates from 2009 to 2013 by 4.5 percentage points more than hospitals that did not form a network with SNFs.
Partnering with hospitals can help SNFs care for high-need patients, especially those denied care in other post-acute settings. Jenn Leitch, MN, RN, CCM, CGS, who served as a nurse manager in the department of care management at Oregon Health & Science University, told Relias Media that the hospital “saved 2,382 hospital days over the fiscal year of July 2019 to June 2020 because we transitioned these patients to skilled nursing facilities sooner.”
The key to keeping 30-day readmission rates low is preventing avoidable hospitalizations. Your nursing staff must be proficient in caring for patients with conditions included in the CMS Hospital Readmissions Reduction Program — acute myocardial infarction, COPD, heart failure, coronary artery bypass graft surgery, and total hip or knee arthroplasty. However, these issues may not always be preventable. Your staff must quickly identify complications of these conditions and provide early treatment before hospitalization is required.
Training plays a significant role here. SNF operators should train their nurses on these skills and check their competency periodically. Short video-based courses that provide a refresher on the assessment and clinical skills necessary to prevent avoidable hospitalization can be helpful. The less often patients from your facility are readmitted to the hospital, the better your chances are of being included in a hospital-preferred network.
Understanding what hospitals are looking for when they choose their preferred SNF network can help you become a successful partner and better coordinate care for your patients. When hospitals refer patients to facilities in their network, it signals to patients that these facilities meet a trusted standard of quality care. This can improve your facility’s reputation, bring in more patients, boost occupancy rates, and increase revenue.
Managing Upside/Downside Risk with Your Post-Acute Network
This webinar discusses how hospitals can incorporate preferred SNF networks into their value-based care initiatives and how to establish a mutually beneficial partnership with their post-acute network to drive clinical performance and improve earned shared savings.Watch the Webinar →