Hospital–Skilled Nursing Facility Collaboration: A Mixed‐Methods Approach to Understanding the Effect of Linkage Strategies

Objective

To characterize the nature and degree of hospitals’ efforts to collaborate with skilled nursing facilities (s) and associated patient outcomes.

Data Sources/Study Setting

Qualitative data were collected through 138 interviews with staff in 16 hospitals and 25 s in eight markets across the United States in 2015. Quantitative data include Medicare claims data for the 290,603 patients discharged from those 16 hospitals between 2008 and 2015.

Study Design/Data Collection

Semi‐structured interviews with hospital and staff were coded and used to classify hospitals’ collaboration efforts with s into high versus low collaboration hospitals, and risk‐adjusted, claims‐based hospital readmission rates from were compared.

Principal Findings

Hospital collaboration efforts were defined as establishing partners, transition management initiatives, and hospital staff visits to s. High collaboration hospitals were more likely to send patients to s (as opposed to home, home with home health, or other settings), sent a higher share of patients to high quality s, and had fewer hospital readmissions from sooner than did low collaboration hospitals.

Conclusions

Although collaboration with requires significant administrative and clinical time investment, it is associated with positive patient outcomes.