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skilled nursing facility (SNF)

A facility staffed by nurses, providing a higher level of care than a nursing home. Intravenous therapy & wound dressing changes are generally available. Notes: - Medicare part A does not pay for skilled nursing facility without a qualifying hospitalization (see Medicare part A & 3-day hospital stay rule) [6] - Medicaid covers what Medicare does not (see Medicaid) [2] - skilled nursing facility performance measures not consistently associated with hospital readmission or death [1] - 23% admitted to SNF rehospitalized with with 30 days [2] - patients may alternatively be discharged from hospital to long-term acute care hospital (LTAC) - occupational therapists & physical therapists can predict which patients can have successful skilled nursing facility (SNF) to home discharges - medical providers & social workers can not [2,4,5] - structured handoff tool for transition from hospital to SNF can decrease wait time for receipt of controlled medications & intravenous antibiotics & time to medication administration [6]

Related

3-day hospital stay rule long-term acute care hospital (LTAC) skilled nursing facility discharge

General

nursing home

References

  1. Neuman MD et al. Association between skilled nursing facility quality indicators and hospital readmissions. JAMA 2014 Oct 15; 312:1542 PMID: 25321909
  2. Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  3. Makam AN, Nguyen OK, Xuan L et al. Factors associated with variation in long-term acute care hospital vs skilled nursing facility use among hospitalized older adults. JAMA Intern Med 2017 Feb 5 PMID: 29404575
  4. Simning A, Caprio T, Seplaki CL et al. Rehabilitation providers'prediction of the likely success of the SNF-to-home transition differs by discipline. J Am Med Dir Assoc. 2019;20(4):492-496 PMID: 30630726 PMCID: PMC6451879 Free PMC article https://www.jamda.com/article/S1525-8610(18)30664-9/fulltext
  5. Gardner RL, Pelland K, Youssef R et al. Reducing hospital readmissions through a skilled nursing facility discharge intervention: a pragmatic trial. J Am Med Dir Assoc. 2020;21(4):508-512 PMID: 31812334 https://www.jamda.com/article/S1525-8610(19)30704-2/fulltext
  6. Baluyot A, McNeill C, Wiers S. Improving communication from hospital to skilled nursing facility through standardized hand-off: a quality improvement project. Patient Safety. 2022;4(4):18-25. https://psnet.ahrq.gov/issue/improving-communication-hospital-skilled-nursing-facility-through-standardized-hand-quality
  7. Medicare.gov Skilled nursing facility (SNF) care. https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care