Abstract
Objectives
To examine the association of rurality with skilled nursing facility (SNF) all-cause
30-day risk-adjusted rehospitalization rates.
Design
Cross-sectional study combining Center for Medicare and Medicaid Services Nursing
Home Compare (CMS-NHC) website for 30-day risk-adjusted rehospitalization rates for
2014-2015 with SNF organizational and community variables.
Participants
12,261 non–hospital based skilled nursing facilities in the US.
Measurements
We estimated a multiple linear regression model of percentage all-cause unplanned
risk-adjusted rehospitalization rate within 30 days after a hospital discharge and
admission to the SNF averaged over the third and fourth quarters of 2014 and the first
and second quarters of 2015. The model uses robust standard errors.
Results
After controlling for community- and SNF-level resources, the risk-adjusted rehospitalization
rates for SNFs are lowest in rural areas and large rural towns followed by SNFs in
suburban and then urban areas.
Conclusion
The rural culture that includes a strong sense of connectedness among residents may
contribute to lower SNF rehospitalization rates. Our results suggest that rural SNFs
may avoid future reimbursement penalties and decreased admissions from patients discharged
from hospitals because of their lower rehospitalizaton rates. However, because this
is the first study to address this topic, additional research is needed.
Keywords
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Article info
Publication history
Published online: April 10, 2018
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
