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  • Hospital 'Preferred Provider' Lists Put Pressure on SNFs

    A recent article in Modern Healthcare says that with increasing frequency skilled nursing facilities (SNFs) are being forced to compete for a coveted place on a hospital's list of "preferred facilities" that will receive the bulk of the hospital's referrals. According to the article, the results seem to be paying off—both in terms of improved patient outcomes and lower costs.

    Reporter Melanie Evans tracks trend by focusing on several hospitals that have adopted an "aggressive new strategy" of creating a shortlist of SNFs that will be recommended to patients after discharge. These preferred facilities are accepted based on a host of outcome data from state health reports and Medicare quality measures, including length of stay and readmission rates, in addition to questionnaires and interviews from the hospital.

    And those approval lists can be fairly exclusive. For example, Phoenix, Arizona-based Banner Health accepted 34 SNFs from among 90 applications; Partners Healthcare in Massachusetts included 47 of 140 potential SNFs in its preferred provider list.

    Evans writes that data gained since the switch to a preferred facilities system bears out the underlying assumptions—average lengths of stay are dropping, along with 30-day readmission rates. One Lincoln, Nebraska, hospital saw readmission rates drop from 15% to 11% in 7 months.

    While the SNFs that make the cut are experiencing increased business, the facilities that aren't on the lists may be in for tough times ahead, according to James Michel of the American Health Care Association. "For many providers, it could be life or death," he said in the article.


    • The SNF I worked for 2.8 yrs trumped up a "you're terminated for insubordination". They did not respond when the Unemployment Board called to ask what caused my being terminated. ENTIRE GOAL OF FACILITY was to keep pts in longer, staffing was 1 PT (me) to 3 or 4 PTAs. They have not been able to retain a PT since I was terminated in 10/2013. There are only 2 CNAs on a floor with up to 30 low-level pts. The hosp d/c the pts after 3 days no matter WHAT condition they are in. I called the facility the "step-down unit from the ICU" as many pts were DC'd to us directly from ICU. There were (usually 2 nurses-- one a LPN and if we were lucky, one RN whose SOLE JOB was dispensing meds. If a pt walked 40 ft and his HR increased to 130, and Oxygen sats dropped to 78% (and pt has anemia), there was NEVER a nurse to tell. The LPN would not even know the pt was near death. WE would counsel her to call the doc and get an order for supp oxygen, which she might or might not do, because the atmosphere in the place was dog-eat-dog. If she called the MD he may/may not order the supp O2. She gets in trouble for not calling the doc. I would get "in trouble" for "doing the nurse's job" (when this is CLEARLY the responsibility of the PT to monitor pt's tolerance to light exercise. Being fired was one of the most despairing moments of my career. I WANTED to do a good job. However, per our director (who has now also been fired, incl the dietary mgr, head Nurse, Rec Directror, Head Nurse x 2.EVERYONE angry as pt close to death but no orders for supp O2! It's NOTHING but money now..

      Posted by M Vitek on 5/22/2015 11:40 PM

    • Thanks for the post.

      Posted by bree on 8/23/2015 6:59 PM

    • Interesting post, thanks for sharing.

      Posted by Bree on 8/25/2015 2:08 PM

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