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Readmission Risk Up With Shorter Stay at Nursing Facility

For patients with heart failure discharged to SNF then home, risk highest during first two days at home

THURSDAY, April 4, 2019 (HealthDay News) — For patients with heart failure discharged to a skilled nursing facility (SNF) and then home, the risk for readmission is highest during the first two days at home and is attenuated with a longer SNF length of stay, according to a study published in the April issue of the Journal of Post-Acute and Long-Term Care Medicine.

Himali Weerahandi, M.D., M.P.H., from New York University School of Medicine in New York City, and colleagues conducted a retrospective cohort study involving 67,585 Medicare fee-for-service beneficiaries age 65 years and older admitted in 2012 to 2015 with a diagnosis of heart failure and discharged to an SNF and then home. Patients were followed for 30 days following discharge from the SNF and were categorized according to SNF length of stay.

The researchers found that 24.2 percent of the SNF discharges to home were readmitted within 30 days of SNF discharge. For the composite outcome of unplanned readmission or death after SNF discharge, the hazard ratio was significantly increased on days 0 to 2 after SNF discharge versus days 3 to 30. Hazard ratios were 4.60, 2.61, and 1.70 for an SNF length of stay of one to six, seven to 13, and 14 to 30 days, respectively.

“Although skilled nursing facilities are increasingly popular, our study results lead us to believe that there are gaps in discharge planning from skilled nursing facilities and that the transition home requires more thorough preparation and training,” Weerahandi said in a statement.

One author disclosed financial ties to the pharmaceutical and medical device industries; a second author disclosed ties to the health care industry.

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