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The Impact of an SNFist on Preventable Hospitalizations

Having an SNFist in a post-acute facility can make a significant impact on the number of hospital admissions and readmissions their patients are able to avoid.

A SNFist is a physician who specializes in the care of patients residing in post-acute  settings, such as assisted living or skilled nursing facilities. The Affordable Care Act addresses the issue of  potentially avoidable hospitalizations in an attempt to improve patient care and save Medicare and Medicaid millions of dollars.

hospital-hallway-SNFistThe primary focus is on reducing the number of hospital readmissions that are often avoidable – and always costly in both money and continuity of care. In a post-hospitalist facility, hospital admissions can often be attributed to delayed attention by a physician who is tied up with their other practice or by an over-abundance of caution by nursing staff at the post-hospitalist facility.

“The SNFist sees nursing home patients — whether they are permanent residents or are in intermediate convalescent care — all day, and develops a nuanced understanding of the potential and limitations of the SNF as a care setting,” John Rossheim wrote in a blog for Curaspan, which specializes in patient transitions.

Quick assessment by a SNFist means treatment can begin before the condition becomes acute, avoiding unnecessary hospitalization. In a post-acute facility without a SNFist, the same patient may have to wait until the end of the work day before nursing staff receives a return call from a physician who has been busy with her practice all day – a physician who may be reluctant to drive to a facility at the end of a long work day to attend to a patient whose condition has been deteriorating and recommend hospitalization instead.

This is no small problem. A 2010 clinical investigation found that two-thirds, 134 out of 200, of hospital admissions of nursing-home patients in 20 different Georgia hospitals were very likely preventable.

Of course the impact a SNFist can have on patient care is obvious. But their impact on the facility’s bottom line can also be significant.

The Affordable Care Act calls for reduced reimbursement rates to facilities with high 30-day readmission rates. The penalty began as a 1% reduction in their overall Medicare reimbursement rate, is currently at 2% and will rise to 3% in 2017 where it will remain.

General Medicine, The Post-Hospitalist Company provides on-site SNFist services to a variety of post-acute  settings.

Learn the many ways General Medicine, The Post-Hospitalist Company can help you cut hospital admissions and readmissions, improve patient care and prevent Medicare reimbursement penalties.


Tom Prose