Hospital–Skilled Nursing Facility Collaboration: A Mixed‐Methods Approach to Understanding the Effect of Linkage Strategies

Objective To characterize the nature and degree of hospitals’ efforts to collaborate with skilled nursing facilities ( SNF s) and associated patient outcomes. Data Sources/Study Setting Qualitative data were collected through 138 interviews with staff in 16 hospitals and 25 SNF s in eight markets across the United States in 2015. Quantitative data include Medicare claims data for the 290,603 patients discharged from those 16 hospitals between 2008 and 2015. Study Design/Data Collection Semi‐structured interviews with hospital and SNF staff were coded and used to classify hospitals’ collaboration efforts with SNF s into high versus low collaboration hospitals, and risk‐adjusted, claims‐based hospital readmission rates from SNF were compared. Principal Findings Hospital collaboration efforts were defined as establishing SNF partners, transition management initiatives, and hospital staff visits to SNF s. High collaboration hospitals were more likely to send patients to SNF s (as opposed to home, home with home health, or other PAC settings), sent a higher share of patients to high quality SNF s, and had fewer hospital readmissions from SNF sooner than did low collaboration hospitals. Conclusions Although collaboration with SNF requires significant administrative and clinical time investment, it is associated with positive patient outcomes.