Nursing ETDs

Publication Date

Fall 12-12-2018

Abstract

ABSTRACT

Older adults often require short-term nursing home care after an acute hospital stay to receive skilled nursing or rehabilitation services. Rehospitalization after a skilled nursing facility (SNF) admission is a potential indicator of poor nursing home quality that is associated with substantial risks of complications and increased costs of care. This study examined resident and facility factors associated with 30-day rehospitalizations during a one-year study period from SNFs in New Mexico. The Minimum Data Set 3.0 was used to explore resident factors and Nursing Home Compare data was used for facility factors. Among residents admitted to the SNF from an acute care hospital for 30-days or fewer (n = 2,370), 317 (13.4%) were rehospitalized. In bivariate analyses, several resident characteristics during their SNF stay were associated with significantly increased probability of rehospitalization, including an unhealed pressure ulcer, delirium, shortness of breath, and oxygen use. In multivariable models, the relative odds of rehospitalization were increased in those who identified as American Indian or Alaska Native, residents who rejected care, those with symptoms of delirium, and those who required greater mobility assistance with activities of daily living. The relative odds of rehospitalization were decreased in women and in residents with dementia. However, overall, none of the models improved prediction of rehospitalization. The Nursing Home Compare 5-star rating showed a decline in nurse staff ratings from 2015 to 2016. Policy implications include value-based penalties linked to high SNF rehospitalization rates and policies focused on reducing Medicare costs, while improving nursing home quality.

Degree Name

Nursing

Level of Degree

Doctoral

Department Name

College of Nursing

First Committee Member (Chair)

Mark B Parshall

Second Committee Member

Marie L Lobo

Third Committee Member

Stephen H.A. Hernandez

Fourth Committee Member

Christine A. Mueller

Keywords

skilled nursing facility, rehospitalization, nursing home, policy

Document Type

Dissertation

Available for download on Saturday, December 12, 2020

Included in

Nursing Commons

Share

COinS