Hospitals Becoming More Selective of Skilled Nursing Facilities

During a hospital stay, decisions about patients are made quickly and family members must rely on the expertise of the hospital care team to make the best choices about ongoing care and treatment. When it comes to placement in a skilled nursing facility (SNF), hospital staff must do their best to suggest a facility that offers the specialized care and resources necessary to help a patient continue on the road to recovery.Hospitals Becoming More Selective of Skilled Nursing Facilities

Read more about how hospital teams are becoming more selective when deciding where to refer and place patients, as well as who they endorse.

Skilled Nursing Facilities

Skilled nursing facilities are generally the next stop for people requiring complex medical care after an acute hospital stay. Often used interchangeably with the term “nursing home,” SNFs offer a high level of skilled medical expertise and services. The aim of SNFs is to provide long and short-term care to individuals who are sick, injured or disabled, with the goal of helping them recover. SNFs specialize in a variety of areas, including:

  • General rehabilitation
  • General wound care
  • Parkinson’s care
  • Stroke recovery
  • Terminal illness care

The Selection Process

It is important for hospital staff to make referrals to appropriate and qualified skilled nursing facilities, to not only ensure ongoing, quality care for patients, but to also protect their own bottom line.

The cost to care for an acute patient per day in hospital is astronomical, and hospital readmissions through the emergency room are chaotic and inefficient. With strict Medicare penalties for hospital re-admissions, hospitals are adopting stringent selection processes to ensure the continuum of care is seamless for patients.

There are a number of areas that hospitals look at when selecting which SNFs to refer patients and their families to. These include:


It’s no surprise that quality credentials and positive metrics are especially important when hospitals choose to endorse skilled nursing homes. Specific metrics that are measured include:

  • Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Ratings
  • Fall prevention
  • Hospital readmission rates
  • Infection control
  • Pain management

Staff Turnover

According to Nancy Schwalm, chief business development officer at Vivage Senior Living, “hospitals have figured out that if you have a stable staff, you have better care, so they look for low turnover rates and longevity of leadership.”

Consistency with senior leaders and management is an important factor “because operations and best practices come from the top, so if there is different leadership every time an inspection is performed, it’s like starting from square one,” Schwalm says.

Hospitals must be certain that the facilities they recommend provide quality care because a hospital’s own reputation is on the line when recommending a facility.

Skilled nursing homes continue to play an important role in patient recovery after a hospital discharge, so it is important for hospitals to know exactly what kinds of facilities they are referring patients to. Selectivity by hospital administration ensures checks and balances like the careful monitoring of SNFs, and more importantly, linking patients with the best possible ongoing care.

Families and patients who have questions about their post-hospital care, or a recommended skilled nursing facility should feel free to ask their doctor, hospital administrator or nurse for information about why the hospital is recommending one skilled nursing facility over another.

How are hospitals becoming more selective of skilled nursing facilities where you live? We’d like to hear your stories in the comments below.

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