Do Hospital-Owned Skilled Nursing Facilities Provide Better Post-Acute Care Quality?

44 Pages Posted: 22 Aug 2016 Last revised: 8 Jan 2025

See all articles by Momotazur Rahman

Momotazur Rahman

Brown University

Edward C. Norton

University of Michigan at Ann Arbor

David C. Grabowski

Harvard University - Department of Health Care Policy

Date Written: August 2016

Abstract

As hospitals are increasingly held accountable for patients' post-discharge outcomes under new payment models, hospitals may choose to acquire skilled nursing facilities (SNFs) to better manage these outcomes. This raises the question of whether patients discharged to hospital-based SNFs have better outcomes. In unadjusted comparisons, hospital-based SNF patients have much lower Medicare utilization in the 180 days following discharge relative to freestanding SNF patients. We solved the problem of differential selection into hospital-based and freestanding SNFs by using differential distance from home to the nearest hospital with a SNF relative to the distance from home to the nearest hospital without a SNF as an instrument. We found that hospital-based SNF patients spent roughly 5 more days in the community and 6 fewer days in the SNF in the 180 days following their original hospital discharge with no significant effect on mortality or hospital readmission.

Suggested Citation

Rahman, Momotazur and Norton, Edward C. and Grabowski, David C., Do Hospital-Owned Skilled Nursing Facilities Provide Better Post-Acute Care Quality? (August 2016). NBER Working Paper No. w22515, Available at SSRN: https://ssrn.com/abstract=2827433

Edward C. Norton

University of Michigan at Ann Arbor ( email )

500 S. State Street
Ann Arbor, MI 48109
United States

David C. Grabowski

Harvard University - Department of Health Care Policy ( email )

25 Shattuck Street
Boston, MA 02115
United States

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