Why Do Some CAHs Close Their Skilled Nursing Facility Services While Others Retain Them? (Policy Brief #31)

Document Type

Policy Brief

Publication Date

11-1-2012

Keywords

MRHRC

Abstract

This policy brief addresses the factors related to closure of skilled nursing units by some Critical Access Hospitals (CAHs) and the continued provision of these services by others.

Key Findings

  • Critical Access Hospitals(CAHs) that closed Skilled Nursing Facility (SNF) units cited a range of financial challenges related to payer mix, operating costs, cost allocation methods, and service utilization patterns.
  • The availability of alternative local long term care services, including swing beds, often contributed to hospitals’ decisions to close their SNF units.
  • CAHs that continued to operate SNF units were driven primarily by community need, despite the financial disincentive for doing so. Hospitals reported substantial variation in their strategies for using swing beds for SNF, rehabilitation, and post-acute services.
  • Given ongoing concerns about financial viability and low census rates among some CAHs, further research on the ability of CAHs to expand patient services and revenues through swing bed use is warranted.
  • Additional research on the quality and outcomes of skilled care delivered by CAHs in SNF and swing beds is also recommended.

Topics

Community Impact, Health Care Services. Hospital Services, Nursing Facilities

Funding Organization

Federal Office of Rural Health Policy

Grant Number

PHS Grant No. U27RH01080

Additional Files
policybrief31-cah-snf-services.pdf (164 kB)
Why Do Some CAHs Close Their Skilled Nursing Facility Services While Others Retain Them? (Policy Brief #31)
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