McKnight’s Articles

Maybe you don’t want to be in that preferred network …

… Or, maybe you have more in common with the hospital than you think. Poor-performing hospitals tend to coexist in the same market as poor-performing skilled nursing facilities. Surprised?

How many times have you heard (or said) this statement?: “It’s the patients they’re sending me that set me up for failure.” While that might be true, it appears that the improvement opportunity exists on both sides of the fence.

Your initial reaction to the concept is likely outrage or understanding. Outrage at being referred to as a poor performer and/or understanding that referrals from a troubled hospital cannot be good news for a SNF. First, let’s define what we mean by “poor performing.”

In a recent study, we explored the relationship between a hospital’s Five-Star rating and readmission rate, to a SNFs Five-Star rating and rehospitalization rate. We grouped hospitals and SNFs into their respective 306 Hospital Referral Region (HRR) and looked at the average (mean) performance on these outcomes.

For those unfamiliar with the Hospital Five-Star rating system, it comprises 57 quality measures that relate back to seven domains: readmission, mortality, safety, timeliness, satisfaction, effectiveness and efficient use of medical imaging. You are probably most familiar with the hospital readmission measure, along with the SNF outcomes mentioned, but if not, please let me know and I’d welcome the chance to review them with you over a cup of coffee.

Continue reading Steven Littlehale’s guest column on