Table 1. Characteristics of SNFs in the Top Quartile by Telemedicine Use for SNF Visits in 2020 to 2021a.
| SNFs by telemedicine use, No. (%) | Adjusted odds ratio (95% CI) | ||
|---|---|---|---|
| High | Lower | ||
| No. of SNFs | 3609 | 10 842 | NA |
| No. of telemedicine visits in the group | 1 687 008 | 989 088 | NA |
| Proportion of telemedicine visits, median (IQR), % | 18.4 (13.2-29.3) | 1.7 (0.4-4.2) | NA |
| Ownership | |||
| For profit | 2573 (71.3) | 7667 (70.7) | 1 [Reference] |
| Government | 244 (6.8) | 599 (5.5) | 0.83 (0.69-0.99) |
| Not for profit | 792 (22.0) | 2576 (23.8) | 0.95 (0.85-1.05) |
| Part of chain | |||
| Yes | 2527 (70.0) | 7739 (71.4) | 0.93 (0.85-1.03) |
| No | 1082 (30.0) | 3103 (28.6) | 1 [Reference] |
| Region | |||
| South | 1173 (32.5) | 3924 (36.2) | 1 [Reference] |
| Midwest | 1606 (44.5) | 3121 (28.8) | 1.44 (1.30-1.58) |
| Northeast | 242 (6.7) | 2214 (20.4) | 0.39 (0.33-0.45) |
| West | 588 (16.3) | 1583 (14.6) | 1.24 (1.08-1.42) |
| Geographyb | |||
| Metropolitan | 1954 (54.1) | 8052 (74.3) | 1 [Reference] |
| Micropolitan | 725 (20.1) | 1276 (11.8) | 1.86 (1.66-2.07) |
| Small urban | 519 (14.4) | 968 (8.9) | 1.59 (1.40-1.80) |
| Rural | 411 (11.4) | 546 (5.0) | 2.06 (1.77-2.40) |
| No. of certified beds | |||
| ≤80 | 1531 (42.4) | 3372 (31.1) | 1 [Reference] |
| 81-120 | 1328 (36.8) | 3958 (36.5) | 0.81 (0.74-0.90) |
| ≥121 | 750 (20.8) | 3512 (32.4) | 0.68 (0.61-0.76) |
| Overall star ratingc | |||
| 1-2 | 1429 (39.6) | 3910 (36.1) | 1 [Reference] |
| 3-4 | 1416 (39.2) | 4332 (40.0) | 0.87 (0.79-0.95) |
| 5 | 764 (21.2) | 2600 (24.0) | 0.83 (0.74-0.94) |
| Nurse hours per resident-day | |||
| <1.3 | 1200 (33.3) | 2843 (26.2) | 1 [Reference] |
| 1.3-1.7 | 1487 (41.2) | 4695 (43.3) | 0.82 (0.75-0.91) |
| >1.7 | 922 (25.6) | 3304 (30.5) | 0.74 (0.66-0.83) |
| Residents with Medicaidd | |||
| ≤50% | 1126 (31.2) | 3974 (36.7) | 1 [Reference] |
| 51%-70% | 1098 (30.4) | 3260 (30.1) | 1.11 (1.00-1.24) |
| ≥71% | 1385 (38.4) | 3608 (33.3) | 1.53 (1.36-1.71) |
| Resident race and ethnicity, mean (SD), %e | |||
| Black | 8.7 (15.0) | 12.7 (17.3) | 0.87 (0.84-0.89) |
| White | 86.1 (17.7) | 81.9 (19.8) | 1 [Reference] |
| Other | 5.3 (9.3) | 5.4 (9.5) | 0.99 (0.95-1.04) |
Abbreviations: NA, not applicable; SNFs, skilled nursing facilities.
SNFs in the high telemedicine-use group had more than 9.8% of their SNF visits delivered in telemedicine. Included are SNFs that had at least 10 SNF visits for their residents in both 2020 and 2021. Ownership, chain, bed, and rating information is from January 2020 (Centers for Medicare & Medicaid Services Nursing Homes Compare). SNFs with missing information in Centers for Medicare & Medicaid Services Nursing Homes Compare are excluded (n = 800).
Area type is classified based on Rural-Urban Commuting Area Codes27: metropolitan (1-3), micropolitan (4-6), small urban (7-9), or rural area (10).
Medicare star ratings range from 1 (much below average) to 5 (much above average). This score is a composite ranking of individual SNFs that incorporates multiple measures of SNF quality, staffing, and health inspection performance.
The proportion of Medicaid-covered residents among all Medicare residents within the SNF.
The mean proportion of residents with a specific race and ethnicity represents the proportion of unique Medicare beneficiaries residing in the SNFs of that group. Odds ratios are provided for the variable scaled by 10 (the odds of an SNF being in a high telemedicine-use group associated with a 10 percentage point increase in the race and ethnicity among all Medicare residents). The other race and ethnicity group includes the categories Asian, Hispanic, North American Native, other, and missing.