Table 2. Comparison of SNFs in Top Quartile of Improvement Overall, SNFs in Top Quartile of Improvement With a Baseline Below Median Level of Performance, and Overall Samplea.
| Characteristic | Most improved SNFs (n = 3743) | Most improved with below median achievement (n = 1839) | Overall sample (N = 15 306) |
|---|---|---|---|
| SNF VBP program performance | |||
| Baseline readmission rate, mean (SD), % | 0.20 (0.02) | 0.22 (0.02) | 0.19 (0.02) |
| Performance readmission rate, mean (SD), % | 0.18 (0.01) | 0.20 (0.01) | 0.19 (0.02) |
| Score, mean (SD)b | |||
| Achievement (range, 1-100 | 56.40 (26.16) | 13.15 (11.15) | 32.65 (27.68) |
| Improvement (range, 1-100) | 52.33 (20.39) | 20.90 (14.37) | 14.79 (24.43) |
| Performance (range, 1-100) | 61.44 (20.77) | 23.22 (13.56) | 34.49 (27.48) |
| Incentive payment multiplier (range, 0.98-1.02)b | 1.00 (0.01) | 0.98 (0.01) | 0.99 (0.01) |
| Facility characteristics, No. (%) | |||
| Multifacility | 2116 (60.1) | 914 (58.0) | 8490 (60.0) |
| Hospital based | 115 (3.3) | 36 (2.3) | 484 (3.4) |
| For profit | 2660 (72.0) | 1437 (79.7) | 10 691 (71.2) |
| Government owned | 210 (5.7) | 75 (4.2) | 851 (5.7) |
| No. of changes in ownership, mean (SD) | 1.72 (2.10) | 1.66 (2.06) | 1.67 (2.06) |
| No. of beds, mean (SD) | 114.35 (65.91) | 115.68 (55.83) | 108.55 (60.13) |
| No. of admissions per bed, mean (SD) | 2.47 (2.35) | 2.50 (2.41) | 2.31 (2.28) |
| Occupancy, mean (SD), % | 80.52 (14.57) | 80.44 (14.30) | 79.93 (14.81) |
| Urban location, No. (%) | 2767 (74.9) | 1425 (79.1) | 10 901 (72.6) |
| Net operating margin, mean (SD), % | −0.43 (13.32) | −1.23 (12.94) | −0.74 (13.87) |
| Star rating, mean (SD), (range, 1-5)b | |||
| Overall | 3.36 (1.32) | 3.14 (1.31) | 3.34 (1.32) |
| Quality | 4.05 (1.07) | 3.81 (1.16) | 3.99 (1.10) |
| Survey | 2.81 (1.26) | 2.71 (1.25) | 2.81 (1.26) |
| Staffing | 3.08 (1.04) | 2.97 (1.03) | 3.10 (1.06) |
| Nurse staffing rating, mean (SD) (range, 1-5)b | 3.26 (1.12) | 3.08 (1.13) | 3.28 (1.15) |
| Patient-level characteristics in facility | |||
| Age, mean (SD), y | 79.29 (6.03) | 78.30 (6.19) | 79.21 (6.35) |
| White (facility level), mean (SD), % | 78.10 (22.57) | 74.57 (23.50) | 78.67 (22.38) |
| ADL Score, mean (SD) | 16.96 (2.03) | 17.12 (2.15) | 16.83 (2.14) |
| Medicaid, mean (SD), % | 59.16 (23.25) | 61.58 (22.47) | 59.71 (23.18) |
| Case-mix index, mean (SD) | 1.19 (0.14) | 1.18 (0.16) | 1.18 (0.17) |
| Length of stay, mean (SD), d | 34.57 (21.96) | 34.97 (22.60) | 36.71 (24.57) |
| County-level characteristics | |||
| Black, mean (SD), % | 12.66 (13.66) | 14.74 (14.02) | 11.96 (12.99) |
| Hispanic, mean (SD), % | 13.99 (14.80) | 14.59 (15.21) | 13.80 (15.22) |
| White, mean (SD), % | 79.14 (15.36) | 77.16 (15.21) | 80.04 (14.79) |
| ADI score, mean (SD) | 5.65 (1.66) | 5.62 (1.63) | 5.72 (1.67) |
| Herfindahl-Hirschman Index score, mean (SD) | 0.20 (0.24) | 0.18 (0.24) | 0.21 (0.24) |
| MA enrollment, mean (SD), % | 31.0 (14.0) | 32.0 (13.0) | 31.0 (14.0) |
Abbreviations: ADI, Area Deprivation Index; ADL, activities of daily living; MA, Medicare Advantage; SNF, Skilled Nursing Facility; SNF VBP, Skilled Nursing Facility Value-Based Purchasing.
a
Most improved SNFs are those with top quartile improvement scores. Most improved with below median achievement are those with achievement scores below 50.
b
All ranges were set by the Centers for Medicare & Medicaid Services to indicate low (smallest number) and high (largest number) scores.