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Design and Construction of an Urban Runoff Research Facility
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Urban-Rural Differences in Skilled Nursing Facility Rehospitalization Rates.

Jan P Clement1, Jaya Khushalani1, Marianne Baernholdt2

  • 1Department of Health Administration, Virginia Commonwealth University, Richmond, VA.

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Skilled nursing facilities (SNFs) in rural areas have lower rehospitalization rates. This rural advantage may stem from community connectedness, potentially impacting SNF reimbursement and admissions.

Keywords:
Long-term careaccess to carehealth services researchrehospitalizationurban-rural location

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Area of Science:

  • Gerontology
  • Health Services Research
  • Rural Health

Background:

  • Skilled nursing facilities (SNFs) play a critical role in post-hospital care.
  • Rehospitalization rates are a key quality indicator for SNFs.
  • Understanding factors influencing rehospitalization, such as geographic location, is crucial.

Purpose of the Study:

  • To investigate the relationship between rurality and 30-day all-cause risk-adjusted rehospitalization rates in SNFs.
  • To determine if SNF location (rural, suburban, urban) impacts rehospitalization outcomes.

Main Methods:

  • A cross-sectional study utilizing data from the Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare website (2014-2015).
  • Analysis included 12,261 non-hospital-based SNFs across the US.
  • A multiple linear regression model assessed the association between rurality and rehospitalization rates, controlling for SNF and community variables.

Main Results:

  • SNFs located in rural areas and large rural towns exhibited the lowest risk-adjusted rehospitalization rates.
  • Suburban SNFs had higher rates than rural ones, followed by urban SNFs.
  • These findings persisted after controlling for community and SNF-level resources.

Conclusions:

  • Rurality is associated with lower SNF rehospitalization rates.
  • A strong sense of community connectedness in rural areas may contribute to these lower rates.
  • Further research is needed to confirm these findings and explore underlying mechanisms.