New from the Flex Monitoring Team: CAHs and SNFs--why some continue services, why some don't

The Flex Monitoring Team is pleased to share with you findings from their study on factors influencing Critical Access Hospital decisions to close or retain their skilled nursing facility (SNF) units. 

Why Do Some Critical Access Hospitals Close Their Skilled Nursing Facility Services While Others Retain Them?

Click to download the Briefing Paper and/or the Policy Brief 

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 as is research on the quality and outcomes of skilled care delivered by CAHs in SNF and swing beds. 

Authors of the Briefing Paper and Policy Brief are John A. Gale, Zachariah T. Croll, Andrew F.Coburn, from the University of Southern Maine, and Walter R. Gregg from the University of Minnesota.

For more information on this study, please contact 

John Gale at the University of Southern Maine Maine Rural Health Research Center