How Certain Nurses Can Lower Hospital Readmission Rates at SNFs

For skilled nursing providers looking for ways to reduce unnecessary hospitalizations, taking on advanced practice registered nurses (APRNs) could be the way forward.

That’s according to Marilyn Rantz, professor of nursing for Missouri University’s Sinclair School of Nursing. In 2012, the nursing school received almost $15 million from the Centers for Medicare and Medicaid Services (CMS) for an initiative aimed at reducing rehospitalizations of nursing home residents by involving APRNs in daily operations.

In addition to Missouri University, six other sites received similar grants, including universities and healthcare providers in Alabama, Nevada, Colorado, Indiana, New York and Pennsylvania.


The Missouri program involved recruiting and placing an APRN to work with staffers and residents at 16 nursing homes in St. Louis. There, the nurses helped detect and manage the conditions that can cause otherwise hospitalizations among seniors, such as heart failure, urinary tract infections, or respiratory infections.

The program has shown plenty of promise in the five years since it was launched, Rantz said Tuesday during a guest appearance on a St. Louis Public Radio show.

“Embedding APRNs in the nursing home environment, providing a support team for them to be successful in that environment, has proven to be…among the best intervention so far,” she said.


Hospital stays are generally more expensive than nursing home stays, and by reducing costlier hospitalizations, the CMS program can save taxpayers a fortune over time.

“It is a huge savings for the taxpayers,” Rantz said. “It rolls up into billions and billions and billions of dollars, nationwide.”

It’s also of critical importance to skilled nursing providers, which beginning in October 2018 will see 2% of their Medicare funding withheld if hospital readmission rates don’t meet certain benchmarks.

CMS renewed the APRN program across the seven sites last year. Moving forward, Rantz said she hopes to make it easier for APRNs to work in more U.S. nursing homes by pushing for changes to certain regulations.

“There are some changes that need to take place for this to work nationwide and better across Missouri,” she said. “We need to change the regulations that over-regulate APRN practice, particularly in nursing homes.”

Listen to the full discussion on the St. Louis Public Radio website.

Written by Tim Regan

Companies featured in this article:

, ,