Who Makes It Home: Skilled Nursing Facility to Community Transitions for Medicare Beneficiaries With Serious Mental Illness
This work finds within-group differences in characteristics associated with SNF discharge outcomes among the population of patients with SMI at both the person- and organization-levels. Policymakers should consider how to leverage value-based payment (VBP) programs, including new SNF-VBP requirements, in a way that more realistically accounts for the resources (e.g., time, staffing) required to coordinate care for this population. Similarly, an explicit focus on investments along the continuum should center around services that facilitate community retention (e.g., home- and community-based services).
Authors
- Tetyana Pylypiv Shippee (ORCID: https://orcid.org/0000-0003-1804-2527)
- Carrie Henning‐Smith (ORCID: https://orcid.org/0000-0002-0273-0387)
- Donovan T. Maust (ORCID: https://orcid.org/0000-0003-4740-2640)
- Dori A. Cross (ORCID: https://orcid.org/0000-0003-3489-3954)
- Taylor Bucy (ORCID: https://orcid.org/0000-0002-9049-1100)
Institutions
- University of Minnesota (US)
- University of Kansas (US)
- University of Michigan (US)
- VA Ann Arbor Healthcare System (US)
- Minnesota Department of Health (US)
Publication Details
- Journal
- Journal of the American Geriatrics Society
- Published
- 2025-11-13
- DOI
- https://doi.org/10.1111/jgs.70205
- Primary Topic
- Geriatric Care and Nursing Homes
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Agency for Healthcare Research and Quality
- National Institute on Aging