According to John Rossheim, “An SNFist is a primary-care physician who practices within the four walls of one or more nursing homes, as an employee or contractor. The SNFist sees nursing home patients — whether they are permanent residents or are in intermediate convalescent care — all day and develops a nuanced understanding of the potential and limitations of the SNF as a care setting. The SNFist is typically paid a salary or contracting fee by the nursing home and the nursing home collects reimbursement for physician services from public and private payers.”

Success in achieving positive resident/patient outcomes is more critical now than ever before. The link between quality and payment in long-term and post-acute care (LTPAC) is growing stronger, as evidenced by the Skilled Nursing Facility (SNF) Value-Based Purchasing Program (VBP), Improving Post-Acute Care Transformation (IMPACT) Act, SNF Quality Reporting Program (QRP) and more. Minimizing potentially preventable hospital admissions is now the goal of the entire LTPAC setting. An elevated hospital readmission rate can ultimately lead to financial penalties, decreased referrals, and decreased overall revenue. In addition, regulatory activity is intensifying through focused surveys on adverse events including dementia care and MDS. The Five-Star Rating system and Nursing Home Compare have been revised and will add items in the future as it broadens public reporting and transparency. Most importantly, consumers expect and deserve high-quality care. That is where an SNFist can help:

How an SNFist Helps You Provide High-Quality Care

1. SNFists provide higher quality patient care

An SNFist program provides post-acute patients with higher quality patient care than conventional post-acute care models because they were formed to meet the special needs of patients in post-acute facilities. Physicians can gain a more detailed understanding of the nuanced functions and procedures not only specific to post-acute care, but those that are specific to your post-acute care facility. Further, an SNFist/Post-Hospitalist program upholds the values of patient-centered care, helping resident patients develop high levels of personal agency so they can participate in their recovery and stabilization.

2. SNFist Programs provide much-needed continuity of care

Having an SNFist program makes communication more convenient. Physicians and clinicians are on site, so there is no need to coordinate communication with external parties. SNFist/Post-Hospitalist programs significantly reduce the issue and cost of patient transportation by facilitating appointments on site and by seeing patients more frequently to prevent unnecessary hospitalizations. Since the SNFist/Post-Hospitalist is familiar with the limitations of the facility, they can suggest ways that resident patients can participate in the management of their health care using the resources that are available to them in the facility.

3. SNFist/Post-Hospitalist Programs are proven to reduce hospital readmissions

The Medicare Payment Advisory Commission reports that 25 percent of hospital readmissions for post-acute patients are avoidable and caused by negligent care in a post-acute care facility. Because SNFist physicians and clinicians are on site, they are more apt to catch illnesses and unforeseen problems earlier in their development - before they require emergency treatment. Providing high-quality professional care and bringing in an SNFist /Post-Hospitalist program is a proven method for showing impact based on hospital readmission data.

4. SNFists can help improve the public's perception of long term care

SNFist/Post-Hospitalist programs allow physicians to have the time to truly care for their patients and understand all of the nuances and particularities of working in post-acute care. By incorporating an SNFist program into the structure of your post-acute care organization, both the staff and the residents will do their best, and the public will see that.

The entire framework of an SNFist outlines key elements from both an organizational and clinical nature that are critical to successful clinical and organizational outcomes. Positively, these elements reflect common denominators that cross multiple care situations. Therefore, instead of being yet another initiative or single focused project to achieve just one outcome, it is a way of acting, thinking and being that will benefit multiple areas across an organization.