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04/19/2023 1
San Diego SNF Resource Analysis
July 24th 2014
04/19/2023 2
National University EffortResults of Student Research• Determining SNF health delivery capacity• What are the Skilled Nursing Care Resources
in the San Diego Community and are their GAPS in Services available?
• Investigators: Sharon Segrist, Joe Feliciano
• Internship Coordinator-Kiera Schminke, MPH
04/19/2023 3
Presentation of Results
• Methodology• Conduct of Survey• Aggregation and Extrapolation of
Data• Discussion of Results
04/19/2023 4
Methodology-Data Sources
• Utilization of Skilled Nursing Facilities– Facility register- County of San Diego
Skilled Nursing Facility Emergency/Disaster Task Force
–Office of Statewide Health Planning 2012 reporting data
– Survey Monkey Results from +58% of local facilities
– Imperial County Information
04/19/2023 5
Conduct of Survey
• Sourced from Interact tool kit used in MDS reporting and analysis
• Tested 10 key questions with SDHCA Board of Directors
• Sent out surveys• Follow up with calls and emails
04/19/2023 6
Aggregation of Data
• Regional Analysis- utilizing the County of San Diego Emergency Services Region model
• Local Hospitals in relation to skilled care facilities
• Collection of self reported data on specialty services
• Use of Extrapolation technique to draw conclusions with results
04/19/2023 7
RESULTS
04/19/2023 8
National/ State ComparisonBeds per 10,000 population
Natl State San Diego 0
10
20
30
40
50
60
Series1
04/19/2023 9
Regional Capacity
North In-land20%
North Cen-tral8%
East 38%
North Coastal12%
Central 10%
South12%
Skilled Nursing Beds by RegionSan Diego County 2014
04/19/2023 10
Occupancy by Region 2013
North In
land
North Centra
lEast
North Coasta
l
Central
South0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
Series1
Skilled Nursing Facility Occupancy by Region 2013
04/19/2023 11
Relational Data
• Average number of SNFs- within 5 miles of hospital
63 %
04/19/2023 12
Unserved Communities
• These local communities have no/limited skilled nursing facilities:
• These local communities have the most skilled nursing facilities:
• El Cajon, Kearney Mesa, Escondido
Alpine North Park Rancho San Diego
Ramona Bonsall San Ysidro
Julian La Costa Point Loma
Kensington Imperial Beach Mission & Ocean Beach
04/19/2023 13
Service CapacityMost skilled nursing facilities provide:
Specialized Diet Management
04/19/2023 14
Service Capacity
Few Facilities Offer:
04/19/2023 15
How soon after admission is the patient evaluated by a physician?
24 (50.00%)
04/19/2023 16
Wound Care Services
04/19/2023 17
Pharmacy Services
04/19/2023 18
Socio-Economic Factors
• Corporation Owned facilities 32%• Privately Owned facilities-LLC’s- 52%• Non Profit Facilities 15%• Leading owner-operators in San
DiegoSHEA Family Covenant Front PorchPlum Windsor RemingtonElmscroft Brighton LifeCare
04/19/2023 19
Identified Gaps
• Few private or negative pressure Isolation Rooms
• Trach and Vent Management Programs
• Location of patient placement – close to hospital not close to family/home
• Quick Access to MD’s post admission
04/19/2023 20
Recommendations
• Conduct SNF Survey Annually• Improve Participation of Facilities in survey• Publish results in Quick Guide• Explore the expansion of the care conversation
with families, patients and primary care physicians• Explore preference to place patients in facilities
nearer to their home community• Refine the role of Hospital Case Managers and Post
Acute care management
04/19/2023 21
Dual Eligibles & other Fun
• Battle of the Case Managers to “own” the patient
• Lack of Understanding about the operational pattern of SNF nursing units
• Everyone must incorporate each other into the planning for a patient’s/resident’s care.
• Continued Care Compact
04/19/2023 22
Thank you!