# Post-acute Care Outcomes of Patients with Alzheimer's Disease and Related Dementias: the Role of Skilled Nursing Facility Specialists

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2022 · $627,223

## Abstract

PROJECT SUMMARY
Over 1.1 million patients admitted annually to skilled nursing facilities (SNFs) for post-acute care after a
hospitalization have Alzheimer’s Disease or Related Dementias (ADRD), and their outcomes are poor and
variable. Given the high clinical complexity and care coordination needs of patients with ADRD, one potential
solution to improving the outcomes of patients with ADRD receiving SNF care is through physicians who
specialize in SNF-based care. “SNFists” (i.e., physicians for whom SNF patients comprise the majority of their
practice) are becoming increasingly common. Our prior work found a 37% increase in the prevalence of
SNFists from 2012 to 2015, with a high degree of variability across markets. In this study, we will examine
whether physicians specializing in SNF-based care improve functional outcomes and reduce potentially
avoidable healthcare utilization (such as hospital readmissions) of patients with ADRD receiving post-acute
care in SNFs. To accomplish these goals, we will expand an existing dataset of Medicare claims and SNF
clinical assessment data for Medicare fee-for-service beneficiaries discharged from an acute care hospital to a
SNF from 2012 through 2019. Using this database, we will examine the trends in physician specialization in
SNF care in the context of market, facility, and physician characteristics. Next, we will measure the impact of
physician specialization in SNF care on the outcomes and healthcare utilization of patients with ADRD using
difference-in-differences cross-temporal matching. Lastly, we will conduct semi-structured interviews with key
SNF personnel (e.g., director of nursing, medical director) to quantitatively identify practice strategies and care
processes that differ between physicians in high- vs. low-performing SNFs based on the outcomes of patients
with ADRD. When complete, these studies will inform practice and policy to optimize (increase or reduce) post-
acute care patients’ access to physicians who specialize in SNF-based care. The findings will be used to
develop interventions to improve the value of SNF-based post-acute care for patients with ADRD.

## Key facts

- **NIH application ID:** 10328560
- **Project number:** 5R01AG070944-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Hye-Young Jung
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $627,223
- **Award type:** 5
- **Project period:** 2021-01-15 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10328560

## Citation

> US National Institutes of Health, RePORTER application 10328560, Post-acute Care Outcomes of Patients with Alzheimer's Disease and Related Dementias: the Role of Skilled Nursing Facility Specialists (5R01AG070944-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10328560. Licensed CC0.

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