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

Award Number: R01AG070944
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 01/15/2021
PERIOD OF PERFORMANCE END DATE: 12/31/2026

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


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2025	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT STREET	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	5	10/10/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $631,425 )
2025	2025	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	001	5	7/25/2025	NON-COMPETING CONTINUATION	$51,546
2025	2025	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	5	12/20/2024	NON-COMPETING CONTINUATION	$579,879
														Subtotal = $631,425

Issue Date FY: 2024 ( Subtotal = $672,733 )
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	001	4	5/23/2024	NON-COMPETING CONTINUATION	$67,273
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	4	1/16/2024	NON-COMPETING CONTINUATION	$605,460
														Subtotal = $672,733

Issue Date FY: 2023 ( Subtotal = $632,751 )
2023	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	3	3/7/2023	NON-COMPETING CONTINUATION	$632,751
														Subtotal = $632,751

Issue Date FY: 2022 ( Subtotal = $627,223 )
2022	2022	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	2	4/7/2022	NON-COMPETING CONTINUATION	$627,223
														Subtotal = $627,223

Issue Date FY: 2021 ( Subtotal = $628,869 )
2021	2021	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	001	1	2/2/2021	NEW	$0
2021	2021	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	1	1/13/2021	NEW	$780,735
2021	2021	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	002	1	8/12/2021	NEW	-$151,866
														Subtotal = $628,869

Grand Total All Awards = $3,193,001

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

Award Number: R01AG070944

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 01/15/2021

PERIOD OF PERFORMANCE END DATE: 12/31/2026

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