For skilled nursing operators, a 27.8% rehospitalization rate among appeal losers is a measurable outcome tied to discharge timing and a liability under value-based purchasing arrangements.
Of 453 eligible SNF admissions, 47 (10.4%) patients filed 58 appeals [mean age 79.3 (SD = 10.6), 25 (53.2%) female, 20 (42.6%) in traditional Medicare, 27 (57.4%) in MA]. Median (IQR) time from SNF admission to first appeal was 19.0 (15.0–30.5) days. Eleven patients (23.4%) won their appeals. The 30-day rehospitalization and 30-day mortality rates among those who won their appeals were 0% (n = 0 of 11) and 18.2% (n = 2 of 11), respectively. Among those who lost their final appeal, rates were 27.8% (n = 10 of 36) and 0% (n = 0 of 36), respectively. The most common reason for appealing was patient and/or family/caregiver concern about discharge readiness (n = 28, 59.6%).
— Journal of the American Medical Directors Association, February 2, 2026
Deardorff, W. James, et al. “Can I Stay, or Must I Go Now? A Cohort Study of Discharge Appeals in a Post-Acute Skilled Nursing Facility.” Journal of the American Medical Directors Association, 2 Feb. 2026. https://www.jamda.com/article/S1525-8610%2825%2900625-5/fulltext.
As Coverage Denials Pile Up, Functional Gains and SNF Transitions Take Center Stage
With length-of-stay shrinking and appeals netting just an average of four days more skilled nursing care, researchers say it’s time for providers to focus on function, transitions and better documentation. In a new study of discharge appeals, researchers found that the 10% of post-acute patients who sought longer stays commonly cited concerns about discharge readiness. Appeals led to an average of just four more days of nursing home care “without much additional functional improvement and [patients] still mostly went home.”
— McKnight’s Long-Term Care News, February 8, 2026
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