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2014-01-08news-articleNews<p>Under the leadership of teams from Partners Continuing Care (PCC) and Population Health Management (PHM), Partners HealthCare has formed its first-ever Skilled Nursing Facility (SNF) Collaborative Network which will offer our patients improved, more coordinated care.</p>

Partners Forms Skilled Nursing Facility (SNF) Collaborative Network Aimed at Improving Patient Care

January 8,  2014

Under the leadership of teams from Partners Continuing Care (PCC) and Population Health Management (PHM), Partners HealthCare has formed its first-ever Skilled Nursing Facility (SNF) Collaborative Network which will offer our patients improved, more coordinated care. Forty-seven SNFs from across Massachusetts were selected to participate in this Collaborative and were chosen based on specific measures of quality.

The 47 SNFs- including PCC skilled nursing facilities in Salem, West Roxbury and the North End, as well as the Clark House in Westwood- cover critical geographies for Partners HealthCare System’s acute care hospitals. The 47 SNFs in the Collaborative have met the initial quality standards established by Partners, and have committed to work with Partners on an ongoing basis. These facilities will collaborate with Partners’ teams to share educational opportunities and best practices, with the goal of further improving care in their facilities.

This is an important development for our patients. Hospitals and physicians are looking to manage patients across care settings, and skilled nursing facilities play a vital role in building an effective continuum of care for PHS patients.  Coordination of care is enhanced through focused collaboration and dialogue among facilities, with the overall goal of matching patient needs to SNF capabilities, improving transitions of care, reducing readmissions, and improving patient outcomes.   

Teams of experts from Partners acute care hospitals, post-acute facilities and physician organizations created a thorough and objective selection process for the SNFs in the collaborative. The scoring methodology was developed with input from physicians, nurses, case managers and skilled nursing facility administrators, as well as external experts from local and national integrated health systems, skilled nursing facilities, and Pioneer ACOs. Existing skilled nursing facility preferred provider agreements from local and national integrated health systems were also reviewed.

To be considered for the Collaborative, SNFs needed to demonstrate a MA DPH Survey Performance Score of 125 and a CMS 5-star rating of 3 or greater. Those facilities were further scored using a system based on a set of objective criteria, including publicly reported data regarding quality, clinical capabilities, medical coverage and the use of technology.  It was important to establish a baseline for quality measures, as the expectation is that all of the SNFs will engage in improvement activities which will further improve scores, and thus improve the care our that patients receive.

A total number of 140 SNFs applied, and 47 were selected to be in the collaborative for year one. Facilities that did not apply, or were not selected to participate in the collaborative this year will be able to re-submit information during an annual ‘open enrollment’ period (June 1 – June 30 of each year)  to be considered for participation.

It is important to note that, facilities that were not selected to be part of the collaborative may still receive Partners patients.   PCC liaisons will continue to service all SNF accounts and manage referrals to or from Spaulding and Partners HealthCare at Home. Additionally, facilities that were not selected may work with their local PHS acute care hospital on specific quality improvement initiatives, and may apply for inclusion in the collaborative in Year 2 and beyond.

The development of this network is an important milestone for Partners, PCC and PHM, as the healthcare landscape is becoming more aligned, with specific networks integrating services. While many other health systems have formed SNF networks, the PHS SNF network is focused on the pillars of collaboration, ongoing performance improvement and providing the optimal customer experience for patients and families.

In December, Partners hosted the first meeting of the SNF Collaborative Network. Over 200 attendees from all 47 SNF facilities - as well as representatives from each of the Partners acute hospitals, post-acute facilities and Partners HealthCare at Home - gathered to meet, hear about the guiding principles of the network, learn more about how the network will measure success, and have an opportunity to start building lasting collaborative relationships. The group also made productive decisions around the structure, topics and speakers for future Collaborative meetings.

For more information about the Partners HealthCare SNF Collaborative, please contact the SNF Collaborative team at