Deardorff Post-acute SNF Mortality and Home Discharge Index

Population: Community dwelling Medicare Fee for Service beneficiaries aged 66 years and older who were admitted to a skilled nursing facility for short-term post-acute care following a hospitalization.

Note: This index comprises two models. The first model is intended for use on Day 1 of SNF admission. The second model is intended for use on day 7 of SNF admission and includes predictors from the Minimum Data Set. In both models, individuals enrolled in Medicare Advantage plans were excluded.

Outcomes: 6-month all-cause mortality and successful community discharge (defined as a discharge home from the skilled nursing facility with no hospitalization or death in the 30 days following discharge)

Scroll to the bottom for more detailed information

Risk Calculator
1. Has your patient been admitted to a skilled nursing facility for 7 or more days?

3. What is your patient’s biological sex?

4. Is your patient on Medicaid?

5. Select which comorbidities your patient has from the following list:
• Weight loss

• Heart failure

• Diabetes with complications (e.g., nephropathy, retinopathy, ulcer)

• Renal failure, severe (e.g., chronic kidney disease stage 4 or 5 or end stage renal disease)

• Liver failure, severe (e.g., cirrhosis with complications such as esophageal varices)

• Dementia (e.g., Alzheimer’s disease, vascular dementia)

• Other neurologic disease (e.g., multiple sclerosis, hydrocephalus)

• Lung disease (e.g., asthma, chronic obstructive pulmonary disease, chronic bronchitis, pulmonary hypertension)

• Metastatic cancer (e.g., metastatic gastrointestinal, lung, kidney, prostate cancer)

• Solid cancer without metastasis (e.g., lung, kidney, prostate)

• Leukemia/lymphoma (e.g., acute lymphoblastic leukemia, chronic lymphocytic leukemia, Hodgkin lymphoma, follicular lymphoma)

• Paralysis (e.g., paraplegia, hemiplegia, quadriplegia)

7. What was the primary reason your patient was hospitalized?

Note: Categories are listed by frequency in the study cohort (most to least
common).
8. Did your patient have any surgical procedures performed in the hospital?

Note: Categories are listed by frequency in the study cohort (most to least
common).
9. Was your patient admitted urgently/emergently or was it an elective admission?

10. How many hospitalizations has your patient had in the past year, excluding the hospitalization directly preceding the current SNF stay?






SNF Day 1 Index

SNF Day 7 Index with predictors from the Minimum Data Set

  • The Day 7 index was developed in 426,680 community-dwelling Medicare Fee-for-Service beneficiaries aged 66 years and older who were discharged to a skilled nursing facility for post-acute care after a hospitalization between 2017-2019 and remained at a SNF for at least 7 days (median age 81, 63% female, 8% Black)
  • Overall, 20% died by 6 months and 58% experienced a successful community discharge
  • Internal validation was performed via bootstrapping.

Discrimination: For 6-month mortality, this risk calculator sorts individuals who died at 6 months from individuals who were still alive correctly 79% of the time. For successful community discharge, this risk calculator sorts individuals who experienced a successful community discharge from individuals who did not correctly 73% of the time.

6-month mortality:
good

Successful community discharge:
good

Calibration: Calibration plots suggested good calibration across the range of predicted risk for both outcomes.

Citation: Deardorff WJ, Gan S, Jing B, et al. An Updated Mortality and Community Discharge Prognostic Model for Older Adults Admitted to Skilled Nursing Facilities for Post-Acute Care. Journal of the American Medical Directors Association. Published online January 31, 2026.
doi:10.1016/j.jamda.2025.106103.

Note: In the cohort for the SNF Day 1 index, 22% died by 6 months, and 54% experienced a successful community discharge. In the cohort for the SNF Day 7 index, 20% died by 6 months, and 58% experienced a successful community discharge.

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The information provided on ePrognosis is designed to complement, not replace, the relationship between a patient and his/her own medical providers. ePrognosis was created with the support of the Division of Geriatrics at the University of California San Francisco. However, its content is strictly the work of its authors and has no affiliation with any organization or institution. This web site does not accept advertisements. If you reproduce the material on the website please cite appropriately. For feedback and questions regarding the site please email Sei Lee, MD (sei.lee@ucsf.edu), Alex Smith, MD (aksmith@ucsf.edu) or Eric Widera, MD (eric.widera@ucsf.edu).