Operational Determinants of Preventable Hospital Readmissions From US Post-Acute Care Settings: A Structured Narrative Review (2021-2026)

Despite more than a decade of value-based reimbursement under the Hospital Readmissions Reduction Program and the Skilled Nursing Facility Value-Based Purchasing program, 30-day readmission rates from US post-acute care (PAC) settings remain at 20% to 25% among skilled nursing facility residents and contribute more than $15 billion annually to Medicare expenditure. Elevated rates have persisted despite sustained policy attention. This suggests that the dominant clinical quality frame captures only part of the problem.