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Managing CHF in a Skilled Nursing Facility

“The ICG technology will identify SNF residents with impending heart failure before they decompensate allowing time to make necessary medication adjustments that will prevent the decompensation” 

Prof. Arman T. Askari, Former Cardiac Chairman at Cleveland Clinic

“The MyNICaS apparatus offers a simple, noninvasive, reliable, and continuous measurement of Cardiac Index (CI) in patients with particular emphasis on CHF. This measurement when combined with Mean Arterial Pressure (MAP) and the calculation of Cardiac Power Index (CPI) with SVRi is destined to become a safe, simple and rapid, noninvasive method for evaluating and treating primarily coronary patients with CHF.”

Chest Magazine

“The key component to reducing CHF readmission in Skilled Nursing Environment  the effective management of the residents’ hemodynamics.”

Dr Nicole Orr Tufts Medical Center (Provider Magazine 2018)

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CHF in SNF’s





The Problem:

• Heart Failure patients are normally discharged from hospital with diuretics and Beta blockers but not enough afterload reduction

• Physicians in the community tend not to change medications prescribed at the hospital

• At a certain point of time patients may become hypovolemic resulting in decompensation and increased edema

• High hospital readmission (about 20-22% within 30 days and 50% within 6 month)

Our solution

• Adjust medications (Diuretics, Afterload reduction, Beta Blockers) as patient’s hemodynamics and volume changes over time (preload, contractility, afterload)


Expected results:

• Significant reduction of hospital’s readmission (by > then 50%)


How do we “break the CHF-RTH chain” ?

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Breaking the CHF Readmission  “Chain”


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MyNICaS is the ONLY bio impedance technology/device that meets FDA guidelines for statistical bio equivalence to thermodilution. MyNICaS is currently being utilized in acute care hospitals throughout the world.

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Reduced Hospital re-admissions can be achieved through the SNF application of Hospital technology developed for personalized medication management

MyNICaS is a non-invasive “regional body” bio impedance technology that allows the physician to monitor medication effectiveness on a timely basis.

This procedure allows for the timely adjustment of a patients’ medications based on the trending of data derived from specific fluid (total body water), cardio-vascular and respiratory status…  

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Re-admission Reduction $100k per year based on 2 pts per month who remained in SNF 8 to 10 days

Projected Increase in skilled patient admissions due to Cardio NAV Program (24 per year based on 2 new admissions per month)

CHF in the Skilled Nursing Facility


ROI for CHF Re-admission Reduction Program

- Re-admission Reduction $100k per year

- Based on 2 pts per month who remained in SNF 8 to 10 days

- Increase in skilled patients $46k net profit per year

- Based on 1 new admission per month

- Potential 2% Medicare Reduction post SNF VPB Oct 2019

- Based on 10% Medicare Utilization $26k per year

NOTE: Assumes empty beds are available in skilled unit

   (Retained patients and new admissions generate Pharmacy Revenue)

SNF Cardio Nav CHF Readmission Reduction Program

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