Abstract

Background: Congestive heart failure (CHF) remains a leading cause of hospital readmissions, particularly among older adults in post-acute care settings. 

Objective: This study evaluated the impact of a zone-based CHF protocol on hospitalizations and 30-day readmission rates in a skilled nursing facility

 Methods: A retrospective cohort analysis involved 155 patients with CHF from January 2023 to December 2024; a color-coded protocol guided daily monitoring, symptom escalation, and post-readmission quality review. Statistical analysis included paired t-tests, subgroup analysis, and multiple linear regression. 
Results: Hospitalizations decreased from a mean of 5.85 in 2023 to 3.66 in 2024 (p < .001). 30-day readmissions declined from 4.21 to 1.90 (p < .001). No significant outcome differences were observed by age, sex, or race. 

Conclusions: Implementation of a structured, nurse-led CHF care protocol was associated with significant reductions in hospital utilization. Findings support using zone-based symptom monitoring to improve outcomes regardless of patient demographics. This model is scalable for similar post-acute care settings. 

Keywords: Congestive Heart Failure (CHF), admission/re-admission rates, zone-based CHF protocol, older adults, ages 50+