Nursing homes hospitalize residents when physicians and nursing staff determine that residents require acute-level care
Nursing homes hospitalize residents when physicians and nursing staff determine that residents require acute-level care.
According to DHHS Office of Inspector General (OIG), in fiscal year 2011, nursing homes transferred one quarter of their Medicare residents to hospitals for inpatient admissions, and Medicare spent $14.3 billion on these hospitalizations. Nursing home residents went to hospitals for a wide range of conditions, with septicemia the most common. Annual rates of Medicare resident hospitalizations varied widely across nursing homes.
Nursing homes with the following characteristics had the highest annual rates of resident hospitalizations: homes located in Arkansas, Louisiana, Mississippi, or Oklahoma and homes with one, two, or three stars in the Centers for Medicare & Medicaid Services’ (CMS) Five-Star Quality Rating System.
The OIG recommended to: (1) develop a quality measure that describes nursing home resident hospitalization rates and (2) instruct State survey agencies to review the proposed quality measure as part of the survey and certification process. CMS agreed with both recommendations.
Penalties:
In a recent article in MedPage Today, A new study suggests that financial penalties provide an effective incentive to reduce avoidable readmissions, particularly at low-performing hospitals. Based on 30-day readmission rates after initial hospitalization for acute myocardial infarction, congestive heart failure or pneumonia, researchers found that hospitals with the highest incidences of readmissions also saw the highest reductions in readmissions when the financial penalties started kicking in.
How Pharmacogenetics Can Help:
Pharmacogenetics aligns current and future medications with each persons unique genetic profile. This simple test addresses key clinical concerns such as falls, dementia, sleep, pain and many other areas that effect residents in a nursing home setting on a daily basis. Having evidence-based reports for each individual resident, helps manage medications and in turn, reduces falls, helps residents sleep better, and allows the healthcare team to manage pain based on prescribing medications you know have the ability to give that person therapy.
Person-Centered Care:
CMS is now using person-centered care and care plan in their language when addressing LTC facilities. Pharmacogenetics is “person-centered” care and provides the healthcare team with documentation for each individual when preparing a medical plan of action. These pharmacogenetic reports will help identify problem areas or drug reactions that could be avoided preventing falls and/or readmissions.
PGx Medical in conjunction with Dr. Linda Shell, MA, RN are now accepting community organizations and providers in a Person-Centered Care Pharmacogenetics Pilot Program To see if your community qualifies, go to: Pilot Program, or email info@pgxmed.com, or call 405-509-5112.
Source: MedPageToday.com, oig.hhs.gov