What long-term care providers can do to reduce rehospitalizations

When a loved one is admitted to a nursing home it can be a difficult time filled with conflicting emotions and worries. One of those worries should not include wondering whether their loved one is at the beginning of an endless cycle of hospital and long-term care admissions. Too many residents around the country enter the revolving door leading from long-term care facility to hospital and back. Of the nation's more than 15,000 nursing homes, one-fifth send 25 percent or more of their patients back to the hospital, according to a Kaiser Health News analysis of data on Medicare's Nursing Home Compare website.

These transfers can be dangerous to residents, increasing the risks for delirium, medication errors, lapses in care, falls and infection. Some residents become sicker or even die as a result of rehospitalizations. Unfortunately, many residents end up going back to the hospital for potentially preventable conditions such as dehydration, infections and medication errors. Avoidable hospitalizations are very costly to Medicare and Medicaid. Congress created the Skilled Nursing Facility Value-Based Purchasing Program incentives in the 2014 Protecting Access to Medicare Act. This program cuts payments to facilities with high rehospitalization rates and gives financial incentives to those with low rates. With good reason, the Centers for Medicare & Medicaid Services (CMS) and other payers have become increasingly interested in improving coordination of care and reduction of rehospitalizations. There are simple ways long-term care providers can protect their residents from the trauma of a rehospitalization mistake and save their facilities from potentially having their payments cut.

Early intervention. It’s important for the welfare of residents that long-term care providers are able to catch potential problems early before hospitalization becomes necessary. Nursing staff must improve its ability to see changes in a resident’s condition and to intervene whenever possible.

Track rates. Providers can learn where their gaps are by tracking hospital readmissions and looking for trends. Monitor days and times residents are being sent to the hospital. Look for common types of conditions that are sending residents to the hospital.

Adequate staffing. Helping residents spend less time in the hospital requires a team effort. It’s important to have adequate staff that is trained to identify and treat situations that lead to hospitalization. For example, studies have shown that facilities who employed a full-time physician were able to lower rehospitalizations. It’s vital that residents have access to physicians, nurse practitioners, and physician assistants.

Educate residents. Communication is absolutely essential to preventing avoidable readmissions. Successfully reducing readmission rates may depend on a resident’s ability to understand three things: their diagnosis, the care they receive, and their discharge instructions.

Drug regimen reviews. Providers should put a focus on medication reconciliation. They should know which medications residents were taking before they were admitted to the hospital, what they were taking while they were in the hospital and what they were prescribed when they were discharged. In recent times, the U.S. government has called for closer scrutiny on the review of long-term care residents’ medication records. Facilities should work closely with their pharmacy services provider to employ technical solutions to spot medication irregularities earlier and provide better resident care.
Turenne PharMedCo- Pharmacy Services has a team of pharmacists that works with facilities to identify potential problems with resident medication. To learn more contact us here


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