Medicare to Penalize Nursing Homes for High Hospital Readmission Rates

Medicare to Penalize Nursing Homes

One of the simpler explanations behind telemedicine is that it reduces patient transfers between nursing homes and hospitals. What is of the utmost importance is the care that these facilities are providing. On one hand, hospitals have been penalized for the rate at which patients return. Now, nursing homes will be held accountable for hospital readmissions.

Both re-hospitalization and readmission rates are scrutinized over a 30-day period. The federal government has fined hospital s with high readmission rates since 2012. The Centers for Medicare & Medicaid Services (CMS) has begun publicly reporting this information. As of October 2018, it will begin withholding a percentage of Medicare reimbursements and reallocate some of those funds for higher performing facilities. As a result, low performers with high readmission rates will be penalized.

The contention among skilled nursing providers is that patients are being discharged from hospitals too early and in worse condition than when they left. Meanwhile, CMS officials argue that the facilities are not properly assessing or caring for their returning residents. A simple solution offered by telemedicine is that its services make it easier to keep patient care in one location and minimize the need for transfers.

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Pressure comes from many directions in healthcare. Providers must keep those lines of communication open. Families paying insurance will push for shorter lengths of stay, which could lead to patients being discharged prematurely. If their loved one’s condition changes at the nursing home, they may be quick to order a return to the hospital.

Once nursing homes are able to identify these changes early and monitor them in-house, this traffic should slow significantly or come to a halt. With communication, loved ones can be reassured that readmission may not be necessary. In conjunction with telemedicine, nursing homes should work closely with hospitals to develop care plans. Employing more physicians and APRNs (advanced practice registered nurses) will increase focus on infection prevention and promote careful antibiotic use.

Telemedicine leads to more timely and accurate assessments which are ultimately the key to reducing hospital readmissions. One-site evaluations don’t usually result in patient transfers. Improved communication with families can dissuade families from insisting that loved ones be sent to the hospital. It is important to note that even if a resident returns home before being admitted to the holiday, it will still be counted as a readmission if it is within the 30-day window. Guess what? In telehealth, location is irrelevant when it comes to patient evaluation.

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