November 27th, 2012 | 0
Earlier this month, we offered some Strategies to Reduce Readmission and got a very positive response from readers. So, we’ve decided to expand on our tips and strategies and to provide some specific advice for lowering readmission strategies when releasing patients into specific post-hospital environments. Since so many patients go to long-term care (LTC) facilities after leaving the hospital, we’ll be starting with some tips to reduce readmissions when patients are released into a long-term care situation.
Tips for Reducing Readmissions from Long Term Care
Long-term care facilities are staffed by medical professionals so in many ways it should be easier to avoid readmission when a patient is released to a facility rather than sent home. Unfortunately, due to a variety of problems including inadequate communication with long-term care facilities; choosing the incorrect facility; and overstaffed and underperforming long-term care providers, readmission rates still remain stubbornly high. In fact, according to the Robert Wood Johnson Foundation, approximately ¼ of Medicare beneficiaries discharged into a skilled nursing home were readmitted to hospitals within 30 days, at a cost of $4.34 billion.Continue Reading
November 26th, 2012 | 0
Imagine you are sitting in your kitchen at a table handed down to you from your parents, sipping coffee from your favorite mug, when there’s a knock at the door. It’s a county employee who very politely explains that she has been asked by your landlord to check on you. A bit perplexed, you assure her that you are fine. A week later the worker returns with a few others to inform you that you are being moved to a place where you’ll get nice new furnishings and three meals a day, that all your needs will be met, and this is permanent. The favorite mug can go with you, but you will not be allowed to take the heirloom table – or most of your personal belongings. Does this scenario sound improbable? Not if you are one of the many elders who are involuntarily relocated each year, either from their own homes to eldercare facilities or from one facility to another.
This may seem an extreme example, but it is true that Adult Protective Service (APS) workers, social service agencies, and well-meaning family members can remove elders from their homes with little time to prepare. Discharge planners are in a similar predicament: If an older adult cannot be discharged to his or her home safely, then home has to become somewhere else. The scenario above is told from the older adult’s point of view. What’s missing is the part about the strong odor of urine throughout the apartment, the empty refrigerator, and newspapers stacked on the radiator. Naturally someone does not swoop down and forcibly remove someone from a situation that is just fine, but that is exactly how it feels to the older person who is living in questionable or unsafe conditions. The reasons for relocation may be an unclean environment, history of falls, household hazards, medication errors, neglect by self or others, or physical changes that make self-care impossible.Continue Reading
November 21st, 2012 | 2
A few weeks ago, I reported that most seniors on Medicare tend to stick to the plan they initially chose even though as the years go by they might be able to get a cheaper model by junking the old one. Medicare beneficiaries are more like bank customers than car buyers, it seems. Once they choose a plan—whether it’s a traditional Medigap policy or one of the new Medicare Advantage (MA) plans—they keep it.
A study from the National Bureau of Economic Research, a private, nonprofit research organization, checked out this phenomenon and concluded that if seniors stayed in a plan they could end up paying ten percent more in premiums than if they switched to a newer plan. New plans often have cheaper premiums because health insurance sellers—engaging in a kind of bait and switch—entice shoppers with low price tags and then as they get older and sicker and have medical claims, the premiums go up. Still, people hang on to what they have.Continue Reading
November 18th, 2012 | 0
There is ever-increasing evidence that shows serious deficiencies in patient care quality exists during transitions between care facilities. Many issues can arise in these circumstances that can jeopardize patient’s safety and they all seem to share similar problems and solutions. Issues such as medication errors, lack of appropriate follow-up care, insufficient or inaccurate information transfers are easily avoided. If discharge planners do their part to improve on these issues it will lead to transitions into continuing care that are smoother and will result in happier patients and ultimately better care.
- “Know your patient” The most important aspect of patient care is to “know your patient”. This goes beyond knowing only their personal information and medical condition(s). Discharge planners should thoroughly immerse themselves in a patient’s medical chart. You must know what care your patient needs at all stages of their care and also be able to explain this in understandable terms to both your patient and their family.
November 15th, 2012 | 0
New national elder abuse reporting requirements have gone into effect for nursing homes. They are a great innovation in the pursuit of elder abuse prevention across the nation. No one likes to talk about elder abuse, which is precisely one of the conditions that permits it to go on. It’s time that we all take a few minutes to review elder abuse basics.
Elder and dependent adult abuse applies to people over 18 who depend on others for their basic needs. All elderly Americans, wherever they live, are considered a vulnerable population. Seniors who live in residential care and nursing homes are in the minority, as most seniors live in their own home or with family. Even seniors who live alone in the community benefit from our oversight and attention.Continue Reading
November 15th, 2012 | 2
Higher-quality patient care at the hospital has historically been thought to reduce the possibility that the same patient will be readmitted within 30 days’ time. However, according to a recent study, it appears that this may not be the case. A more effective approach to readmission data may be the development of care guidelines for those suffering from different illnesses – for example, distinguishing between heart attacks, heart failure, and instances of pneumonia.
The following data was compiled from the site listed in the above article, Hospital Compare. Readmissions data between hospitals throughout California from the database download was examined, and the hospitals were compared against one another. The data was then broken down into “Heart Attack,” “Heart Failure,” and “Pneumonia” readmission categories.Continue Reading
November 7th, 2012 | 1
Readmission is a major problem in U.S. hospitals, so much so that Hospital Impact reports that one out of every five Medicare patients is readmitted to the hospital within 30 days of being discharged. Hospital Impact reports that these readmissions come at a cost of approximately $17.5 billion each year.
While Fierce Healthcare reports that Medicare has a new policy- called a Readmissions Reduction Program – that docks up to 1 percent of pay for hospitals with high readmission rates, simply penalizing hospitals isn’t the answer. No hospital or rehabilitative care facility wants patients to be sent back into the hospital. The problem, as News Medical reports, is that hospitals are lacking in cohesive strategies to reduce readmission. Developing a detailed discharge plan, therefore, is a key first step in helping patients to thrive once they’ve left the hospital. So, how can hospitals succeed at doing this? Here are a few tips.Continue Reading
November 5th, 2012 | 0
According to researchers at Mount Sinai School of Medicine, health-care costs during the last 5 years of life exceed patient’s total assets for 25 percent of the Medicare population. This is because although Medicare provides a significant amount of health care coverage, it does not cover co-payments, deductibles, homecare services, or non-rehabilitative nursing home care.
This shows just how important it is to ensure that patients make full use of their Medicare and Medicaid covered services. The care coverage in Skilled Nursing Facilities (SNF’s) varies between Medicare, Medicaid and private insurance. The task of sorting through various websites and insurance paperwork to figure out your eligibility for these services can be a challenging task.Continue Reading
November 2nd, 2012 | 1
This post originally appeared here: http://online.wsj.com/article/SB10001424052970203937004578079184108523030.html?mod=googlenews_wsj#project=INVESTOR1027&articleTabs=article and was published by The Wall Street Journal.
Andee St. John is searching for an assisted-living facility near Columbia, S.C., for her 69-year-old mother, who was hospitalized recently after several falls. But finding the place with the right combination of price, amenities and services has been difficult.
So far, Ms. St. John has consulted with a financial adviser, a geriatric social worker and an elder-law attorney as part of her research.
“It’s been very eye-opening,” Ms. St. John says. “You don’t just pay one fee a month for assisted living. There are all these different add-ons.”
A growing number of families are wrestling with the same dilemma: rising costs for long-term care and a mind-boggling array of options.
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