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Program seeks to cut hospital readmissions by nursing homes

The federal government is taking steps to try to reduce the number of nursing home patients who return to the hospital within 30 days after their previous stay with a program they've recently implemented.

Based on readmission rates over the next year (from Oct. 2018 through Sept. 2019), nursing homes with the highest readmission rates will have their Medicare benefits cut by almost 2 percent, while those with the lowest rates will get 1.6 percent more money for their patients who are eligible to receive Medicare benefits.

In an effort to improve the quality of patient care, Medicare has been providing incentives to hospitals in recent years based on criteria that include readmission rates. However, extending these incentives to nursing homes could reduce instances of patients being discharged before they're ready and also improve the quality of post-hospitalization care that patients in these homes receive.

The new incentive program is expected to redistribute some $316 million in Medicare funds from those facilities that don't perform well to those that do. It's also predicted that it will save the Medicare program some $211 million in benefits it won't be paying to nursing homes.

Not everyone is pleased with the new program. Some consumer advocates say it will make nursing homes fearful of taking in very sick patients who are more likely to require hospitalization. They also fear that it may discourage nursing homes from sending patients back to the hospital, even when it's necessary.

If you have a loved one in a nursing home who requires hospitalization, it's essential to ensure that they stay as long as needed and that they receive the care they require once they're back at the nursing home. If you believe that a nursing home hasn't taken proper care of a loved one after a hospitalization or that it didn't readmit your loved one to the hospital when it was necessary, it may be wise to talk with an experienced attorney to find out what your legal options are.

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