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Getting proactive on hospital readmissions

admin — Fri, 18 Nov 2011 15:29:44 +0000

McKnights writes about Getting proactive on hospital readmissions:

“To address the matter, Signature HealthCARE, which operates 73 long-term care facilities in seven states, this year launched a pilot program dubbed TransitionalCARE. The program more closely monitors patients at risk for readmissions and eases patient transitions between care settings. The process began about 20 months ago, focusing on transitions between the hospital and nursing facilities, as well as transitions from the nursing facilities to home.”

If you’re not already, consider screening for RTA risk factors as part of your pre-admissions program. You can target patients who will benefit from additional therapies as well as report back to referrers on steps you are taking to help minimize their referrals bouncing back.

Use pre-admission screening to identify patients who might benefit from additional therapy

admin — Fri, 11 Nov 2011 20:35:38 +0000

A good post from Luke Fallon on http://ltlmagazine.com on increasing Medicare length of stay to help your facilities increase Medicare census and compensate for Rehab RUG rate reductions. Pre-admission screening is the perfect time for this, and in conjunction with customized assessment forms should be part of your referral management process. View Post.

PAC Providers have major role to play

admin — Thu, 11 Aug 2011 21:26:02 +0000

Post acute care (PAC) providers have a major role to play in reducing readmissions.

Reducing Returns to Acute (RTAs)

admin — Tue, 26 Jul 2011 16:54:26 +0000

On April 18, the federal Centers for Medicare & Medicaid Services (CMS) created a proposed rule for the Medicare Hospital Inpatient Prospective Payment System (IPPS) that encompasses a number of important changes. In particular, the proposed IPPS rule lays out many basic aspects of the Hospital Readmissions Reduction Program, specifying what constitutes a readmission, and helping hospitals to begin calculating excess readmissions.

For most hospitals, this promises to have a significant impact to their business. But there are concrete steps you can take to work on reducing return to acute readmissions, beginning with how you manage patient referrals. A systematic approach to preadmission screening will ensure that you identify patients with significant risk factors (such as previous readmissions) before they become your responsibility. And once you have this preadmission data electronically, you can flag patients that you know you’ll need to pay special attention to as well as build better profiles of what types of patients best match your care programs.

Preadmission screening does not have to slow your referral management process down. In fact the right platform can speed things up by ensuring all admission stakeholders have realtime access to the latest patient data.

AHA wants ethnic, race and language proficiency to factor in readmission program

admin — Fri, 10 Jun 2011 19:15:05 +0000

The hospital readmissions reduction program, or HRRP, was included in the Patient Protection and Affordable Care Act and offers financial incentives to hospitals that treat Medicare beneficiaries to reduce preventable readmissions. In a letter from American Hospital Association President and CEO Richard Umbdenstock to CMS Administrator Dr. Donald Berwick, Mr. Umbdenstock makes the case for including ethnic, race and english proficiency as part of HHS’s risk adjustment methodology. According to AHA’s letter, racial disparities extend to hospital readmissions, and a Journal of the American Medical Association article this year reported that hospitals serving a disproportionately large number of minorities have higher readmission rates. Therefore, AHA asserted, a hospital could be penalized under the HRRP for serving large numbers of minority patients than for actually providing poor care.

Read more at ModernHealthcare.com (registration required)

SNFs can expect hard road for funding

admin — Thu, 09 Jun 2011 19:32:47 +0000

Cynthia Morton, executive vice president for the National Association for the Support of Long Term Care, maintains that while Congress’ perceptions of long-term care are changing the proof is in the funding. In that regard the outlook is pretty dismal for skilled nursing.

More at ltlmagazine.com

Providers adjust to MDS 3.0 and RUG-IV

admin — Mon, 06 Jun 2011 17:42:05 +0000

From McKnights - “The switchover to MDS 3.0 and RUG-IV may have happened months ago, but long-term care and therapy providers say they are still honing their policies and practices to ensure that residents receive the best treatment possible, and that appropriate reimbursement is attained for the therapy provided. “

Coordinate Care for Better Outcomes and Cost Containment

admin — Wed, 01 Jun 2011 18:55:54 +0000

Joe Flower at the Health Care Blog makes the case for coordination of care on both the moral and cost containment basis. Technology has a central place in enabling this coordination, but you don’t necessarily need a full-blown health information exchange or even electronic medical record to make this happen. Start by looking at who in your organization is most responsible for coordinating care between providers, and what tools you are providing them.

Coordination of care counts most when patients are moving between different acuity levels of care – so called vertical care transitions. For our LTAC and Skilled Nursing Facility clients Admitting Nurse Evaluators (also referred to as Admitting Nurse Liaisons, Admissions Specialist, etc.) are the starting point for managing patient transitions into their facilities while Case Managers are primarily responsible for managing the process out of the facility – particularly if the ‘out’ is some other provider’s ‘in’.

Enabling technologies for managing transitions can help speed your admissions and discharge processes, which helps profitability as well as patient satisfaction and outcomes. Capabilities to consider include:

A flexible system for managing assessment criteria. For Admissions specialists the screening assessments are critical to ensuring you admit the right patients for your facilities and that you remain compliant with the latest state and federal guidelines for your facility type. But assessment criteria are also valuable for ensuring that you have collected the information you need to adequately care for that patient once you admit them. Pharmacy, Nutrition, Rehab, etc. departments will all have their own ‘short list’ of information they’d like to have to ensure they are prepared for the admission, so being able to collect and present this data in a tailored fashion will help streamline the process immensely.
Collaborative review. Web based collaboration ‘portals’ can be used as common areas for providers to ‘meet’ and share information regarding patients, prior to making the actual transition. Bringing the process online means that sharing can begin much earlier in the process, and therefore ensure that when the patient is transferred to the next level of care the receiving providers, as well as patient and family are fully prepared.
By comparing “snap shots” of the patient at the time of admission against time of discharge, patterns can be identified that point to best practices in managing patients and allocation of system resources.

Better coordination of patient care is a ‘win-win’ proposition that helps both the patient and your business.

ACO principles that will shape where hospitals are going

admin — Thu, 26 May 2011 14:50:20 +0000

From beckershospitalreview.com, Steve Ronstrom, CEO, Western Wisconsin division of Hospital Sisters Health System writes about ACO-inspired principles that should govern hospital’s strategic planning even if they do not plan on becoming actual ACOs. It’s an interesting read and suggests how the industry will likely change independent of the current ACO hype.

For independant LTACs and SNFs the most important thing remains how to best represent your capabilities to hospitals who are interested in managing costs across the continuum of care. Hospital CEOs and senior management are going to be looking for post care partners who offer the best value from a cost/outcomes standpoint, who are going to be able to work in an integrated fashion with their own staff (particularly case management) and who will be able to lower readmission rates. Making this points will require a systematic approach to collecting the right data.

Proactive Quality Management

admin — Fri, 20 May 2011 19:41:37 +0000

McKnight’s reports that CMS is introducing software for Quality Indicator Survey inspectors to use as part of their nursing home visits. As has been noticed, capturing quality information will be more and more important to LTACs and SNFs to ensure adequate reimbursement levels and as an aid to business development. And in addition to clinical information, patient satisfaction is increasingly showing up as an important component as well.

The information you capture as part of managing your referrals can also help you be proactive about ensuring quality. Your screening process today is already helping to identify co-morbidities as well as factors that might patients with an increased risk for hospital acquired conditions. But you should also be looking for attitudinal as well as psychosocial information that you can use to understand and manage patient and patient family member expectations. The better you understand your patient’s special needs the better you will be able to ensure that the overall experience is positive.