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Health Reform Takes Aim at Hospital Readmission Rates

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I'm late to this discussion, but what I am seeing in our area (from my perspective of being a Hospice advocate) are the Hospitals discharging patients to SNF rehab. One case in particular: a patient was discharged from the hospital with Cancer and a prognosis of 2 weeks to live. The SNF had her in a 'skilled bed' trying for the usual 100 days. The daughter wanted Hospice for her Mother. The SNF told her that her Mother would have to 'give' up her benefit and pay privately, which is exactly what she did. However, there are many more people that cannot afford to do that; they end up dying while being "skilled". I believe that the Hospitals are using rehab as an alternative to sending patients home and taking the chance that they might return within the 30 day window. How is that 'saving' $ for Medicare? Rehab rates are one of the highest reimbursements that a SNF can get!!! Something is not right?

Kay of IN 10:59AM September 18, 2011

There are so many initiatives and penalties in place with the new healthcare changes. The only issue that I have is, when are patients going to be held accountable for taking care of themselves? With all of these initiatives to prevent readmissions, we are calling patients to follow up, set appointments, etc. What does the patient have to do? What is the penalty for having a health plan and never using for preventive care, but using the ED instead as your primary care physician? We have addressed the problem from the provider's standpoint. It is not time to address how do we hold patients accountable themselves for making and keeping their own appoitnments, taking there medications when they are supposed to, following their treatment plans. Now, its do all that we can to keep them from coming back, but at the end of the day, if they don't show that they are interested in living and being healthy they will come back regardless!!!

TeeYoung of GA 11:04AM July 20, 2011

Often it is up to the Family Caregiver to understand all the discharge directions, have the ability to be there to supervise them and sometimes even perform medical procedures like give injections.
There needs to be Caregiver Coaching in the hospital and followup Community Coaching in every town where there is a hospital or clinic.

Christine Sotmary of NY 3:09PM August 03, 2010

CARE NEEDS TO BE DONE "RIGHT" THE FIRST TIME AROUND..........I.E THERE WILL
THEN BE LESS "RE ADMISSIONS" AS WELL AS LESS INJURIES AND DEATHS.

HELEN of VA 8:58PM July 26, 2010

What about the accountability from patients? As a RN for 24 years, I meet many patients who do not follow the treatment guidelines. They do not take their medication, do not follow dietary guidelines or exercise recommendations. Unfortunately, Americans think that medicine can cure everything and that a pill will solve everything. As a palliative care nurse, I encounter many situations where conditions are irreversible,but patients and their families can't accept it. Americans are living longer and with more medical problems. Medicare and all insurance companies need to facilitate patient accountability as well as health care organizations and providers.

Gloria Lewis of CA 10:02AM July 23, 2010

Hospitals have acted to quick fix emergency situations and get the person out once they appear to be stable. Unfortunately this does not bode well for long term fixes. Hopefully this can get things done right.
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http://www.cubecheck.com

james of CA 6:17PM July 22, 2010

The exuses cited for accepting data for all cause readmissions is a far stretch. Every thinking person knows that the more elderly the higher the risk of having an episode of truama or illness which requires hospitalization. Medicare is defending this because it is the only data they want to collect due to ease of colection and it is the least expensive data to mine.

steve gibson of IA 2:49PM July 22, 2010

Very often, readmissions come as a result of patient error - not just hospital. If patients fail to take their medications as directed (despite education), that blame falls to the hospital. Just short of sending a nurse home with the patient, there is no way to know that the patient is taking their medications as they are supposed to. And many patients are honest about their lack of compliance. Medicare doesn't care and the Healthcare Industry gets bashed. The healthcare world is required to take responsibility - even when the patient refuses to accept any responsibility for their own care.

Angie of FL 2:14PM July 22, 2010

I'm unsure how a Social Worker is competent to review medications. Is it in their scope of practice in most states? I would think a Social Worker would not want to be responsible for knowing the proper doses and routes of medications, the potential interactions on a long list that includes OTCs.

Alice Peterson of FL 12:10PM July 22, 2010

Regarding readmissions, my concern as a myasthenic is very real. This disease is known as the "snowflake disease" because all of us have very different symptoms. Our conditions can change in an hour for no known reason.
I am not familiar with other orphan diseases but this crackdown scares me. I certainly agree that hospitals as well as the health care industry need to cut waste but this in my opinion is not the way.

Louise of FL 12:04PM July 22, 2010