One in Three Nursing Home Patients Are Harmed By Medical Errors

A recent government survey found that approximately one-third of patients who were discharged from hospitals to skilled nursing facilities, were harmed by treatments they received in the facilities. Most of the incidents could have been prevented, according to the report, which was conducted by the U.S. Health and Human Services Department, Office of the Inspector General.

The survey was based on a large sampling of Medicare patients discharged from hospitals to skilled nursing facilities during a one-year period from 2011-2012, NPR reports. Problems observed in the nursing homes included errors related to patient monitoring, and medication errors.

Approximately 60 percent of nursing home residents were harmed by their treatment were readmitted to the hospital as a result, and the report estimates that such readmissions cost Medicare about $2.8 billion a year.

The American Health Care Association, which represents the nursing home industry, responded to the report, telling NPR that this study was conducted before the Association’s quality improvement initiative, which has been showing progress in skilled nursing facilities across the country.

An INQRI-funded study led by Linda Flynn and Dong-Churl Suh examined the “Impact of Nursing Structures and Processes on Medication Errors.” The multidisciplinary research team identified changes in nursing care processes needed to prevent medication errors as well as adjustments in nurse staffing and the practice environment that can facilitate interception of such errors.

Hospitals May Get Funds Cut for High Readmission Rates

Hospitals could see their Medicare payments docked as a result of Affordable Care Act (ACA) reforms that aim to reduce patient readmissions. As a result, more hospitals are focusing on patient and caregiver education to reduce re-hospitalizations.

Under ACA, reductions in Medicare payments for inpatient care will be imposed on hospitals that readmit too many patients within a month of discharge. Cuts could range from a few thousand to hundreds of thousands of dollars depending on the circumstances, the article states.

A Medicare Payment Advisory Commission study estimates that approximately 12 percent of Medicare patients readmitted to the hospital may not need to be. The Commission also found that reducing preventable readmissions by 10 percent could save Medicare $1 billion annually.

For 2014 only three types of readmissions will be penalized under ACA: pneumonia; heart attack; and heart failure. Two more types, chronic obstructive pulmonary disorder and hip and joint replacements, will be factored in next year.

INQRI grantees Dr. Marianne Weiss and Dr. Olga Yakusheva have conducted research examining how the hospital discharge process affects readmission rates. Learn more about their work:

Read "Nurse and patient perceptions of discharge readiness in relation to postdischarge utilization."
Read "Age-related differences in perception of quality of discharge teaching and readiness for hospital discharge."
Read "Quality and cost analysis of nurse staffing, discharge preparation, and postdischarge utilization."

Crackdown on Readmissions

Yesterday, Kaiser Health News published an article which explains the recent strategies employed by the federal government to reduce hospital readmissions. As you probably know, last month Medicare began instituting financial penalties against hospitals it says have had too many readmissions.  The new Kaiser article outlines some of the potential results of this change.

Click here to read the story.

Reflecting On Dr. Berwick's Tenure As CMS Administrator

In this month's edition of Health Affairs, Harris Meyer wrote a fascinating piece reflecting on Dr. Don Berwick's short tenure as the head of the Center for Medicare & Medicaid Services (CMS). In the article, Ms. Meyer discussed the praise Dr. Berwick's body of work at the CMS received from numerous professional organizations and highly respected health leaders.

Click here to read the Health Affairs article (freely available to all).

Study Shows That Nursing Home Medicaid Recipients Have Higher Hospitalization Rates

In a recently published study in the journal, Medical Care Research and Review, Helena Temkin-Greener, PhD, MPH, and her colleagues found that nursing homes may be enticed to send Medicaid recipients to the hospital for care due to financial incentives. The study identified that Medicaid reimbursement for hospitalizations are almost half that of Medicare reimbursements and as a result, may motivate decisions when determining if a patient needs to be transferred to a higher level of care.

Click here to read the full news article.

Click here to access the study (subscription may be required).

Clinics Focused on Medicare Patients Making a Difference

Over the weekend, Rosemary Shinohara, of the Anchorage Daily News, reported about the recently opened Alaska Medicare Clinic. The clinic was established with the intention of holding down costs and improving patient satisfaction by utilizing interdisciplinary teams, made up of registered nurses and medical aides, that spend a great deal of time with patients before they are seen by the lone physician on site.

Click here to read the full news article.

Health Care Taps The Brake On Job Creation

On Monday, Reed Abelson & Katie Thomas, of the New York Times, wrote an interesting guest piece in The Seattle Times discussing the health care industry's reliable job growth during tough times. The journalists also point out that although the industry has continued to grow, looming Medicare & Medicaid reimbursement cuts will have an affect on hospitals' expansion and hiring plans. The article concludes with a few paragraphs regarding the current and future need for nurse assistants, registered nurses and nurse practitioners & midwives.

Click here to read the article.