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CMS initiative looks to reduce hospitalizations among nursing home residents

July 11, 2011
by root
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The Centers for Medicare & Medicaid Services (CMS) announced last Friday a new demonstration program to help states reduce the number of preventable hospitalizations for residents of nursing homes.

The program—a joint effort between the Center for Medicare and Medicaid Innovation and the Medicare-Medicaid Coordination Office—coincides with the Obama administration’s goal of reducing hospital readmission rates by 20 percent by the end of 2013.

CMS-funded research on Medicare-Medicaid eligible nursing facility residents in 2005 found that almost 40 percent of hospital admissions were preventable, accounting for 314,000 potentially avoidable hospitalizations and $2.6 billion in Medicare expenditures.

CMS will competitively select and partner with independent organizations that provide enhanced clinical services to people in approximately 150 nursing homes. Interventions could include using nurse practitioners in nursing facilities, supporting transitions between hospitals and nursing facilities, and implementing best practices to prevent falls, pressure ulcers, urinary tract infections or other events that lead to poor health outcomes and expensive hospitalizations.

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My facility has hired several nurse practitioners to try to decrease the number of residents we send out to the hospitals. We are working on expanding the clinical skills of the nurses to be able to care for sicker residents.. The problem, however, is no increase in payment for these residents so we are trying to care for them with the same numbers of staff members.
On one hand we have the local hospital practically demanding we start giving IV lasix and IV solumedrol and on the other hand the DPH questioning if it appropriate in and SNF.

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