Medicare fines over hospitals' readmitted patients to begin on Monday Oct 1,2012 - page 4

by kcmylorn

Medicare fines over hospitals' readmitted patientsding... By RICARDO ALONSO-ZALDIVAR, AP 42 minutes ago My take on this is: This could have positive implications for nurses in that if alot of these hospitals perform... Read More


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    Home Health RN here. Starting 2013 there will be medicare cuts to home health, possibly a copay per 9 week certification
    period. This leads to decreased visits, increased documentation, limited CNA use(medicare doesn't pay for CNAs) and increased
    accountability for rehospitalization. Hospitals are already choosing HHa that have the least rehospital rates, that may lead to them
    being picky and choosing cases that are not chronic repeaters. No job security here!!
  2. 0
    I think cutting the funding to home health, and therefore the usage of home health is cutting the nose off to spite the face. How are we to get continium of care if Home care benes are cut? Has any of the Home care Nurses written a letter to the CMS or DHS about this? (as stupid as it sounds).
  3. 0
    Here the nurse navigators are not connected to cancer treatment. Cancer patients may have them as well, but the Navis I was referring to are specifically charged with preventing readmission.
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    Home health has been the main beneficiary in the 4 years we've been working with this new rule. Increased use of home health accounts for the majority of the cuts we made to our readmission rates.

    Home health will be seeing a reduction in their reimbursements, which I'm fine with. Home health is not only one of the most profitable sections of healthcare, it's one of the most profitable industries in general. For comparison, look at companies that do pretty well for themselves; Nike for instance runs a profit margin of about 9%, HP and Dell run closer to 6%. Home health runs a profit margin on medicare patients of 19%, or about $3.6 Billion per year. The reimbursement cut is only 2.3 percent, which will mean they'll have to get by with $3.51 Billion in profits rather than $3.6.
  5. 0
    Quote from SC_RNDude
    ... I don't think that will have much impact on staffing...
    Agree.
  6. 0
    Quote from chuckster

    Sadly, this is probably true.

    ... the average fine is going to be $125,000, that is pretty close to the cost of hiring just one additional nurse. So in our example, the cost to avoid the fine is ten times greater than simply paying the fine. The rational economic decision is clear...
    Agree.
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    Thanks for the site, Muno.
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    I'm a home health RN for another week or so (getting the he** out of healthcare). This readmit thing is getting bad. The reality for those of you in bedside nursing and PCP offices is that I can only do so much with a stethoscope and a blood pressure cuff. Most PCPs don't go into the hospital anymore so when I call an MD with an adverse finding at a HH visit, I expect an intervention NOW, not 24 hours from now. And the intervention should not be "send them to the ER I haven't seen this patient in 4 months." For example, 2 weeks ago, visit to Mrs. "Smith", she was feeling kind of weak, took her BP, sitting 110/70, standing BP 68/46. Ok Mrs. Smith, let's call your PCP. Her doctor was a family doctor connected to a hospital system. After I spent 15 minutes on hold waiting to speak to a live person, I spent another 15 minutes telling the operator why I need the MD/NP/PA to call me back. I waiting another 30 minutes or so with the patient, no call back. So I gave her the intervention myself, have a can of chicken noodle soup (all of it), drink 2 tall glasses of water and I'll be back in an hour to check on you. And don't take anymore BP meds (physically took them out of her pill box). Went back in an hour and she had improved but I did not receive a call back from the doctor until the next day.

    I cannot stop a stage 4 lung cancer patient from developing pneumonia, nor can I head off that case of steroid psychosis r/t steroids at chemotherapy. Here's a news flash, patients are non compliant, especially in their own home. Crappy food, poor living conditions, and limited caregivers make for a difficult environment keeping these people well in the home.
    Havin' A Party! and Altra like this.


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