I was sent to a training seminar this week. "assessment training". Some of this training was the trainer talking about obamacare and what it means to "us". I am wondering how many other facilities are already taking steps to "deal" with the new issues and exactly what steps are they taking?
She told us as of Oct 1st the hospitals will have to give free care to anyone we have to send back to them for five specific diagnoses if that diagnosis is what they were there for in the first place and it is within 30 days of their discharge. We are required to be able to maintain these patients or improve them. If we have to send people back the hospitals are not going to keep sending us any patients because we will be costing them money. We are not really LTC anymore even if the people coming to us are not "rehab and send back home" patients.We are more like med surg units now. Yeah med surg with LTC nurse to patient ratios. It is already a nightmare, I can hardly wait for it to get even "better" with NO LTC patients and ALL med surg filling my 25 beds.
She also said that we are going to be pushing hard and fast to get out of LTC altogether and be strictly rehab because there is a 28% cut to medicare and it will no longer be profitable to take these patients and most likely we will not even be able to break even on them. (Well this explains why we have been cut to the bone on staffing, having people called off, nurses working as aids, not allowed to have any overtime, told to clock out and go finish our work after we clock out crap)
We are also going to be losing Dr's willing to treat them because they will not make any money either. Without Dr's willing to treat we obviously cannot take those patients in.
Well where ARE they going to go? She had nothing to say about what will happen to all these medicare patients nor the medical assistance patients that are taking an even bigger cut. She said 50% cut for them! Is there some kind of provision in Obama's plan to deal with millions of medicare patients and no facilities or Dr's willing to treat them?
Aug 20, '12
by NRSKarenRN, BSN, RN
After 2011's 11% Medicare cut, SNF's will be getting an 1.8% increase Oct.1st, 2012.
What every one is bracing for is the Accountable Care Act's penalties for excess readmissions and Quality care initiatives.
Overall Medicare cuts to beneficiaries are not happening,
[FAQ: Decoding The $716 Billion In Medicare Reductions
...Hospital reimbursements would be reduced by $260 billion from 2013-2022, while federal payments to Medicare Advantage, the private insurance plans in Medicare, would be cut by approximately $156 billion. Other Medicare spending reductions include $39 billion less for skilled nursing services; $66 billion less for home health and $17 billion less for hospice. The law does not make any cuts to the amount of benefits beneficiaries receive and adds some new benefits
, including closing the "doughnut hole" gap in Medicare prescription drug coverage, and new preventive services, such as an annual wellness visit with a physician.
Medicare To Penalize 2,211 Hospitals For Excess Readmissions
The new penalties are based on data for three health conditions: heart attack, heart failure and pneumonia that have patients readmitted to hospital within 30 days of discharge.
Hospitals are looking at ways to cut costs. Referring to home care is one option, but 30% patients are readmitted within 30 days. So looking at SNF's to discharge clients to is very attractive. SNF's have to prove themselves with quality care, low transfer rates back to hospitals and improved functional scores.
SNFs Facing an $800 Million Bludgeoning in Medicare Cuts Under Balanced Budget
Between FY 2012 and FY 2021, SNFs are expected to absorb at least $3 billion in new cuts thanks to “bad debt” provisions contained in the Middle Class Tax Relief and Job Creation Act of 2012, and overall, the industry is already slated to absorb $48 billion in funding cuts in that same window.
How Advancing Excellence is Reducing Hospital Readmissions
Last edit by NRSKarenRN on Aug 20, '12