Ask the nursing expert ... about readmissions penalties

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Angel McGarrity-Davis, RN, CDONA, NHA
Angel McGarrity-Davis, RN, CDONA, NHA

What do we need to know about federal authorities coming out with more penalties for hospitals?

Round 2 of the government's campaign to reduce the number of patients being readmitted to a hospital within 30 days arrived this month. There are 2,225 hospitals that will have payments reduced, and fines will be assessed in the $227 million range. 

Some of the larger hospitals could lose more than $1 million. The overall number of penalized hospitals stayed about the same over the past year. 

Skilled nursing facilities must not sit and ponder this for too long — the time to act is now! There are major changes in our post-acute world. We can be the game changers in the whole broken healthcare system. 

Nurses can be leaders in saying what is needed. For instance, we should have reimbursement for the clinical/rehabilitation programs we use that  keep patients out of the hospital. We can point to proven, evidence-based outcomes showing this to be true. It should be recognized that we are preventing the exacerbation of problems by focusing on and using the necessary follow-up on preventative wellness, medication compliance and disease management.  

We do these things for better healthcare, reduction of costs, and because it is the RIGHT thing for patients and their quality of life. 

Yet, it is a win-win: We are trying to increase our revenue, and we save taxpayers money. 

If we do not act, the changes will go on without us, SNFs will begin to be penalized for readmissions along with hospitals, and/or bundled payment will begin. 

At that point, we will not have as much say in reimbursement or the rise of accountable care organizations. That's why I believe that the choice is ours — but not for long.


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