Nurses are the first line of defense in preventing readmissions, expert says

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To help hospitals prevent costly readmissions, long-term care providers need to get serious about partnering with local hospitals, an expert said Tuesday.

In a McKnight's webcast Tuesday, titled “Reducing Hospital Readmissions in the New Era of Healthcare Reform,” speaker Frosini Rubertino, R.N., emphasized the important role SNFs play in helping hospitals reduce costly readmissions. The information could not be more timely, as starting Oct. 1 Medicare began fining certain hospitals for readmissions of Medicare beneficiaries within 30 days of discharge.

Rubertino said the most important thing SNFs can do is to train frontline nurses to identify which residents are most vulnerable for a readmission — and verify that they know how to document and report vulnerabilities to their supervisors. It's also critical that nurses receive training on category of services — such as which residents are covered by Medicare versus Medicaid — and training on category of services.

“If you pair that with lack of knowledge with absence of documentation, you have a recipe for hospital readmission,” Rubertino cautioned.

SNFs need to get moving in forging clinical partnerships with hospitals, she said.

“Initiate general information sessions. Go beyond having lunch and marketing sessions. The cultures you create are different, but you have a common vision to improve care,” Rubertino concluded.

Click here to download a tool SNFs can use for their readmission efforts.

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