Are Hospitals Overlooking Patient Care to Avoid Re-admission Penalties?

Last year, Medicare created new federal regulations that cause hospitals with high re-admission rates to be penalized. These changes came after studies showed seniors were being readmitted at an alarming rate, back into hospitals within a month of being discharged. The new regulations were meant to be a ‘slap on the wrist’ for hospitals who weren’t viewed as providing proper care.

Medicare has reduced its payments to hospitals whose re-admission rates remain high in these three areas: pneumonia, heart attacks and heart failure. The idea behind these penalties is to improve our health care system, which has largely been funded based on volume rather than value. Yet, many medical professionals believe the regulations placed on hospitals are unfair, questioning how hospitals can be held liable for patients’ personal lives once they are released. These professionals believe skilled nursing care or family homecare is a more reasonable solution.

Since skilled nursing care or family homecare may not be an option for everyone, some less-reputable hospitals have found a different albeit artificial way of lowering their re-admission rates. The practice includes classifying patients for days, sometimes longer, as out-patients through the use of observational care. By not admitting or classifying a person for ‘in-patient’ care in the first place, hospitals are able to reduce their re-admission rates considerably. However, under most insurance carriers outpatient or observational care is either not covered or a greater percentage of the cost is charged to patients. Even more worrisome is if a senior becomes weakened due to their illness, to the point where they need rehab services; Medicare requires a full 72-hour period of ‘in-patient’ admission before they will cover rehab costs. As stated above, observational care does not count as ‘in-patient’ admission therefore the patient would be solely responsible for all charges.

To improve your loved one’s chances of avoiding re-admittance to the hospital consider senior home care in Scottsdale. At Cypress HomeCare Solutions, we have twenty years of experience in family homecare and services including transportation, meal-planning, housekeeping, personal care and more. We strive to maintain the highest caliber of private care by constantly evaluating our client’s needs and caregivers’ skills. Contact us online or give us a call at 602-264-8009 to discuss the importance of elderly care in Scottsdale and the surrounding cities.

 

Posted on July 12, 2013