Skilled Nursing Facilities Must Prevent Avoidable Hospital Readmissions

One of the primary concerns for both skilled nursing facilities (SNFs) and hospitals is the high rate of 30-day hospital readmissions and emergency department (ED) transfers by older adult patients.  The Centers for Medicare & Medicaid Services (CMS) recently included these events as short-stay quality measures that will give skilled nursing facilities further incentives to decrease potentially preventable hospital transfers.  Skilled nursing facilities are increasingly pressured by hospitals to decrease 30-day readmissions due to financial penalties to hospitals for specific readmissions and high readmission rates in general.  Moreover, it is imperative that skilled nursing facilities decrease the high number of preventable hospital admissions and emergency department visits due to the increasing number of Medicare advantage patients, accountable care organizations, and combined payment programs.  The skilled nursing facility hospital readmission quality measure that is going to be established in the upcoming years will give further incentives for these facilities to decrease readmission rates.

Substantial evidence has shown that a significant proportion of hospitalizations and emergency department visits in the skilled nursing facility population are likely avoidable. Data from a recent study found that skilled nursing facility staff that examined almost 6000 hospital transfers considered an estimated 23% of transfers to be potentially preventable or avoidable.  According to the study, transfers back to the hospital that happen right after skilled nursing facility admission may be related to an increased incidence of potentially preventable complications with care transitions.

A recent article published in the Journal of the American Medical Directors Association—The Society for Post-Acute and Long-Term Care Medicine described the effectiveness of root cause analyses when performed by skilled nursing facility staff and also identified clinical and other causes related to hospital readmissions within 48 hours and within 30 days skilled nursing facility admission.  The goal of this research was to contribute to the reduction of potentially avoidable hospital readmissions and emergency department visits and their related problems and expenses.

Researchers found that, ultimately, rapid transfer of an elderly patient discharged from the hospital to a skilled nursing facility back to the hospital occurs quite frequently, and commonly occur in patients who are identified as high risk at the time of admission to a skilled nursing facility, and are more than likely to be clinically unstable during their time of transfer.  It is important for skilled nursing facilities to implement evidence-based strategies to improve care for their elderly residents and to help prevent unnecessary visits back to the hospital and emergency department.

It is well known that most older adults who reside in long-term care facilities battle with multiple health issues and are highly vulnerable to adverse events.  Unfortunately, it is far too common for these residents to receive inadequate and inappropriate care while under the responsibility of skilled nursing facilities and assisted living facilities with low staffing levels and/or untrained staff.  These care facilities should be held responsible, however, when older adult residents suffer from poor quality of care. If you or a loved one has been a victim of elder abuse or neglect in a residential facility, such as one in Burbank or Calabasas, California, please contact our office today. We are a team of experts and attorneys in elder law who are passionate about helping the elderly, especially when they have suffered unnecessarily due to inadequate care.