For those looking for a nursing home, Medicare.gov has a great service. It’s called Nursing Home Compare and it rates local nursing homes by using a five start system. It uses several criteria to determine the rating including claims and inspection data. Now the system is adding some new criteria to the ratings. Outcomes.
The Affordable Care Act has forced all providers in the healthcare system to focus on outcomes but until now only hospitals have gotten penalized for not performing well. Now nursing homes will be scrutinized for one patient outcome in particular.
Re-admissions have been identified as the prime indicator of poor healthcare outcomes in recent years and have been the focus of The Centers for Medicare and Medicare in their quest to reform healthcare. Re-admissions are patients who have been admitted to the hospital and nursing home within 30 days of their last discharge. CMS believes that if a re-admission becomes necessary it is because:
- The patient was not completely stable and required a return trip
- The discharging hospital did not do enough to set up a support system that would prevent the patient from readmitting.
Focus Means Better Service
The second point is why this focus on re-admissions is great for healthcare consumers especially from nursing homes. It finally forces nursing homes to strongly consider the environment in which a patient is discharging and the challenges it presents. The high quality nursing homes already do this but now all nursing homes will have to consider whether a patient is ready for discharge based on the health or the patient rather than the Medicare/insurance coverage clock.
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The focus on re-admissions and outcomes has already made a significant difference in the hospital setting. Some patients with chronic illness have a community liaison assigned to them upon discharge to offer support and guidance after a stay at the hospital. Home care companies are also increasing contact with their patients to prevent unexpected trips to the hospital. Similar programs are being developed for nursing homes and their patients.
All in all the added criteria to Nursing Home Compare is a good thing for healthcare consumers. Visit Medicare.gov to check out your local nursing home ratings.