Nearly half (45 percent) of cases in which a nursing home resident is hospitalized are preventable.

That is one of the conclusions from a massive report released last week by the Centers for Medicare and Medicaid Services (CMS), eloquently titled, “Evaluation of the Initiative to Reduce Avoidable Hospitalizations among Nursing Home Residents.”

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The study was based on observations of 144 nursing care facilities run by seven different Enhanced Care and Coordination Providers (ECCPs) in seven different states in 2014.

Some of the nursing facilities were used as control groups, where nothing was changed, while others were subject to various interventions designed by each ECCP.

In every state observed, about 25-30 percent of all nursing home residents were hospitalized at one point. Similarly, in every state, about 10-15 percent of residents were hospitalized for what was later determined to be a preventable event.

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While ECCPs were allowed to pioneer a variety of different interventions, they were given a general set of guidelines for what their policies should accomplish, including improving communication between inpatient facilities and nursing homes about a resident’s health information and devising a way to better monitor the drugs administered to patients to prevent polypharmacy.

The good news, reports the CMS, is that the introduction of these new types of interventions succeeded in reducing both Medicare spending and hospitalizations at all seven sites.

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CMS is touting the report as evidence that efforts to prevent hospitalizations and reduce costs--including by tying reimbursement rates to the frequency with which patients are readmitted to a hospital after a surgery--do not have to come at the expense of patient health.

Similarly, CMS is highlighting research that shows nursing home professionals are prescribing fewer unnecessary antipsychotics to residents.

Instant Insights /

Hospitalizations of many nursing home residents preventable

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