It’s no secret that some nursing homes will neglect their residents in the interest of their own greed for profits and wealth, but less well known is the fact that those nursing homes are often rewarded by the government for that mistreatment. NPR recently published an article on this topic, citing statistics like one in five nursing home residents sent from hospitals on Medicare are returned to the hospital within thirty days.
Rather than taking care of their patients to the best possible extent, hospitals and nursing homes choose to send them back and forth to one another because it benefits them financially. For one thing, it’s cheaper for each facility to treat a patient as little as possible. For another, both hospitals and nursing homes have historically received encouragement from the government for this behavior, getting financial rewards for things like admission, readmission, and discharge to and from the facility.
As an example, an elderly woman could be admitted to a hospital for a severe injury. She could then be transferred from there to a nursing home earlier than the injury demands because it’s in the hospital’s financial interest to move her out as fast as possible. Then, at the nursing home, she doesn’t receive the care she needs because the place is understaffed and it costs more money than they wish to pay to properly treat and rehabilitate her. So she gets sicker and they eventually send her back to the hospital. This act of “boomeranging” patients back and forth is well known in the world of health policy.
Noticing this trend, the government has begun its efforts toward fixing the situation. According to NPR, “In 2013, Medicare began fining hospitals for high readmission rates in an attempt to curtail premature discharges and to encourage hospitals to refer patients to nursing homes with good track records.” There are also plans to incentivize nursing homes to improve in similar ways.
These moves are a step in the right direction, but most believe there’s still a lot to do here in the interest of patient care.