DISCHARGE LOGJAM: Nursing Homes Turn Away Expensive Admits
"Medical gridlock" is the latest complaint in the wake of stringent Medicare cutbacks, as nursing homes across the country continue to fold and "a growing number of skilled nursing facilities" decline to admit high-cost patients who "still have complex problems but no longer need hospital care." The result is ever-increasing patient backlogs for hospitals struggling to find homes for elderly discharges, the Wall Street Journal reports, with elderly patients staying "sometimes weeks or even months longer" than their acute care needs dictate. At the same time, Medicare cutbacks have precipitated the closing of numerous home health agencies, eliminating the possibility of sending some patients home. The Journal profiles the dilemma in some detail, including an anecdote about an Everett, WA-based hospital that finally got a nursing home to accept a discharge only when the hospital agreed to continue to pay for the patient's expensive antibiotic. The only winner in the scenario? Firms like NeighborCare, which "sells nursing centers cost estimates of prospective patients' drugs" to enable them to make educated decisions about whether to accept or deny admission. As the nursing home industry continues to press HCFA for relief, Dr. Robert Berenson, director of HCFA's Center for Health Plans and Providers, noted, "We're expediting research to be able to adjust payment rates appropriately if the evidence shows that is needed" (McGinley, 5/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.