NURSING HOMES: Leave Patients Lingering in Hospitals

      Nursing homes are shunning elderly and disabled patients with "costly medical needs" because of payment restrictions that went into effect under the Balanced Budget Act, the Washington Post reports. As a result, "some patients are staying in hospitals much longer than necessary and other are being forced to enter nursing facilities far from their homes and families." Those most frequently rejected by nursing homes include "patients requiring intravenous antibiotics, tube feeding, dialysis and ventilator support" - all money-losing services under the BBA, according to nursing homes officials. Under the new payment methodology, rates are "based on average industry costs for different types of care" rather than the actual costs incurred. Some nursing homes are now sending representatives to hospitals to screen patients, while others use the services of Genesis Health Ventures, a drug supplier that screens patients for nursing homes and has, since July, seen its screenings increase from 50 to 500 per week. "We know that most of those people that we do that analysis for are not being admitted," said Genesis CEO Michael Walker. Although federal law prohibits nursing homes from accepting some Medicare patients while rejecting others, monitoring compliance is difficult, as nursing homes can assert that they lack the room or resources to care for certain patients. Currently, plans are underway at HCFA to conduct a study to "assess beneficiaries' access to nursing homes." "In some cases it may be appropriate for acutely ill patients to spend a little more time in a hospital before being transferred to a skilled nursing facility," said HCFA Administrator Nancy Ann DeParle (Hilzenrath, 6/7).