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Connecting Experience and Marketing

You don't want to tick this guy off by offering a bad experience do you? When you understand how these two areas relate to each other, you will clearly see how they impact the culture of your organization, your employee engagement strategy and your marketing strategy.

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Assisted Living Spotlight10

Physicians Biggest Obstacle in Smooth Transitions of Care

Wednesday April 23, 2014
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Maybe not a smooth transition!

Poor communication between physicians is the No. 1 issue hurting patient transitions between hospitals and nursing homes, according to a recent survey of long-term care professionals.

Researchers with the University of Missouri Sinclair School of Nursing devised a survey to gauge problems with care transitions. They received responses from care teams at 178 nursing homes in Missouri. The teams included a variety of workers, including nurses, physicians, Minimum Data Set coordinators and administrators.

The most common problem identified was "no communication between hospital physician and accepting physician," the researchers found.

Thirty percent of re-hospitalizations in nursing homes occur for residents who have been there for seven days or less. Getting care right from the start makes a big difference in whether a nursing home stay is successful.

Transitions can be traumatic, especially when people are frail. For people coming into a nursing home from the hospital, that transition is smoother when there is good coordination and hand-offs between the nursing home and the hospital and when there is good coordination internally within the nursing home across shifts and departments.

There is a considerable base of evidence about practices that can alleviate transfer trauma. These practices focus on ways of anticipating and meeting people's psycho-social needs, helping them acclimate to unfamiliar surroundings, and providing immediate comfort and security.

More at McKnight's Long-Term Care News and Assisted Living

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Medicaid Fraud Unit Issues 2013 Report - Home Health on Naughty List

Monday April 21, 2014
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The Office of the Inspector General Medicaid Fraud Control Unit (MFCU or Unit) issued its Fiscal Year (FY) 2013 Annual Report highlights statistical achievements from the investigations and prosecutions conducted by 50 MFCUs nationwide. The Unit recovered $2 billion through its enforcement.

MFCUs investigate and prosecute Medicaid provider fraud and patient abuse and neglect in health care facilities or board and care facilities. About three-quarters of criminal convictions involved fraud; about one-quarter involved patient abuse and neglect.

FY 2013 criminal convictions for fraud: 74 percent

Fraud convictions included convictions for (1) conspiracy to commit health care fraud, (2) health care fraud, (3) submitting false statements related to health care matters, (4) making a false statement in regard to health care reimbursements, (5) grand larceny, and (6) violations of anti-kickback statutes. For example, in August 2013, the New York MFCU obtained a conviction of the owner of several pharmacies for stealing $7.7 million from the New York State Medicaid program. The pharmacist submitted phony bills for drugs that were never dispensed to patients. He was sentenced to a prison term of up to 3 years and was ordered to repay the stolen money to the New York Medicaid program.

FY 2013 criminal convictions for patient abuse and neglect: 26 percent

Cases of patient abuse and neglect included aggravated assaults; injury to an elderly or disabled person; and theft of patient funds. For example, in September 2013, the Maryland MFCU obtained a conviction of a nursing home aide for abuse of a vulnerable adult in the second degree. The convicted aide was placed on 2 years of probation, during which time he is prohibited from being employed in any position that includes the supervision of vulnerable adults.

Criminal Convictions

Convictions related to fraud consistently represented the majority of all criminal convictions. FY 2013 criminal convictions involved a variety of provider types, most notably home health agencies. Criminal convictions most frequently involved home health care aides (26 percent of all criminal convictions), other medical support (7percent), and physicians (7 percent).

Home health care aides: 26 percent of criminal convictions

Home health care aides weremost commonly convicted of fraud, often for claiming to have rendered services that were not provided to vulnerable beneficiaries.

Other medical support: 7 percent of criminal convictions

The category "other medical support" includes individuals, facilities, or organizations, whether licensed or unlicensed, that provide medical support services. This category specifically excludes pharmacies; pharmaceutical manufacturers; suppliers of durable medical equipment; laboratories; providers of transportation; home health care agencies and aides; nurses; physician assistants; nurse practitioners; and radiologists. Individuals in this provider category were convicted of a wide variety of offenses.

Physicians: 7 percent of criminal convictions

Criminal convictions of physicians involved offenses such as fraud (including prescription fraud) and billing for services not rendered.

Medicaid Fraud Control Units recovered about $10.3 million from nursing facilities in fiscal year 2013. Civil fraud settlements and judgments accounted for the majority of nursing home recoveries. These cases led to $8.3 million in recoveries. Criminal fraud investigations led to about $1.1 million being recovered. Civil abuse and neglect cases represented about $771,000 in recoveries, and criminal abuse and neglect convictions resulted in roughly $155,000 being recovered, the report stated.

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Inpatient Rehabilitation Hospital Patients Have Better Outcomes Industry Sponsored Study Claims

Friday April 18, 2014
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Can dedicated rehabilitation hospitals reduce readmissions more effectively than nursing homes? This sponsored study suggests yes. What do you think?

A study released at a meeting of the March meeting of the American Medical Rehabilitation Providers Association (AMRPA) shows that patients treated in inpatient rehabilitation hospitals and units had better long-term clinical outcomes than those treated in nursing homes.

The ARA Research Institute, an affiliate of the AMPRA, commissioned Dobson-DaVanzo & Associates, LLC, to conduct a retrospective study of inpatient rehabilitation hospital and unit patients and clinically similar nursing home patients to examine the downstream comparative utilization, effectiveness of post-acute care pathways, and total cost of treatment during the five years following the implementation of the 60 percent rule.

"This study shows that patients treated in inpatient rehabilitation hospitals and units have better outcomes, go home earlier and live longer than those treated in skilled nursing facilities," said Bruce M. Gans, M.D., AMRPA board chair, and executive vice president and chief medical officer of Kessler Institute for Rehabilitation.

Key Findings

The study's key findings show:

  • Over a two-year episode of care, inpatient rehabilitation hospital and unit patients clinically comparable to skilled nursing facility patients, on average: returned home from their initial hospital rehabilitation stay two weeks earlier; remained home nearly two months longer; stayed alive nearly two months longer.

  • Of matched patients treated: inpatient rehabilitation hospital and unit patients showed an 8 percent lower mortality rate than skilled nursing facility patients; inpatient rehabilitation hospital and unit patients with 5 of the 13 diagnostic conditions showed significantly fewer hospital readmissions than skilled nursing facility patients; inpatient rehabilitation hospital and unit patients made 5 percent fewer emergency room visits per year than skilled nursing facility patients.

See the full study.

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The staff experience: employees have human needs too!

Wednesday April 16, 2014

Here is an excerpt from my recent Hospital Impact blog. In essence, healthcare must heal itself before it can heal others.

This month's blog post extends from both my January and February posts. In January, I shared how short-sighted financial decisions hurt patient experience. In February, I discussed my new role as primary caregiver to my mom, suggesting that instead of focusing on patient experience, we should look at the human experience.

One comment on the January post serves as a good segue for the rest of this piece.

"Health and wellness, just as death and dying, affect all of us. Clinicians and administrators share in the wins and defeats in healthcare. As nurses, we need to be in the mix, collaborating with various stakeholders, while holding the hand of another human being to ease their suffering."

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