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Illinois nursing home abuse attorneysWhile nursing homes are often seen as hospital-type facilities, a nursing home is not a hospital. Hospitals provide acute care for patients who require it, with doctors largely taking responsibility for overseeing each patient. A nursing home or skilled nursing facility provides 24-hour care at a comparatively lower level than that available in a hospital, with nurses generally providing patient oversight.

It is not uncommon for a patient in a nursing home to require hospitalization from time to time, but recent reports suggest that too many nursing home patients are being discharged from the hospital only to end up back in the hospital within 30 days. These readmissions are so concerning that the federal government has announced it would be altering Medicare payments to nearly 15,000 nursing homes and skilled nursing facilities across the country based on how often residents went back to the hospital within a month of leaving. As a result, some 4,000 facilities will get bonuses while almost 11,000 will have their payments lowered.

Preventable Admissions

According to several analyses, the hospitalization of nursing home patients has been decreasing over the last few years. Experts say that in 2016, however, 11 percent of nursing home-to-hospital admissions could have been avoided with better medical care in the nursing facilities—many of which included patients who went back to the hospital after a prior admission and discharge

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Chicago nursing home abuse attorneysJust weeks after news outlets exposed the often deplorable conditions in many nursing homes managed by the Department of Veterans Affairs, now a new story about inadequate nursing home conditions is making headlines. Medicare rates nursing homes on a five-star system, with five stars being the best and one star being the worst. Nursing homes' failures to keep the facilities adequately staffed with registered nurses or to provide records showing staffing information result in a lower score. Medicare just significantly reduced its quality ratings in 1,400 United States nursing homes because of concerns regarding staffing.

Governing Bodies Cannot Rely on Self-Reported Data from Nursing Homes

Medicare began gathering and disseminating statistics on nursing home care after the Affordable Care Act of 2010 (ACA) was instituted. Before the ACA required Medicare to keep tabs on nursing homes, the program relied solely on self-reported and unverified information from nursing homes. Unfortunately, it seems as if nursing homes were not entirely truthful about the number and quality of staff at their facilities. After Medicare received payroll archives from nursing homes, it became apparent that many facilities were critically understaffed.

Medicare Requires At Least One Nurse to Be on Duty

Payroll records reveal that many nursing homes do not have an adequate number of staff supervising and caring for residents. Medicare requires that at a minimum, one registered nurse must be available for at least eight hours a day in nursing home facilities. Nurses are the highest-trained caregivers involved directly in patient care at long-term care facilities and are an irreplaceable asset. In addition to helping nursing home residents with medical needs, nurses are also tasked with supervising other caregivers and aides. Many of the nursing homes which received lowered ratings were given the deduction because the facility did not meet the registered nurse requirement.

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Illinois nursing home abuse and neglect lawyersThe arm of the federal government tasked with providing health care coverage to seniors and the disabled is taking aim at “boomerang hospitalizations” of nursing home residents. Medicare officials have begun taking steps to address high hospital readmission rates, especially for patients who already require skilled nursing care and will reportedly increase those efforts on the nursing home side by this fall.

What Is a Boomerang Hospitalization?

Many nursing home patients require acute medical attention in a hospital at some point during the stay at a nursing home. This is understandable, considering those in nursing homes are there because they are already dealing with fairly serious injuries, illnesses, and other conditions. The problem, however, seems to be beginning when patients are released from the hospital and sent back to their nursing homes. According to reports, 20 percent of Medicare patients who are discharged from a hospital to a nursing home are readmitted to the hospital within 30 days. This number is 27 percent higher for Medicare nursing home patients than for Medicare patients who do not require nursing home care.

The phenomenon of a quick readmission is called a “boomerang hospitalization” as a reference to the thrown hunting tool that returns to the thrower in midair. Experts suggest that government payment policies have inadvertently led to a pattern of back-and-forth transfers between hospitals and nursing homes for far too many patients.

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