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Explaining High Rate of Hospital Readmission for Elderly

The elderly are particularly vulnerable to readmission after an initial hospital stay. A 2015 study by the American Hospital Association found that nearly 18% of all hospital patients are readmitted within 30 days and that most of those patients were elderly. In fact, 1 in every 5 nursing home residents who stay in the hospital are admitted again within 30 days. For the hospitals themselves, readmissions can be costly. The Affordable Care Act now penalizes hospitals who have high readmission rates. For the elderly, readmission can mean further health issues, depression, and even death.

 

Readmissions for Conditions Resulting from Time in the Hospital
While hospitals provide necessary and life saving care that other health care facilities and providers are unable to, hospital stays can also wreak havoc on a person’s normal daily routine, their hygiene and eating habits, their overall physical and mental health, as well as their physical strength.  Yale cardiologist Dr. Harlan Krumholz analyzed national readmission data and found that most patients returned to the hospital for a medical issue completely separate from the condition for which they were first admitted. He told the New York Times in August that it is his belief that elderly patients are in essence traumatized after a hospital stay, attributed to odd sleeping and wake schedules to accommodate hospital staff’s schedule for testing (blood pressure checks, blood draws, etc), diminished strength from spending all day in a bed, and from consuming different food and new medications. Dr. Krumholz calls the condition “post-hospital syndrome.”

Dr. Krumholz’s study examined patients who initially spent time in the hospital for heart failure, acute myocardial infarction (heart attack) and pneumonia. Of the over 3 million records they studied, they found that hospital readmissions were 67% for those who initially came in with heart failure, 49.5% for heart attacks, and 55.3% for pneumonia. The readmission timing was different for each condition, but all readmissions were within one year of the initial stay. One thing that struck Krumholz and his fellow researchers was the rate of trauma/injury after being hospitalized for any of the three conditions they examined. The risk of falls and other injuries took a significant amount of time to diminish. These findings have lead experts to link hospital stays with hospital-caused conditions and injuries that ultimately put the elderly back in the hospital.

 

Nursing Homes Now Incentivized to Cut Back on Readmissions
Nursing homes’ hospital readmission rates have been a target for the Centers for Medicare and Medicaid Services (CMS). Starting in October, nursing homes who keep their residents’ readmission rates low will receive a financial bonus from CMS. In June, our blog covered the frequent readmission of elderly nursing home residents to hospitals. We now are learning that the problem is more complex than initially believed and that many parties and factors are to blame.

According to Dr. Krumholz and other medical experts, hospital stays themselves are setting the elderly up for other health conditions attributed to being simply being treated in a hospital. We also know that many nursing homes struggle to get a handle on a resident’s health both before and after a hospital stay, requiring not only an initial (and perhaps sometimes hasty) decision to send them to the hospital, but requiring another visit because the nursing home is unable to properly care for a patient following a hospitalization. The number of readmissions for the elderly is astonishing, especially when you consider that families are trusting nursing homes with their loved one’s care because it’s something they know they personally can’t provide. Nursing homes are staffed with doctors, nurses, CNAs, dietitians, and mental health experts who are there to ensure that our loved ones are being properly cared for in order to avoid further health complications and hospitalizations.

Helping Prevent Further Hospitalizations
So what can be done to prevent repeat hospitalizations? Next month begins the implementation of CMS’ financial reward plan for nursing homes who keep readmission rates low, so that’s a start. Since 2012 hospitals themselves have already been following a readmission reduction program as part of the Affordable Care Act. However, the reductions rates are minimal, with just a 1.5% drop from 2012-2017.

Dr. Krumholz advises families to take charge of their loved one’s daily routine while in the hospital. For example: Bringing in foods and activities they like, as well any medical aids that help your loved one hear, see, or that encourage their physical fitness. He also advises that families ask hospital staff to not wake their loved one while they’re sleeping for any test or procedure that can actually wait. Keeping an elderly patient happy and attempting to follow their usual waking, sleeping, eating, and physical activity routines as much as possible will likely ensure that a hospital stay is less traumatic to the system than it otherwise could be.

 

Levin & Perconti: Illinois Nursing Home Abuse and Neglect Attorneys
Since 1992, our attorneys have been dedicated to fighting for elderly rights in any care setting. Using our legal and medical knowledge combined with nearly 30 years of going up against nursing homes and hospitals throughout Illinois and Chicago, we’ve been able to secure record-setting verdicts and settlements for victims of elder abuse and neglect.

If someone you love has been subjected to poor treatment in a nursing home or hospital, including seemingly avoidable hospital readmissions, let our attorneys help you get answers. Consultations are free and can be requested by phone at (312) 332-2872 or by completing our online case evaluation form.