Nursing homes penalized

Reimbursements reduced over high readmission rates

Most Connecticut nursing homes will see their Medicare reimbursements reduced in the coming year for having high resident readmission rates to hospitals.

Of Connecticut’s 224 nursing homes, 75 percent (168) are being penalized by Medicare based on how often their residents were rehospitalized within 30 days of discharge. Twenty-five percent (56) in Connecticut are receiving bonuses for having few readmissions, according to a Kaiser Health News analysis of data from the Centers for Medicare and Medicaid Services.

This is the first time nursing homes are being penalized or rewarded based on how many of their residents are readmitted to hospitals for conditions that could have been prevented. Medicare has administered a similar program for hospitals since fiscal year 2013.

The penalties and bonuses, which are in effect for the federal fiscal year that began Oct. 1, will vary. The topperforming facilities will get about 1.6 percent more for each Medicare resident. The worst-performing facilities will lose almost 2 percent of each resident’s Medicare payment, according to

KHN’s analysis.

For-profit homes, which comprise most facilities nationwide, face larger penalties than nonprofit or government-owned ones.

Losing part of their Medicare reimbursements may be painful for some nursing homes, said Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, which represents 150 nursing homes in the state. Still, the association supports a “value-based purchasing policy,” he said.

Varying penalties

Statewide, the largest penalty levied was a 1.98 percent reduction in reimbursements, and 38 facilities received it. They include: Apple Rehab Laurel Woods, East Haven; Salmon Brook Center, Glastonbury; Milford Health Care Center, Mary Wade Home, New Haven; Lord Chamberlain Manor, Stratford; Notre Dame Convalescent Home, Norwalk; Watrous Nursing Center, Madison; and Valerie Manor in Torrington.

The largest bonus awarded in Connecticut, a 1.65 percent increase in reimbursements, is going to Chestelm Health Care, Moodus; Litchfield Woods Health

Care Center, Torrington; and Hughes Health and Rehabilitation in West Hartford.

Nursing homes increasingly are acting as short-term rehabilitation facilities and, therefore, play a major role in preventing readmissions, said Lisa Freeman, executive director of the Connecticut Center for Patient Safety. More and more, hospitals are discharging patients earlier than they used to, leading patients to recover in a nursing home rather than a hospital.

Nationwide, 10,976 nursing homes are being penalized, 3,983 are receiving bonuses; the rest will see no change in their payments, according to KHN.

Reducing hospital readmissions benefits residents and facilities alike, Barrett said.

This story was reported under a partnership with the Connecticut Health I-Team, a nonprofit news organization dedicated to health reporting.