4 of 7 Floyd nurs­ing homes face Medi­care penal­ties

♦ The pro­gram is de­signed to dis­cour­age fa­cil­i­ties from dis­charg­ing pa­tients too quickly.

Rome News-Tribune - - FRONT PAGE - By Andy Miller Ge­or­gia Health News

Four out of seven Floyd County nurs­ing homes have been pe­nal­ized by Medi­care for avoid­able hos­pi­tal read­mis­sions of nurs­ing-home pa­tients.

Pruitt Health Care, Rome Health and Re­hab, Chulio Hills Health and Re­hab, and Fifth Av­enue Health Care re­ceived penal­ties from the fed­eral gov­ern­ment for how of­ten their pa­tients were read­mit­ted to hos­pi­tals after leav­ing their care.

The nurs­ing homes will have de­creased Medi­care pay­ments for the next fis­cal year end­ing in Septem­ber 2019.

Pruitt and Rome Health and Re­hab are set to lose 1.98 per­cent of Medi­care fund­ing; Chulio Hills will lose 1.91 per­cent; and Fifth Av­enue Health Care will lose 0.64 per­cent.

Mean­while, Winthrop Health and Re­hab will re­ceive a 1.15 per­cent bonus, Ev­er­green Health and Re­hab a 1.18 per­cent bonus, and Etowah Land­ing will re­ceive a 1.42 per­cent bonus dur­ing the same fis­cal year.

The pro­gram of bonuses and penal­ties is in­tended to dis­cour­age nurs­ing homes from dis­charg­ing pa­tients too quickly. That’s some­thing that is fi­nan­cially tempt­ing, be­cause Medi­care fully cov­ers only the first 20 days of a stay and gen­er­ally stops pay­ing any­thing after 100 days, Kaiser Health News re­ported.

The fi­nan­cial in­cen­tives and penal­ties are de­ter­mined by how of­ten nurs­ing home res­i­dents end up back in hos­pi­tals within 30 days of leav­ing.

Re­li­able Health­care Man­age­ment, who over­sees Chulio Hills and Fifth Av­enue Health Care, had penal­ties is­sued against all seven of their nurs­ing homes which are in North­west and North­east Ge­or­gia as well as one lo­ca­tion in metro At­lanta.

An ac­count­ing rep­re­sen­ta­tive for the Rome-based com­pany who de­clined to iden­tify her­self was not aware of any penal­ties at any of their fa­cil­i­ties.

Over this fis­cal year, which be­gan Oct. 1, the best-per­form­ing homes will re­ceive 1.6 per­cent more for each Medi­care pa­tient than they would have oth­er­wise. The worst-per­form­ing homes will lose nearly 2 per­cent of each pay­ment, ac­cord­ing to KHN. Un­til now, Medi­care lim­ited these kinds of in­cen­tives mostly to hos­pi­tals, which have got­ten used to fac­ing fi­nan­cial reper­cus­sions if too many of their pa­tients are read­mit­ted, suf­fer in­fec­tions or other in­juries, or die.

Kathy Floyd, ex­ec­u­tive di­rec­tor of the Ge­or­gia Coun­cil of Ag­ing, said this week that “ty­ing pay­ments to qual­ity of care is a big step for­ward.”

“The head­line cites the cuts, but I’m en­cour­aged by the bonuses,” Floyd said. “Let’s find out what those homes are do­ing to keep read­mis­sions down.”

Medi­care is not mea­sur­ing read­mis­sion rates of pa­tients who are in­sured through pri­vate Medi­care Ad­van­tage plans, even though in some re­gions the ma­jor­ity of Medi­care ben­e­fi­cia­ries rely on those to af­ford their care, KHN re­ported.

Ap­prox­i­mately three out of four, or 75 per­cent, of nurs­ing homes in Ge­or­gia have re­ceived penal­ties from Medi­care for avoid­able hos­pi­tal read­mis­sions of nurs­ing home pa­tients. The 75 per­cent fig­ure is slightly higher than the na­tional av­er­age.

The fed­eral gov­ern­ment gave bonuses for lower read­mis­sions to 23 per­cent of the 373 nurs­ing homes in the state. Two per­cent had no change un­der the new penalty pro­gram.

‘The head­line cites the cuts, but I’m en­cour­aged by the bonuses. Let’s find out what those homes are do­ing to keep re-ad­mis­sions down.’

Kathy Floyd ex­ec­u­tive di­rec­tor of the Ge­or­gia Coun­cil of Ag­ing

Kathy Floyd

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