4 of 7 Floyd nursing homes face Medicare penalties
♦ The program is designed to discourage facilities from discharging patients too quickly.
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