By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Avoiding End of Life Transfers from Nursing Home to Hospital
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Hospital Administration > Avoiding End of Life Transfers from Nursing Home to Hospital
BusinessHospital Administration

Avoiding End of Life Transfers from Nursing Home to Hospital

DavidEWilliams
DavidEWilliams
Share
4 Min Read
SHARE

It’s encouraging to see the California HealthCare Foundation tackle the issue of unnecessary nursing home to hospital transfers that occur in the last weeks of life. The PREPARED project, comprising collaboration between hospitals and nursing homes, showed some success in reducing unneeded hospitalizations, improving quality of life and improving family member satisfaction. The factors that added to the success of the program were fairly predictable. They included:

  • Strong and ongoing administrative leadership and support
  • The presence of advance care planning champions
  • Involvement of doctors
  • A culture of quality improvement
  • The availability of educational opportunities for families and residents

The last factor is noteworthy, because it suggests that better informed people lean toward avoiding unneeded hospitalizations. They don’t see it as rationing or a death panel. Key factors detracting from success were perhaps more enlightening:

  • Some of the participating facilities were undergoing surveys by the California Department of Health Services during the timeframe of the PREPARED project. As the report notes, all elective activities including quality improvement usually get dropped during these surveys, which can last for months
  • Nursing homes have financial incentives to transfer. They get paid for three days to hold the bed for the resident’s return, and they get enhanced payments triggered by the hospital stay
  • Many nursing home staff are ignorant of end-of-life issues in general and lack expertise on the concept and details of advance care planning
  • Lack of knowledge on pain and symptom management
  • Not enough time in the day for staff to take advantage of resources provided by this project

These detractors are fairly discouraging. It’s definitely worthwhile for families of prospective residents to try to get a handle on some of these issues in advance if at all hospitals. I really liked it that the researchers clearly identified three ways that hospitals lose out financially from unneeded end-of-life admissions. These are the most likely findings to encourage change:

  • At least in California, where Kaiser Permanente has a big presence, there are integrated systems where total costs go up if a patient is transferred to an acute setting. To the extent Accountable Care Organizations (ACOs) take global payments, this incentive will spread
  • Even in a fee-for-service environment, these end-of-life nursing home patients can be unattractive to hospitals. That’s because admissions that end in a patient death are typically unprofitable. Costs are high and not fully recoverable
  • Hospitals will begin to be penalized for preventable re-admissions under the Affordable Care Act. Many nursing home residents suffer from conditions such as heart failure and pneumonia that are subject to re-admissions penalties. Avoiding nursing home to hospital transfers at end of life also cuts readmissions

I’d really like to believe that these financial incentives for hospitals are robust but I’m not totally convinced they’re as real as the authors seem to think.

More Read

Utilization Review vs. Utilization Management
Leading Expert On U.S. Health Reform Gives His Two Cents
Secret Shoppers in the Doctor’s Waiting Room- A Twist on Pay for Perfomance
Mobile Health Around the Globe (Bonus Post!): Six mHealth Companies Bringing Health Technology to Developing Countries
e-Patients, Quantified Self and Self-Efficacy; Self-Monitoring Through Technology
TAGGED:hospitalsnursing homes
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

dental care
Importance of Good Dental Care for Health and Confidence
Dental health Specialties
October 2, 2025
AI in Healthcare
AI in Healthcare: Technology is Transforming the Global Landscape
Global Healthcare Policy & Law Technology
October 1, 2025
Choosing the Right Swimwear for Health and Safety
News
September 30, 2025
sports concussions
Concussion In Sports: How Common They Are And What You Need To Know
Infographics
September 28, 2025

You Might also Like

The Importance of Time in Orthopedic Patient Payment Collections

October 29, 2014
Health ReformHospital AdministrationPolicy & Law

Are High-deductible Health Plans Working?

February 8, 2016
Image
BusinessSocial MediaTechnology

Small Practice Medical Website Mistakes and How to Avoid Them

March 14, 2016
health insurance
BusinessFinanceHealth ReformMobile HealthPolicy & Law

Evidence Mounts That Health Insurance Is Necessary, But Not Sufficient for Good Health

August 11, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?