SNF SKILLED NURING HOME FACILITIES

Starting October 1, hospitals in the bottom quartile for readmissions will get across-the-board reimbursement cuts from Medicare

Skilled nursing facilities should capitalize on their data to become attractive partners to either hospitals in trouble, or well-performing hospitals that want to stay on to,

“SNFs have a very attractive opportunity to step up their game,

The door is wide open for SNFs. For those willing to attack readmissions and position quality benefits, there are attractive reasons to partner with them from a hospital’s standpoint given the real value: great care at a great price.”

, “Advancing Accountable Care,” discussed the longevity of the model.

“The philosophy of accountable care is here to stay,

. “Regardless of the [healthcare reform] law, we will continue to pursue this model.”

“I believe nursing homes are in a unique position to help hospitals stabilize patients after discharge,” Another significant role is short-term rehab, to help those discharge patients attain or maintain the quality of care and help their acute care partner achieve the [required] quality measures.”

It’s important for skilled nursing facilities to demonstrate their value and how they compare to others in terms of quality of care and outcomes,

If SNFs can prove they sustainably have low readmission rates, they can position themselves well with hospitals—which revenue and reputation depend on,

“Embrace the gift of early intelligence: attack readmissions now,

Market your attractive outcomes,

Win census for hospitals, and be well positioned when readmissions-related cuts come to your neighbors caught flat-footed,

The paper’s contents include how skilled nursing facilities compare to other post-acute care providers in terms of hospital readmission rates and costs

;What hospitals are looking for, as described by three major health systems;

What data SNFs will need to be attractively positioned with hospitals at the negotiating tables

Three imperatives for SNFs preparing for meeting with hospitals in an outcomes-driven healthcare world.

The bottom line, “Facts are friends, and you must line them up to win partnerships in the new era of post-acute care.”

Long Term Care Nursing Homes

Over the past decade, nursing home utilization and length of stay have decreased.
Although the number of admissions to and discharges from nursing facilities increased approximately 60% from 1995 to 2002(from 67,000 to over 107,000),10 nursing facility bed availability and average census have decreased, reflecting declining length of stays (See Figure 4.)11
Figure 4: Comparison of Massachusetts Licensed Nursing Facility Beds to Census (All Payers), 1995-2008
LicensedCensusMassHealthEmpty Beds# of nursingfacility beds010000200003000040000500006000020082006200420022001200019971995Source: MassHealth Office of Long-Term Care.
Almost half of all MassHealth nursing facility residents stay less than one year; but 20% have extremely long lengths of stay.
In 2008, 46% of MassHealth lengths of stay were one year or less, while 33% were between 1-4 years and 21% were more than 4 years.12
This distribution skews the average length of stay for MassHealth nursing facility residents, which was 2.41years, or 881days, in 2008. In contrast, the average length of stay for
10 Massachusetts Extended Care Federation (predecessor to the Massachusetts Senior Care Association) (2005). The Changing Face of Long-Term Care. Newton Lower Falls, MA: Author.
11MassHealth Office of Long-Term Care. Boston, MA.
12Ibid.

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A Nursing Home Can Be A Social Place

Article Topic: Nursing Home

Tags: nursing home medical hospitals and clinics

Anytime anyone mentions the term "nursing home" most people don't want to hear about it. Gone are the nursing homes of the past where seniors would go to live out the rest of their years just sitting in a wheelchair. True, there are still some elderly people who need extensive care and may spend their entire day in a bed. The nursing home will give them the care and attention that they need. Many nursing homes offer much more than good medical attention and care. They also offer activities that can be enjoyed to brighten and liven up the daily routine.
Before choosing a nursing home it is important to research the kind of care that is provided. A tour should be offered to be able to see the facility up close. Ask many questions and never take anything for granted. Be observant of the cleanliness of the facility. Find out how many nurse's and nurse's aides are on duty throughout the day. Ask how often the doctor comes in to do a physical. Find out about vision and dental care while at the home. Also, learn how much the room will be and how it can be handled financially.
Nursing homes are very expensive and most people don't have the money that can pay for a permanent stay. However, there is financial help that each state handles individually. Find out what help is available and have someone at the home assist with any type of paperwork that needs to be done.
A very important question to ask is if the nursing home has regular activities. There could be card games, bingo, virtual bowling, arts and crafts, trivia, and many other fun things to do. A great nursing home will have regular entertainment come in to play and sing many of the songs that were popular in the youth of the residents. Holidays and birthdays should be celebrated with a festive excitement. With all of this going on, there will be less depression and more acceptance of living at the nursing home.

Getting in your own Neighborhood

Mystic Valley Elder Services is committed to helping elders and adults with disabilities find what they need to live the way they want. Communities are stronger and more vibrant when everyone has the supports and resources they need to participate fully. Your support of Mystic Valley Elder Services makes communities better, makes lives fuller, and returns the control and dignity of independence to the hands of elders and adults with disabilities. Your support makes the world a better place. For all of us.
If you or a person you love wishes to return to an independent life at home, call Mystic Valley Elder Services at 781-324-7705. A care advisor will schedule a time to meet at the nursing facility to discuss community living options.

nursing facilities’ revenues

Research also shows that nursing facilities are much more reliant on government funding compared to physicians. More than half of nursing facilities’ revenues, at 53.2%, are from Medicare and Medicaid, compared to 30.2% of physicians’ revenues, with the remainder coming from private sources.
Labor accounts for about 70% of a facilities’ costs, and when Medicare and Medicaid reduce payments, it often forces facilities to reduce staffing, and this can result in a lower quality of care, according to research cited in the Alliance report.

Patient rehospitalizations from skilled nursing facilities

Patient rehospitalizations from skilled nursing facilities is a costly problem the industry is working to fix, especially after a study revealed accelerated cognitive decline in elderly patients after a hospitalization, and a panel of experts at a recent session during NIC’s 2012 Skilled Nursing Investment Forum said readmissions could be linked to length of stay in a facility.
Across all levels of care, rehospitalizations cost the Medicare system $25 billion a year, said Mark Jaeckle, Manager of Clinical Services at GE Capital’s Healthcare Financial Services, adding that one in three Medicare patients who are admitted to skilled nursing facilities end up being readmitted to hospitals within 30 days.
Data trends show that patients are spending fewer days in hospitals, said Jaeckle. At the same time, he continued, admission to skilled nursing facilities from hospitals has gone up, and hospital readmission rates have also risen.
Skilled nursing facility patients’ average length of stay could be a significant factor in whether or not they’re rehospitalized after transitioning to post-acute care, said Michael Jones, CEO and Principal of Healthtique Group, an owner/operator/manager of senior living communities.
The average length of stay for Medicare residents in a skilled nursing facility is 29 days. But in one of Jones’ facilities, patients were only staying for an average of 19 days—which he later determined to be when co-pays for Medicare Advantage plans kicked in.
Not only do shorter lengths of stay mean a facility is losing out on the revenue that can be generated by more Medicare days, but this can also put a resident at higher risk of hospital readmission if they’re not fully recovered, he said.
This whole dynamic gets much more important moving forward with accountable care organizations (ACOs) and other forms of managed care, said Jones. Shorter stays leading to higher readmissions could damage a facility’s reputation, both for prospective patients and for referral relationships.
Jones said he was told that many of the patients in that particular skilled nursing facility simply could not afford the copays, and that was “just the way it is.”
That’s not an acceptable answer, said Jones. “It’s incumbent upon us to make it better, to convince them to stay longer and get better.” There may not be a hard-and-fast method for increasing average length of stays, but it could help to have discussions with patients and their family members to tell the importance of longer stays, and work out a payment plan, he said.
Having effective communications, accuracy, and compliance is the recipe for success, Jaeckle said.
Rehospitalization rate management will be “critical” for future skilled nursing facility success, he continued, especially as “others—including hospital referral sources—will know your rates even if you don’t.”
Written by Alyssa Gerace

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For review of MSAC and why we should look to our State Legislators

in making the right legislation to keep SENIORS IN THEIR OWN

 HOMES

___	Seniors who become too frail to take care of themselves usually go into a nursing home.
___	Most people who go to a nursing home will remain there until they die.
___	Medicare coverage does not include nursing home care.
___	Medicare pays for nursing home care when you’ve been discharged from the hospital and still need medical care.
___	A Skilled Nursing Facility provides many services that nursing  homes do not provide.
___	A good way to find the right kind of senior housing is to check  with an organization that does accreditation, and provides  descriptions and ratings of its approved facilities.
___	A board and care home offers seniors room and board, and  medical  care as needed.
___	A typical board and care home provides care for 6 residents in a converted single-family home.
___	Assisted living facilities, board and care homes, and nursing homes are regulated by state or federal government licensing boards.
___	All assisted living facilities offer about the same kinds of services        for senior housing.
___	“Assisted living” includes services of doctors and nurses, for seniors        with chronic medical problems.
___	“Independent living” refers to the senior staying where they have lived for years: in the home they have owned or the apartment they  have rented.
___	”Independent living” refers to a large building where seniors have        their own rooms or apartments but share meals in a community  dining area.
___	A Continuing Care Retirement Community (CCRC) is for seniors  who are expected to require more care as they get older because they already have some degree of frailty or medical problems.
___	Elders who can stay in their own home because they have family  to help them or have money to hire caregivers, do not need long-term care insurance, as that type of insurance is for nursing home care.

The answer to all of these questions is “False.” Many people answer “True” to some of these, even after doing some reading about senior housing. Reasons
for the confusion and getting a start in the right direction are covered
in the first article, Choosing Senior Housing and Residential Care.
The other articles describe the major housing types and payment options
. By reading the article descriptions you’ll begin to see why the quiz
 statements are all false.

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