Frequency and Diagnoses Associated With 7- and 30-Day Readmission of Skilled Nursing Facility Patients to a Nonteaching Community Hospital

Journal of the American Medical Directors Association

Volumn 12, Issue 3, 2011, Pages 195-203

  Ouslander, Joseph G ^a,b,c   Diaz, Sanya ^a   Hain, Deborah ^b   Tappen, Ruth ^b  

^a FLORIDA ATLANTIC UNIVERSITY   (United States)

^b FLORIDA ATLANTIC UNIVERSITY   (United States)

^c UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ARTICLE; CARDIOVASCULAR DISEASE; CELLULITIS; CEREBROVASCULAR DISEASE; CHRONIC OBSTRUCTIVE LUNG DISEASE; COMMUNITY HOSPITAL; CONGESTIVE HEART FAILURE; DEHYDRATION; DISEASE ASSOCIATION; ELECTRONIC MEDICAL RECORD; FEMALE; FRACTURE; GASTROINTESTINAL DISEASE; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HIP FRACTURE; HOSPITAL READMISSION; HUMAN; INFECTION; INJURY; KIDNEY FAILURE; MAJOR CLINICAL STUDY; MALE; MEDICAL RECORD REVIEW; MEDICARE; MUSCULOSKELETAL DISEASE; NEOPLASM; NURSING HOME; PNEUMONIA; SEPSIS; SKIN DISEASE; SYNCOPE; UNITED STATES; URINARY TRACT INFECTION; UROGENITAL TRACT DISEASE;

EID: 79951617061     PISSN: 15258610     EISSN: 15389375     Source Type: Journal    
DOI: 10.1016/j.jamda.2010.02.015     Document Type: Article

References (35)

1. Jencks S.F., Williams M.V., Coleman E.A. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med 2009, 360:1418-1428.
2. Creditor M.C. Hazards of hospitalization of the elderly. Ann Intern Med 1993, 118:219-223.
3. Davis K. Paying for care episodes and care coordination. N Engl J Med 2007, 356:1166-1168.
4. Medicare Payment Advisory Commission. A path to bundled payment around a hospitalization. Report to the Congress: Reforming the Delivery System, Chapter 4, pp 83-103, Washington, DC, June, 2008. Available at: Accessed March 7, 2010. http://www.medpac.gov/documents/Jun08_EntireReport.pdf.
5. Centers for Medicare and Medicaid Services. Recovery Audit Contractor. Overview. Accessed December 22, 2009. http://www.cms.hhs.gov/RAC.
6. The Colorado Foundation for Medical Care. Care Transitions QIOSC. Available at: Accessed January 5, 2010. http://www.cfmc.org/caretransitions/about.htm.
7. Department of Health & Human Services, Centers for Medicare and Medicaid Services. Medicare Nursing Home Value-Based Purchasing Initiative. SMDL #08-009, Baltimore, MD, November 14, 2008. Available at: Accessed March 7, 2010. http://www.cms.hhs.gov/demoprojectsevalrpts/md/itemdetail.asp?filterType+dual.%20keyword&filterValue=Value-based&filterByDID=0&sortByDID=3&sortOrder=ascending&itemID=CMS1198946&intNumPerPage=10.
8. Kane R.L., Keckhafer G., Flood S., et al. The effect of Evercare on hospital use. J Am Geriatr Soc 2003, 51:1427-1434.
9. Mor V., Intrator I., Feng Z., et al. The revolving door of rehospitalization from skilled nursing facilities. Health Affairs 2010, 29:57-64.
10. Carter M.W. Factors associated with ambulatory care-sensitive hospitalizations among nursing home residents. J Aging Health 2003, 15:295-331.
11. Grabowski D.C., O'Malley A.J., Barhydt N.R. The costs and potential savings associated with nursing home hospitalizations. Health Aff (Millwood) 2007, 26:1753-1761.
12. Walker J.D., Teare G.F., Hogan D.B., et al. Identifying potentially avoidable hospital admissions from Canadian long-term care facilities. Med Care 2009, 47:250-254.
13. Ouslander JG, Lamb G, Perloe M, et al. Potentially avoidable hospitalizations of nursing home residents: Frequency, causes, and costs. J Amer Ger Soc. In press.
14. Rueben D., Buchanan J., Farley D., et al. Primary care of long-stay nursing home residents: A comparison of 3 HMO programs with fee-for-service care. J Am Geriatr Soc 1999, 47:131-138.
15. Konetzka R.T., Spector W., Limcangco R.M. Reducing hospitalizations from long-term care settings. Med Care Res Rev 2008, 65:40-66.
16. Grabowski D.C., Stewart K.A., Broderick S.M., et al. Predictors of nursing home hospitalization: A review of the literature. Med Care Res Rev 2008, 65:3-39.
17. AMDA. Clinical practice guidelines in the long-term care setting. Available at: Accessed January 9, 2010. http://www.amda.com/tools/guidelines.cfm.
18. Boockvar K., Brodie H.D., Lachs M. Nursing assistants detect behavior changes in nursing home residents that precede acute illness: Development and validation of an illness warning instrument. J Am Geriatr Soc 2000, 48:1086-1091.
19. Loeb M., Bentley D.W., Bradley S., et al. Development of minimum criteria for the initiation of antibiotics in residents of long-term care facilities: Results of a consensus conference. Infect Control Hosp Epidemiol 2001, 22:120-124.
20. Lohfeld L., Loeb M., Brazil K. Evidence-based clinical pathways to manage urinary tract infections in long-term care facilities: A qualitative case study describing administrator and nursing staff views. J Am Med Dir Assoc 2006, 7:271-278.
21. High K.P., Bradley D.F., Gravenstein S., et al. Clinical practice guidelines for evaluation of fever and infection of older residents of long-term care facilities: A 2008 update by the Infectious Disease Society of America. Clin Infect Dis 2009, 48:149-171.
22. Clinical Practice Guideline on " Acute Change in Condition in the Long-Term Care Setting" 2003, American Medical Directors Association (AMDA), AMDA, Columbia, MD.
23. Carusone S.C., Loeb M., Lohfield L. A clinical pathway for treating pneumonia in the nursing home: Part I: The nursing perspective. J Am Med Dir Assoc 2004, 5:271-278.
24. Carusone S.C., Loeb M., Lohfield L. A clinical pathway for treating pneumonia in the nursing home: Part II: The administrator's perspective and how it differs from nurses' views. J Am Med Dir Assoc 2004, 5:279-286.
25. Hutt E., Ruscin J.M., Corbett K., et al. A mutifaceted intervention to implement guidelines improved treatment of nursing home-acquired pneumonia in a state veterans home. J Am Geriatr Soc 2006, 54:1694-1700.
26. Casarett D.J., Quill T.E. " I'm not ready for hospice": Strategies for timely and effective hospice discussions. Ann Intern Med 2007, 146:443-449.
27. Interact II. Working together to improve care and reduce acute care transfers. Available at: Accessed January 9, 2010. http://interact.geriu.org.
28. Colon-Emeric C.S., Lekan D., Utley-Smith Q., et al. Barriers to and facilitators of clinical practice guideline use in nursing homes. J Am Geriatr Soc 2007, 55:1404-1409.
29. Buchanan J., Murkofsly R.L., O'Malley A.J., et al. Nursing home capabilities and decisions to hospitalize: A survey of medical directors and directors of nursing. J Am Geriatr Soc 2006, 54:458-465.
30. Katz P.R., Karuza J., Intrator O., et al. Nursing home physician specialists: A response to the workforce crisis in long-term care. Ann Intern Med 2009, 150:411-413.
31. Levenson S.A. The basis for improving and reforming long-term care. Part 3: Essential elements for quality care. J Am Med Dir Assoc 2009, 10:597-605.
32. Loeb M., Carusone S.C., Goeree R., et al. Effect of a clinical pathway to reduce hospitalizations in nursing home residents with pneumonia-A randomized controlled trial. JAMA 2006, 295:2503-2510.
33. Loeb M., Brazil K., Lohfeld L., et al. Effect of a multifaceted intervention to reduce antimicrobial prescriptions for urinary indications in residents of nursing homes: A randomized trial. BMJ 2005, 331:669-673.
34. Molloy D.W., Guyatt G.H., Russo R., et al. Systematic implementation of an advance directive program in nursing homes: A randomized controlled trial. JAMA 2000, 283:1437-1444.
35. Ouslander J.G., Perloe M., Givens J., et al. Reducing potentially avoidable hospitalizations of nursing home residents: Results of a pilot quality improvement project. J Am Med Dir Assoc 2009, 9:644-652.