Financial and Work-flow Benefits of Reducing Avoidable Hospitalizations of Nursing Home Residents

Journal of Nutrition, Health and Aging

Volumn 25, Issue 8, 2021, Pages 971-978

  Rantz, Marilyn ^a   Vogelsmeier, A ^a   Popejoy, L ^a   Canada, K ^a   Galambos, C ^b   Crecelius, C ^c   Alexander, G L ^d  

^a UNIVERSITY OF MISSOURI   (United States)

^b UNIVERSITY OF WISCONSIN MILWAUKEE   (United States)

^c BJC HEALTHCARE   (United States)

^d Och Spine at New York Presbyterian Hospitals   (United States)

Author keywords

advanced practice registered nurses (APRNs); avoidable hospitalizations; INTERACT; Nursing homes; revenue; workflow in nursing homes

Indexed keywords

ADULT; ARTICLE; HOSPITALIZATION; HUMAN; HUMAN TISSUE; MISSOURI; NURSING ASSISTANT; NURSING HOME PATIENT; NURSING STAFF; PHYSIOLOGICAL STRESS; REGISTERED NURSE; RURAL AREA; WORKFLOW; ADVANCED PRACTICE NURSING; NURSING HOME;

ADVANCED PRACTICE NURSING; HOSPITALIZATION; HUMANS; MISSOURI; NURSING HOMES; WORKFLOW;

EID: 85115220630     PISSN: 12797707     EISSN: 17604788     Source Type: Journal    
DOI: 10.1007/s12603-021-1650-2     Document Type: Article

References (28)

1. Ouslander JG, Lamb G, Perloe M, Givens, JH, Kluge, L, et al. Potentially avoidable hospitalizations of nursing homes residents: frequency, causes and costs. J Am Geriatr Soc2010;58:627–635. DOI: 10.1111/j.1532-5415.2010.02768.x
2. Spector WD, Limcangco R, Williams C, Rhodes W, Hurd D. Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes. Med Care201351:673–681. DOI: 10.1097/MLR.0b013e3182984bff
3. Mor, V., Intrator, O., Feng, Z., Grabowski, D.C. (The revolving door of rehospitalizations from skilled nursing facilities. Health Affairs, 2010;29(1), 57–64. DOI: 10.1377/hlthaff.2009.0629
4. Centers for Medicare & Medicaid Services. Cost drivers for dually eligible beneficiaries: potentially avoidable hospitalizations from nursing facility, skilled nursing facility, and home and community-based services waiver programs; 2010. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Reports/downloads/costdriverstask2.pdf. Accessed October 5, 2018.
5. Agency for Healthcare Research and Quality (AHRQ). National inpatient hospital costs: the most expensive conditions by payer, 2017. HCUP Healthcare Cost and Utilization Project Statistical Brief 2020b;261, 1–18.
6. Buurman BM, Hoogerduijn JG, de Haan RJ, Abu-Hanna A, Lagaay AM, Verhaar HJ, et al. Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline. PLoS ONE 2011;6(11): e26951. 10.1371/journal.pone.0026951 DOI: 10.1371/journal.pone.0026951
7. Morley JE. Opening Pandora’s box: the reasons why reducing nursing home transfers to hospital are so difficult. J Am Med Dir Assoc;2016;17(3):185–187. DOI: 10.1016/j.jamda.2015.12.098
8. Sager MA, Franke T, Inouye SK, Landefeld, CS, Morgan, TM, et al. Functional outcomes of acute medical illness and hospitalization in older persons. Arch Intern Med;2019;156:645–652 DOI: 10.1001/archinte.1996.00440060067008
9. Rantz, M., Popejoy, L., Vogelsmeier, A., Galambos, C., Alexander, G., et al. Reducing avoidable hospitalizations and improving quality in nursing homes with APRNs and interdisciplinary support: lessons learned. Journal of Nursing Care Quality, 2018a;33(1), 5–9. DOI: 10.1097/NCQ.0000000000000302
10. Vogelsmeier, A., Popejoy, L., Kist, S., Shumate, S., Pritchett, A., Mueller, J., & Rantz, M. Reducing avoidable hospitalizations for nursing home residents: role of the Missouri Quality Initiative Intervention Support Team. Journal of Nursing Care Quality, 2020;35(1), 1–5. DOI: 10.1097/NCQ.0000000000000444
11. Ouslander JG, Bonner A, Herndon L, Shutes J. The Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program: An overview for medical directors and primary care clinicians in long-term care. J Am Med Dir Assoc;2014;15:162e170. DOI: 10.1016/j.jamda.2013.12.005
12. Alexander, G. L., Rantz, M., Galambos, C., Vogelsmeier, A., Flesner, M., Popejoy, L. L., … Elvin, M. Preparing nursing homes for the future of health information exchange. Applied Clinical Informatics, 2015;6(2), 248–266. DOI: 10.4338/ACI-2014-12-RA-0113
13. Rantz, M.J., Flesner, M.K., Franklin, J., Galambos, C., Pudlowski, J., et al. Better care, better quality: reducing avoidable hospitalizations of nursing home residents. Journal of Nursing Care Quality, 2015;0(4), 290–297. DOI: 10.1097/NCQ.0000000000000145
14. Ingber MJ, Feng Z, Khatusky G, Wang, JM, Bercaw LE, et al. Initiative to reduced avoidable hospitalizations among nursing facility residents shows promising results. Health Aff;2017a;36:441e450. DOI: 10.1377/hlthaff.2016.1310
15. Ingber MJ, Feng Z, Khatutsky G, Bayliss, W, Bercaw, L, et al. (2017b). Evaluation of the initiative to reduce avoidable hospitalizations among nursing facility residents: Annual report project year 4, February, 2017. Available at: https://innovation.cms.gov/Files/reports/irahnfr-finalyrfourevalrpt.pdf. Accessed April 14, 2017.
16. National Long-Term Care Ombudsman Resource Center (2019). Medicaid bed hold policies by state. https://ltcombudsman.org/uploads/files/support/BedHoldPolicy_by_State_2019.pdf accessed March 2021.
17. Rantz, M. J., Popejoy, L., Vogelsmeier, A., Galambos, C., Alexander, G., et al. Successfully reducing hospitalizations of nursing home residents: results of the Missouri Quality Initiative. Journal of the American Medical Directors Association, 2017;8(11), 960–966. DOI: 10.1016/j.jamda.2017.05.027
18. Agency for Healthcare Research and Quality (AHRQ) (2020a). HCUP Fast Stats — Trends in Inpatient Stays. Accessed August 2020, https://www.hcup-us.ahrq.gov/faststats/NationalTrendsServlet?measure1=02&characteristic1=04&time1=10&measure2=&characteristic2=01&time2=10&expansionInfoState=hide&dataTablesState=hide&definitionsState=hide&exportState=hide Parameters:Measure-Cost (actual); Characteristic-Expected payer; Measure-Cost per stay; Characteristic-all inpatient stays.
19. Patton, M. Q. Qualitative Evaluation and Research Methods. Sage Publications, Newbury Park California, 1990
20. Popejoy, L.L., Vogelsmeier, A.A., Alexander, G.L., Galambos, C.M., Crecelius, C.A., et al. Analyzing hospital transfers using INTERACT acute care transfer tools: lessons from MOQI. Journal of the American Geriatrics Society, 2019;67(9), 1954–1959. DOI: 10.1111/jgs.15996
21. Ouslander JG, Lamb G, Tappen R, Herndon, L., Diaz, Z., et al. Interventions to reduce hospitalizations from nursing homes: evaluation of the INTERACT II collaborative quality improvement project. J Am Geriatr Soc. 2011;59(4):745–753. doi:10.1111/j.1532-5415.2011.03333.x DOI: 10.1111/j.1532-5415.2011.03333.x
22. Huckfeldt, P., Kane, R.L., Yang, Z., Engstrom, G., Tappen, R., et al. Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations. J Am Geriatr Soc. 2018 Sep; 66(9): 1830–1837. DOI: 10.1111/jgs.15476
23. Alexander G.L., Harrell R., Shumate S., Rothert M., Vogelsmeier A., Popejoy L., Crecelius C., and Rantz M. To Text or Not to Text? That is the Question. Proceedings American Medical Informatics Association (AMIA), November 2020;14-18, Virtual Conference.
24. ritchett, A., Canada, K., Galambos, C., Rollin, L., Rantz, M. 2021 Take it to the resident: A model for engaging long term stay residents in advance care planning. Social Work in Health Care. https://doi.org/10.1080/00981389.2021.1878319
25. Galambos C, Rantz M, Popejoy L, et al. Advance directives in the nursing home setting: An initiative to increase completion and reduce potential avoidable hospitals. J Soc Work End Life Palliat Care. 2021. 25; 1–15. doi: 10.1080/15524256.2020.1863895.
26. Grabowski DC, O’Mailley J, Barydt NR. The costs and potential saving associated with nursing home hospitalizations. Health Aff;2007;26:1753–1761. DOI: 10.1377/hlthaff.26.6.1753
27. Rantz MJ, Popejoy L, Vogelsmeier A, Galambos, C, Alexander, G, et al. Impact of advanced practice registered nurses on quality measures: The Missouri Quality Initiative experience. J Am Med Dir Assoc;2018b;9:541–550 DOI: 10.1016/j.jamda.2017.10.014
28. Rantz, M.J., Birtley, N.M., Flesner, M., Crecelius, C., & Murray, C. Call to Action: APRNs in US nursing homes to improve care and reduce costs. Nursing Outlook, 2017;5(6), 689–696. PMID: 28993075. DOI: 10.1016/j.outlook.2017.08.011