Hospital Worker: "Do you have any idea how hard we work to get you the physician's discharge summary so it could come to you right along with the patient?"
SNF Worker: "I appreciate the effort. I really do, and it's useful in some ways, but you have to remember that we are a nursing facility. Physicians don't understand nursing, and no physician I've ever met writes a plausible story about what the nursing needs of the patients are, and what the care plan is."
A lot of the issue, too, has to do with what Jencks calls "resetting how much patients need to know about their disease, their treatment and their care, and how much families need to know, to a higher level of understanding and awareness." Not only does the evidence suggest that when this happens, there are stunning differences between study groups and control groups, the hospitalization decreases extend to 60 and 90 days. "These community-based interventions are quite significant," he said.
Jencks says that hospitals should not sit around. "You're going to have to find approaches to deal with it, and you can't use a formula where it takes you three years to accumulate data just to know what's happening...You need to get cracking on this now."
* Note: CMS' downloadable data files cover a three-year period between July 1, 2007 and June 30, 2010, while the three-year measurement period the federal agency intends to use for penalty payments starts one year later, from July 1, 2008 to June 30, 2011. The 371-page rule governing the details for how those readmissions will be risk adjusted and penalties finally determined was published in the federal register Aug. 18.