Readmission Rates Revealed for 292 Worst Hospitals

Cheryl Clark, for HealthLeaders Media , September 1, 2011

Being mentioned next to the word "worse" in one of the latest Centers for Medicare & Medicaid Services' HospitalCompare data files is the kind of achievement no hospital aspires to.

The list names 292 hospitals whose 30-day readmission rates were the highest in the nation in at least one of three disease categories, acute myocardial infarction, pneumonia and congestive heart failure over three years.

Of the 4,627 hospitals listed , 54 were "worse" in two categories and seven hospitals were "worse" in all three categories. More than one-third of hospitals had too few cases to be scored.

Rates of readmission were recorded as high as 33.8%.

Webcast: Slash Your Readmission Rates

Although these hospitals aren't necessarily the same ones that will be financially penalized for being in the highest 25% of readmissions starting October 1, 2012 – the three-year spreadsheet uses only two of the three years being evaluated for payment* – it's close enough to give organization leaders a pretty good idea what their chances of getting a reimbursement cut from Medicare look like right now.

The data tables should clue them in as to whether their organizations should be working like crazy to find out why their patients keep coming back, and reverse that trend.

In an Aug. 5 briefing about the HospitalCompare update with CMS administrator Don Berwick, MD, the agency's chief medical officer Patrick Conway, MD, said that was the intent. He said CMS's goal in publishing the data now is so "hospitals will know their readmission rates. ... Some of those hospitals will improve and no longer get the payment adjustment, and [for] hospitals that don't improve and do end up in the lower group, there will be a payment adjustment."

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3 comments on "Readmission Rates Revealed for 292 Worst Hospitals"

Deb Fiscus (10/18/2011 at 6:44 AM)
I have always felt that readmission rate as a measure of success was blantantly unfair. A hospital can provide the best care and get the patient ready for homegoing and still the patient will be back because they have not followed the discharge instructions [INVALID]quit smoking,change diet patterns, exercise either because they are unwilling, unable or can't afford the changes. Our hospital provides nutrition counseling, ongoing support for diabetics, smoking cessation and community exercises that are free, but we still have over 50% of the county who are hypertensive, diabetic and/or morbidly obese. These are the people who are consistantly readmitted even with the best efforts of the hospital staff. They refuse to make the needed life changes to keep them out of the hospital and thus continue to be readmitted for the recurrent problems that could be alleviated by following the discharge instructions and availing themselves of the available community resources. They choose NOT to and there is no punishment for them, only for the hospital that continues to readmit them. I envision a list of "DO NOT admits for 30 days following discharge" in the hospital ERs in order to preserve the Medicare funding.

Mary Freebern (10/17/2011 at 8:33 AM)
I have worked as a nurse in both areas (acute care and long-term care). There is a huge difference in what kinds of information is required to give the patients the care they need. In acute care facilities the need is for the patient history, medications being taken, and the length of time the patient has suffered from the current symptoms. A long-term care facility needs to know what steps they can take to keep the patient healthy and what to watch for in the case of a re-occurrence of symptoms. These criteria are vastly different and require better communication between these facilities. Nurses at a long-term care facility need to be able to follow a defined care plan that will assist them in keeping their patients out of the hospital. Unfortunately, most acute care nurses don't know what kinds of information that the nurses at the long-term facility need to know. I feel that if the acute care nurses and the nurses that work in long-term care could get together and discuss the information that is needed by the long-term care nurses that the patient would definitely benefit. This could be in the form of a specific check sheet or a questionnaire that is used by each facility. In that way they could be certain that the after care provided by the accepting facility would be more conducive to assuring the patient gets the best possible care. This would greatly decrease the need for re-hospitalization. The main focus of each nurse is providing the best possible care for their patients.

Chris Zona (9/2/2011 at 9:37 AM)
when one looks at the scores they need to look at the population being severe. If these are end-stage patients with no resources, even the best care will result in readmission rates that are high. It is no surprise that even though well known hospitals which served these populations have the statistics. Until we have insurance that will pay for long-term care and more resources outside the hospital, these rates will not change substantially.




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