According to the Kaiser Family Foundation, 25% of Medicare residents living in nursing homes in 2011 were readmitted to a hospital at a total cost of $14 billion that year. As 2018 approaches, skilled nursing facilities are facing a 2% reduction in Medicare reimbursement if they do not control their hospital readmission rates.
Why are so many older adults in long-term care headed back to the hospital?
- A large percentage of the population in senior communities are experiencing various stages of Alzheimer’s disease and related dementias (ADRD). The CDC reported in 2014 that approximately 50% of nursing home residents had been diagnosed with ADRD.
- ADRD has been shown to increase the risk of falls for older adults. According to the Alzheimer’s Association, 26% those over the age of 65 living with Alzheimer’s disease will be admitted to a hospital because of a fall.
- Many antipsychotic drugs commonly prescribed to older adults living with dementia have been found to have negative health consequences, including an increased risk of falls. A cohort study conducted in Canada in 2014 found that atypical antipsychotic medication use by older adults increased their 90 day risk of falls.
Knowing this, what can senior care providers do to become less reactionary when it comes to readmissions in favor of a more cost effective, preventative mindset?
- With individualized and digitized therapeutic engagement, senior care providers can meet the needs of residents and provide purposeful activities that increase quality of life and decrease the need for antipsychotic drugs to manage behaviors associated with ADRD. Last month at the LeadingAge National Conference, Linked Senior presented a case study in partnership with Kendal on Hudson that showed the impact of therapeutic engagement on decrease antipsychotic drug use.
- Providers can improve communication between staff and family members. Once staff know how to effectively connect with loved ones to better understand the biopsychosocial needs of each resident based on their life history, they can more confidently connect those residents to activities that are meaningful to them.
Although the Activities or Life Enrichment Department in senior care is not typically considered a revenue generating entity, it can certainly be a key piece of the rehospitalization puzzle. Improve engagement by making it individualized and person-directed and you will improve your bottom line by decreasing falls, avoiding costly pharmacological interventions and avoiding compliance risks.