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Shrink Readmissions by Adding Nurses

Philip Betbeze, for HealthLeaders Media, October 11, 2013

Currently, the highest penalty for readmissions according to CMS policy is a 1% reduction in DRG payment. Somehow I doubt whether avoiding some of those 1% by adding three hours per patient day is going to pay off immediately.

Other payers may have penalties as well, but most readmission penalties apply to Medicare patients only. But if you focus only on the numbers, you'll miss all the other benefits of increasing nurse staffing, McHugh maintains. Further, the CMS penalty will rise to 2% for fiscal year 2014, and other penalties that may be affected by nurse staffing ratios appear likely as well, McHugh asserts, in future years.


See Also:
Readmissions 'Drop Like a Rock' with Predictive Modeling


"So right now, this won't pay for itself entirely, but the good thing about focusing within is that the benefits of higher nurse staffing levels aren't isolated to particular patients, but apply to all of them," he says. "Besides, penalty percentages are going up and the number of conditions that are covered [by readmissions penalties] are being added."

Still, based on this study and in general, there's no magic number on nurse staffing levels, McHugh says. And there are ways to make more of your nurse staffing or get more out of it without necessarily adding headcount or unit labor costs. For instance, says McHugh, improving the education level of your nursing staff, or by requiring higher educational standards, "you get more bang for your buck."

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1 comments on "Shrink Readmissions by Adding Nurses"


Phyllis Kritek (10/14/2013 at 3:37 PM)
Thank you for covering this studies methodology, analysis and outcomes. I would observe that Aiken, et al demonstrated that the average cut in nursing personnel in acute care in the 90s was 9%. We concurrently cut LOS dramatically, so we had far fewer nurses caring for far more seriously ill patients. Not surprisingly, the IOM announced we had serious drug errors (To Err is Human) and that apparently patient safety was related to nursing care (Keeping Patients Safe).During longer LOSs nurses were able to do continuity of care, patient education, family education and case management. We eliminated it. We discovered this was a bad idea. Now we are trying to reinvent the wheel. The answer to this issue was available in the 90s however the apparent invisibility of nursing care created this problem. This study is best understood as a part of the history of health care in the US.