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.
"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."