A new report from Kaiser Health News uncovers a troubling practice that may startle many hospital patients who must be referred to nursing homes: The ones affiliated with hospitals are often some of the most poorly-rated.
Nursing homes are the next step down for patients who might no longer be in critical condition, but still require additional daily care. Choosing a facility is an important decision, though, especially considering government data showing almost 40 percent of long-term nursing facilities have been cited by health inspectors over the last three years for either causing harm to a patient or operating in a way that injuries are probable. Despite this, hospital managers are reportedly failing to share objective or personal knowledge about the quality of the nursing homes to which they are referring their patients. In some cases, the report indicates, managers are actually pushing patients to the facilities associated with the hospitals, even when they know there are alternatives that are comparable or better.
Nursing home abuse and nursing home neglect isn’t disclosed to prospective patients and family members by the hospital managers, even when they know about it. A spokesman for the California Advocates for Nursing Home Reform recently noted that even some of the most poorly-rated nursing homes are still packed because hospitals keep sending their patients there.
Although there is a governmental rule holding that hospitals aren’t allowed to limit or specify which facility a patient can go for treatment. However, this rule doesn’t stop hospitals from sharing information about the quality of a facility. The problem is that many don’t offer objective information to patients, which is why it’s so important that they and their family members do their own homework.
The Kaiser Health News chronicled one such situation in which a woman watched her 88-year-old mother rapidly deteriorate after being transferred to a hospital-affiliated nursing home that had only a one-star quality rating from Medicare. Her mother had just undergone a hip surgery at a nearby hospital. Her family had been pleased with the degree of her care, so they took the hospital staffer’s suggestions for nursing home placement. She said they handed her a paper with the names of numerous facilities, with the one affiliated with the hospital at the top of that list. They kept pointing to it. She trusted the experience and reputation of the hospital and staffers.
However, her mother’s condition soon worsened. She was reportedly given inappropriate medications, among other lapses in care that ultimately led to her death. It was only later the family would learn of the facility’s rating, and the fact that the center had been cited time after time for substandard care and nursing home neglect, which included long response times to calls for help, disrespect toward patients and an inadequate interest in promptly assisting patients who were in pain.
Although there are some hospitals that take initiative to compile updated Medicare quality ratings of local nursing homes, that’s the exception rather than the norm.
Quality information is available at Nursing Home Compare, which is where Medicare publishes its facility assessments. There is also talk that the federal government might step in and require hospitals to offer patients quality information about their options, while still making sure to respect their choice. The rule, if enacted, would apply not just to nursing homes, but also to rehab centers, home health agencies and other places where patients might need to go after a hospital stay.
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Why hospital patients go to nursing homes with poor ratings, Dec. 19, 2016, By Jordan Rau, Kaiser Health News
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