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Hospital coalition aims to drop patient readmissions

State could penalize local facilities if mandates meant to keep patients from returning aren't met.

September 13, 2012|By Mark Kellam, mark.kellam@latimes.com
  • Glendale Memorial is one of three local hospitals trying to drive down readmission rates before a state deadline.
Glendale Memorial is one of three local hospitals trying… (Times Community…)

Local hospitals are ramping up efforts to drive down their readmission rates as an Oct. 1 deadline looms for them to achieve results or face state-imposed penalties.

Of all the patients readmitted to the three local hospitals — Glendale Adventist, Glendale Memorial and Verdugo Hills — about 35% return within three days, said Terrie Stanley, vice president of strategy and business development for the Partners in Care Foundation.

Even worse, 65% are readmitted within 14 days, she added during a meeting of the Glendale Healthier Community Coalition on Thursday.

Starting Oct. 1, hospitals will need to make sure their readmission rates for patients with pneumonia, congestive heart failure and coronary disease are below a rate established by the Centers for Medicare and Medicaid Services using past information from each site and statistics from hospitals of similar sizes and demographics.

The rate varies by hospital based on the complex formula.

The penalty can mean the loss of up to 1% of a hospital’s annual Medicare base reimbursements.

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“That can be significant for some hospitals,” Stanley said.

Already, the first round of penalties has been calculated for fiscal year 2013. Glendale Memorial will lose 1% and Glendale Adventist will lose 0.7%, according to information from the Medicare agency. Verdugo Hills will lose no reimbursements.

The local coalition is seeking a grant for about $2 million annually for up to five years from the Medicare agency to help fund the readmission-reduction effort.

Statewide, the majority of readmitted patients come from skilled nursing facilities, said Chad Vargas, clinical project manager with the Medicare agency and a member of the Glendale coalition.

A pilot project will be launched soon to complete a transfer form that would be assigned to each patient released to a skilled nursing facility, Vargas said, so the patient’s medical history can be easily accessed.

“Skilled nursing facilities said, ‘We don’t get from the hospital the information that we need to take care of that patient,’” Vargas said. “And hospitals said, ‘We’re not getting information from the skilled nursing facility to help facilitate the care when (patients) get to the hospital.’”

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