December 4, 2018

Most Maine nursing homes penalized for readmission rates

Two thirds of Maine's nursing homes — 67 of 100 skilled care facilities — will receive a reduction in Medicare funding because of a new federal program that penalizes them for high rates of patient hospitalization.

The facilities could see up to a 2% drop in Medicare payments based on how many patients returned to a hospital within 30 days of being discharged to the nursing home over the past year, Kaiser Health News reported Monday.

The Skilled Nursing Facility Value-Based Purchasing Program also rewards nursing facilities with low hospital readmission rates. In Maine, 31 facilities will receive up to a 1.6% bonus on Medicare payments, and two facilities will see no change in federal funds as a result of the program.

Nationally, almost 4,000 nursing facilities will receive bonuses, while 11,000 will be penalized, according to Kaiser's analysis of new federal data.

The program is intended to prevent unnecessary, expensive hospital stays for Medicare recipients.

Nursing facilities receive Medicare reimbursement for only a short period of time, typically no more than 100 days. In 2016, an estimated 11% of patients were hospitalized for conditions that might have been prevented with better care at their nursing home, Kaiser reported.

Although two-thirds of Maine's facilities will be penalized under the new program, the state fared better than most in the portion receiving bonuses, 31%, ranking with Pennsylvania at No. 19. Vermont was the only New England state to score higher, with 46%, the seventh-highest.


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