Pekin Hospital latest to look at closing its skilled nursing unit

With Pekin Hospital seeking a states capitulation to tighten its learned nursing facility, Proctor Hospital could soon be a only one of a areas four major hospitals with a special section for patients who need a longer-than-typical stay.A hospitals plan to tighten a learned nursing section isnt unusual these days. But, taken with a hundreds of such units which have closed around a country, its a case study in how changes as well as reductions in Medicare reimbursements control what hospitals offer or dont offer.This is an issue of inhabitant interest, says R. Tamara Konetzka, an associate highbrow of health policy as well as economics during a University of Chicago. People have been concerned about this all over a country.Increasingly, patients have been leaving hospitals as well as continuing short-term, post-hospital caring in learned nursing units during nursing homes or, with a assistance of home healthcare programs, in their own homes.When it comes to shutting hospital-based learned nursing units, Konetzka says, a big question is, Is it good for patients? Theres no decisive answer, though it is clear which hospital-based units have been more costly to operate. Pekin Hospital is successful overall, though its learned nursing section has lost tighten to $5 million over a past three years, according to Jo Ellen Patterson, vice president of studious caring services. The sanatorium is licensed for 125 beds, including a 27-bed learned nursing unit. On average, a section operated with about nine patients a day during 2011.Average length of stay?Nine to ten days. Combined with decreases in Medicare reimbursement rates, Patterson says, It hasnt been cost effective to continue running a unit.A growing trendMore than 1,000, or about a third of all such hospital-based units, have closed since a 1990s. Methodist Medical Center closed its section in 2006. OSF Saint Francis Medical Center never had one within a hospital. Instead, OSF Healthcare has offered short- as well as long-term learned caring during OSF St. Clare since 1971.Technically, a learned nursing facility is a nursing home within a hospital. The Centers for Medicare as well as Medicaid Services (CMS) sets Medicare reimbursement rates for them much as if they were nursing homes. For example, patients who need short-term therapies or wound caring after operation have been expelled from a hospitals acute care, or in-patient, section as well as eliminated to a learned caring unit.Both Pekin as well as Proctor officials contend most of a patients in their learned caring units need earthy or occupational therapy after orthopedic surgery.The trend toward hospital-based learned nursing comforts began in a 1980s after CMS restructured Medicare reimbursements for hospitals, from fee-for-service to one pile sum, for patients in acute-care units. The fee-for-service structure assured sanatorium profits, according to Konetzka, though a government wanted to control costs. Hospitals began releasing patients quicker as well as sicker, Konetzka says, because they no longer had a financial incentive to keep patients any longer than necessary. The faster they expelled a patient, a more income they made.In which environment, hospitals satisfied if they non-stop learned nursing facilities, they could keep patients hospitalized longer, plus get a aloft fee-for-service reimbursements from Medicare, based upon learned nursing units technical definition as a nursing home. More than 2,500 hospitals non-stop learned nursing units. When Pekin non-stop its section in 1993, Patterson says, Medicare was encouraging hospitals to open learned nursing comforts by offering good reimbursements. From Medicares standpoint, it was a cost-saving measure because a hospitals learned nursing facility was less dear than an acute care, or in-patient, unit. For a while, it seemed similar to a win-win situation.This was probably good for patients; they could continue to get caring in a hospital, Konetzka says. And it was always good for hospitals.But by a late 1990s, Medicares costs for hospital-based learned nursing comforts were one of its fastest growing expenditures. CMS stepped in again, with a brand new payment system for hospital-based learned nursing facilities, just as it had done for acute-care units a decade earlier. Hospitals would be paid based upon a set cost per day rather than reimbursed upon a fee-for-service basis. Additionally, CMS has steadily cut reimbursement rates opposite a board, most recently in October. Hospital-based learned nursing comforts have been shutting ever since. From 2003 to 2009, a total series dropped 36 percent to 930. Looking to a futureProctor has no plans to tighten its unit.A lot of patients prefer to come to us essentially because of a availability of a learned nursing unit, says Proctor spokesman Steve Wilson.Though licensed for twenty-nine beds, Proctor operates only 20 in its learned nursing unit. Last year, a annual occupancy rate was 66 percent with an normal length of stay of 8.2 days.In Pekin, officials sent out more than 50 letters to nursing homes with learned caring units within a 45-minute expostulate of a hospital. Based upon a response, Patterson believes potential future patients will have alternatives if Pekins section closes.The sanatorium does not plan to lay off any of a 23 employees, including 15 full-time employees, who work in a unit. They will be moved to other positions within a hospital.Hospital officials could know by mid-July if a Illinois Health Facilities as well as Services Review Board approves their application to tighten a unit. Then, theyd have to give 30-day notices to a Illinois Department of Public Health as well as any patients upon a section during which time.Deciding to tighten a section was not easy, Patterson said. We wanted to do everything you could to make it successful.If Pekin wins a state boards approval, a plan is to spin a section into in isolation rooms, which would push in isolation rooms from 30 percent to 80 percent of a hospitals total rooms.For Konetzka, it still goes back to money, specifically a tax dollars which fund Medicare payments. If hospital-based learned nursing comforts have been more costly for no good reason, maybe its a good thing for them to close, she says. But you have to step carefully as well as look during what happens with patients. Thats a part you just dont know.Pam Adams can be reachedat 686-3245 or padams@pjstar.com.Powered By iWebRSS.co.cc

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