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					        NEWS | Resident Care


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                                                              Nursing homes show quality
                          Sherrie Dornberger, RNC,
                          CDONA, FACDONA
                          President, NADONA                   gains in healthcare analysis
                                                              By Brett Bakshis                                                 use of restraints.
        Does the three-day hospital stay                      Improvements in some mea-                                           But there wasn’t all good
        start when the resident reaches the                   sures of nursing home and                                        news for nursing homes: The
        emergency room?                                       hospital quality were among                                      majority of states saw hospital
                                                              the few bright spots in a new                                    and nursing home readmis-
        No! The three-day hospital stay for the               state-by-state analysis from                                     sions increase over the results
        requirement to take advantage of the                  the Commonwealth Fund                                            from the 2007 Scorecard, indi-




                                                                                                                                 Photo: iStockphoto
        Medicare A benefit starts when the                     that shows healthcare systems                                    cating “poor care coordination
        resident is admitted to his or her room.              nationwide are under a great                                     and continued inefficiency in
            No matter how long he or she is                   deal of stress.                                                  the use of resources.”
        in the ER, that period does not count                    Nursing homes overall          Nursing homes have reduced        Other results in different
        toward the required time. Also, any                   showed a marked improve-          reports of pain and made other areas were spotty. Costs, qual-
                                                                                                caregiving improvements,
        “observation period” does not count.                  ment in a number of quality-      according to a Commonwealth
                                                                                                                               ity and access to care varied
        If a hospital decides to observe the                  of-care areas. They include       Fund report.                   wildly state-to-state and mea-
        resident in the ER or an observation                  fewer instances of pressure                                      sure-to-measure, the report
        room, this time does not count toward                 ulcers, less frequent use of      released in early October.     says. Healthcare coverage is
        the three days.                                       physical restraints and reduced      Every state in the union deteriorating in many states.
            And, in case you were wondering,                  reports of pain, according to     saw at least a 5% performance More information about the
        the day of discharge does not count                   the 2009 State Scorecard on       improvement when it came to report is available at www.
        either. So in one scenario, you could                 Health System Performance         both pain management and commonwealthfund.org. ■
        have a resident spend two days in the
        ER for observation, get admitted to a
        room for three days, and then be dis-
        charged on the third day. Although he                 Falls send 1 in 10 seniors to EDs in 2006
        or she has been out of your facility for
        five days, the resident would only have                By James M. Berklan               nearly 2.5 times as likely to                         room visits after a fall, with
        two of the three days needed to qualify               Seniors who fell and went to      later enter the long-term care                        hip fractures accounting for
        for Medicare
				
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