A pilot program focused on improving the care of long-term nursing home residents is getting money to expand and reach more patients.
The program called OPTIMISTIC has been successful in its first phase at reducing unnecessary patient transfers from nursing homes to hospitals, including at sites in Indiana.
Research shows moving frail nursing home patients to hospitals for treatment can have negative impacts on their health and be costly.
The first phase of OPTIMISTIC focused on putting more nurses in 19 selected nursing home facilities who would provide direct care to residents and training to staff.
Results show a nearly 30 percent reduction in the number of potentially avoidable hospitalizations since 2012.
Dr. Kathleen Unroe is the phase 2 project director. She says this phase adds new incentives for nursing homes that care for sick patients in house, rather than transferring them to a hospital.
“If a long stay nursing home resident, and they’re defining that as at least 100 days in the facility, becomes sick with any one of the six most common medical conditions and a physician, a physician assistant or a nurse practitioner certifies that they have that condition the nursing facility can draw down a new payment from Medicare for a seven day benefit period,” Unroe says.
And they would use that money to pay for a higher level of acute care at the nursing home. Right now, nursing homes can only get that higher payment if they transfer the patient to the hospital and the patient is hospitalized for a minimum of three days before returning to the nursing home.
The project is in the process of selecting nursing homes that will be included in the second phase, which will officially start in the fall.