South Carolina hospitals lose funds due to high readmission rates

On Behalf of | Sep 11, 2015 | Medical Malpractice

When someone is discharged from the hospital, it is a day of relief for the patient and loved ones. Whatever caused the patient to be hospitalized in the first place is under control to the point that constant medical monitoring is no longer required. The last thing that a patient wants to think of is a return visit in the near future.

Unfortunately, that is too often the case in South Carolina hospitals. Each year, the government studies readmittance rates for Medicare patients to determine funding for the program. Hospitals with high rates of readmissions within six months of discharge are scrutinized to determine whether their Medicare reimbursements should be cut. This year, nearly 50 hospitals in South Carolina will lose a portion of their funding on the basis of this study which focuses on patients with heart attacks and heart failure, COPD and pneumonia, and hip and knee replacements.

As might be expected, the hospitals point to numerous errors in the way the numbers are calculated that make the rate look worse than it actually is. Hospital officials say that all that is considered is the objective information about whether the same patient is readmitted, regardless of the reason. So a heart patient who is in a car accident a month after discharge and admitted with injuries from the accident is still counted as a readmission.

Another group is focused on solving the problem rather than deciding who to blame. Preventing Avoidable Readmissions Together was formed in 2012 to look at problems patients have upon returning home. Some of the issues include lack of help at home after discharge, lack of transportation for filling prescriptions and going to follow-up appointments, and low-income individuals who don’t have the money to buy healthy food to manage a condition post-release.

While the truth may be somewhere in the middle, the fact is that too many patients are being readmitted to the hospital too soon after what was hoped to be a cured or managed condition. Some of these are likely due to some form of misdiagnosis or failure to properly treat the condition during the first hospitalization. If you or a loved one is caught in the revolving door of a hospital that can’t seem to find the proper treatment or diagnosis, a consultation with a medical malpractice attorney may be helpful in determining your rights for compensation.

Source: The State, “Beaufort Memorial loses a portion of Medicare funding,” Matt McNab, Sept. 6, 2015


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