Hospitals seek more aid to house patients they can’t discharge
Health worker shortages are keeping hospitals from discharging patients for post-acute care and prompting pleas to Congress for per diem Medicare payments to cover the longer stays.
Why it matters: The requests add to a long list of health industry asks that Congress will have to sort through in the lame-duck session and underscore how the fallout from the pandemic is still rippling through the health care system.
How it works: Discharging patients to long-term care facilities was challenging even before the pandemic, but COVID-19 dramatically disrupted the process, making it hard for facilities to accept patients in the midst of outbreaks.
- It’s costly to keep patients in a hospital when they no longer need to be there, since facilities are typically paid a fixed rate based on a patient’s condition or diagnosis.
- The patients who can’t be discharged are still too sick to go home and may have mobility issues, conditions like diabetes, or mental health needs.
- Providence Health in Spokane, Wash., for example, is on track to spend nearly $18 million this year on nursing care for patients who no longer need to be hospitalized at its two facilities. A handful of patients have been on the premises for more than 100 days, Susan Stacey, Providence chief executive for inland northwest Washington state, told Axios.
- “We’re having workforce issues downstream, so that per diem could provide some targeted temporary relief to hospitals,” said Aimee Kuhlman, a vice president of advocacy at the American Hospital Association.