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 'Large Infusion of Cash' Needed to Address Adverse Events, Top Journal Editor Says

Providers (and hospitals) can do a better job of preventing “adverse events” in nursing homes, but the best answer is “a large infusion of cash” into the sector to hire—and pay—the most talented caregivers, the leader of the Journal of the American Medical Directors Association says in a new editorial.

In the first edition of the journal since the Department of Health and Human Services inspector general found that almost one-quarter of Medicare patients had suffered some form of “adverse event” in the nation’s rehab centers, Editor-in-Chief (and medical director) John Morley says “there is clearly a set of low-hanging fruit” that the profession can address to improve care.

Hospitals can write clearer discharge instructions, for instance, and providers can offer “extensive pharmacy reviews,” he says.

“However, to solve the problems highlighted by the [inspector general’s report], it will take a large infusion of cash into the long term care industry,” Morley writes. “This needs to go to paying higher salaries for all who work in the industry, especially nurse’s aides and nurses.”

In a phone interview with Provider, Morley said that he wasn’t trying to pass the buck. But he does want the profession (and lawmakers and policymakers) to focus on finding ways to hire and retain top talents for the profession.

“I think the reality is, you need more people in the nursing homes—people at both higher levels and who are better-paid,” Morley says. “That doesn’t mean that those of who work in the homes, including me, are blameless. If my wife yells at me in the morning, I’m a different caretaker during the day than I would have been if my wife hadn’t yelled at me in the morning.”
Cutting hospital admissions will help save money, but so will simplifying discharge instructions (“hospitals do an incredibly bad job at that,” he says) as well as “shifting” hospitals’ attention and dollars away from what he sees as a bloated acute care system.
“We could pay attention to the discharge, rather than say, ‘Well, we’re trying not to skip giving aspirin to someone who may or may not have had a myocardial infarction,’” Morley says. “The money could come from not doing an MRI, or a CT, on the same organ in the hospital. There are lots of places to save money that could go into nursing home care. I don’t think it’s really that big of a deal.”
(Bill Myers is Provider’s senior editor. E-mail him at wmyers@providermagazine.com. Follow him on Twitter, @ProviderMyers.)




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