The Life Care Center of CollegedaleCLEVELAND, Tenn. — Putting physicians in some nursing homes owned by LifeCare Centers of America has nearly cut in half the frequency in which patients have to return to the hospital, the head doctor for the Cleveland, Tenn.-based nursing home chain said Monday.
Dr. Ken Scott, corporate medical director for the chain, told more than 250 center directors Monday they have the ability to “change the face of long-term care.” Scott said putting doctors in nursing homes sounds simple but hasn’t been attempted previously on such a large scale.
Scott said placing doctors in the company’s homes was in the idea stage three years ago and began shortly afterward. Currently, he said, there are 45 doctors in LifeCare’s 225 facilities nationwide.
The chief goal of having doctors is to help reduce what’s called the “bounce-back rate,” when a hospitalized patient leaves hospital care but is readmitted for related health problems within 30 days.
Recent studies show the bounce-back rate is increasing and adding billions to Medicare costs, he said. The federal government has pilot programs set to begin next year that will penalize hospitals with high bounce-back rates by cutting off payments.
By having a doctor on site, Scott said, nursing homes can reduce unnecessary trips to the hospital and provide a “high-touch, low-tech” approach to helping patients.
The scenario he described of what often happens when a nurse calls the assigned doctor outside the home for patient problems elicited a lot of nods and murmurs from around the room.
Beecher Hunter, Life Care president“There’s a high probability that the doctor on the other end of the phone has never seen your patient, never talked to your patient, in all likelihood has never stepped foot in your building,” he said.
So, in a litigious environment, the doctor will play it safe, cut the nurse off from explaining the patient’s problems and order a trip to the emergency room, often a costly and sometimes unnecessary result, he said.
An example he gave afterward was where one of the doctors has ordered fewer chest X-rays because, when he’s at the LifeCare home, he can stop by the patient’s room and do a hands-on examination with a stethoscope to tell if there’s chest congestion.
Scott said in the LifeCare nursing homes that have a doctor the average bounce back rate is 13 percent. The nationwide average, according to industry studies, is 25 percent, he said.
Scott spoke to the nursing directors as part of a three-day conference that company President Beecher Hunter called a way for the corporate headquarters to show appreciation for the very difficult job the directors do while allowing them to meet face-to-face and network problems they see at their facilities across the country.
“We wanted them to have an opportunity to get away from the building for a few days, kind of relax a little bit, and we wanted them to be re-energized again and revisit the reason they got into the nursing profession,” Hunter said.
This “week’s meeting was the second time Joan Broadwell, a nursing director at a LifeCare nursing home in McMinnville, Ore., had been to the annual event.
“I’ve learned a lot from all the other directors of nursing, all the breakout sessions are about what’s going on in our industry but really the best part is that we learn from each other,” Broadwell said.
Contact staff writer Todd South at tsouth@timesfree press.com or 423-757-6347.