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Boomerang Hospitalizations of Nursing Home Residents

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Boomerang hospitalizations severely impact patient health and put patients at significant risk of potentially life-threatening complications. Patients who are prematurely released from hospital care and patients who receive substandard care from their nursing home provider are at considerable risk of becoming entrapped in the boomerang cycle. Regulators are taking notice and in 2016, it was estimated that potentially avoidable hospital readmissions had dropped from 12.4% in 2011 to 10.8% in 2016. While the rates of boomerang admissions are declining, it is a problem that continues to affect millions of nursing home residents across the country.  

Defining Boomerang Hospitalizations

Boomerang hospitalizations involve nursing home patients who are admitted to hospitals, discharged back into the care of the nursing home facility, and then readmitted into a hospital within 30 days. This process causes considerable damage to the patient’s health and well-being. The cycle of readmission and discharge places considerable strain on the patient’s immune system. The longer the cycle continues, the more pronounced and complex the damage becomes. For example, patients can be admitted for the treatment of a laceration or broken bone, discharged, and later readmitted for treatment of potentially life-threatening infections acquired during the first hospitalization. 

The Problem

Approximately 20% of Medicare patients discharged from hospitals into the care of a nursing home are readmitted into a hospital within 30 days. This rate is 27% higher than for Medicare patients who are not under the care of a nursing home facility. The disparity between the two indicates that there are significant problems within nursing care facilities which are placing patients within these facilities at unnecessary risk. In many cases, the problem of boomerang hospitalizations can be traced to inadequate staffing, improper training, and failure to adhere to established safety protocols. It is also the result of Medicare payment policies which essentially reward hospitals for discharging patients early. Similarly, nursing home facilities are encouraged to hospitalize patients to avoid having to pay for regular examinations, laboratory tests, and other forms of care which decrease their profit margins.    

Fines and Penalties

Since 2013, Medicare has issued fines to hospitals whose readmission rates are beyond acceptable limits. As of October 2018, nursing homes will also be subject to fines and other penalties if their readmission rates exceed these limits. Conversely, nursing home facilities that reduce their rates of readmission are eligible to receive bonuses as an incentive. 

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