Senior Living Communities

Re-hospitalization (non-eINTERACT) Report

An Enterprise user has access to summary information related to transfers to the hospital. This report shows the readmission to hospital rate (30 day Medicare Rehospitalization Rate; and an All Payer 30 day rehospitalization rate; rehospitalization (# and %). You can customize the report using different filter options.

  1. Management Console > Reporting tab > select Clinical > General Clinical section > select Rehospitalization Report link.

  2. Select specific communities by clicking select next to Specify Communities, then click the community you want.

  3. PointClickCare Rehospitalization Report (non-eINTERACT enabled communities).

  4. Set Rehospitalization Rate:

    1. All Payer 30-day Rehospitalization Rate.

    2. Medicare 30-day Rehospitalization Rate.

    3. Medicare and All Payer 30 – Day Rehospitalization Rate.

  • Based on configuration, the term Buildings, Community, or Communities may appear in report set up.

  • Based on configuration the term admitted, Move In, or Occupancy may appear in the report.

  • Additional filters available:

    • Payer Type – select individual Payer Type then Payer, select multiple Payers.

    • Diagnosis – click Change link to select specific Diagnosis/Diagnosis Codes, can select multiple Diagnosis.

    • Day of Week – When selected, the report shows a column for each day of the week with the rate and percentage of rehospitalizations for each day.

    • Average LOS – When selected, the report shows a column for resident average length of stay at the community before being rehospitalized.

    • Physician – Click the select link to select specific physicians, can select more than 1 physician.

    • Date Range – Rolling 12 month Rate or Single Month Rate.

    • Highlight Percentages – numerical value (applies to pdf format only).

  • Report format is pdf or Excel.

  • When selecting a Date Range, you may see a message.

    • For example, if a resident is discharged on Jan 31, there is an approximately 45 day window in which staff create, complete, and submit and MDS.

Data Calculations

30 Day Medicare Rehospitalization Rate OR All Payer Rehospitalization Rate

Description

Calculation

  • Number of residents who were discharged to an acute hospital (discharged or transfer to an acute hospital from a nursing home) within 30 days of their current stay admission date to the nursing home from an acute hospital.

  • Residents qualify if part A Medicare is paying for their stay (i.e. Medicare 5-day assessment).

  • Readmitted for any reason

  • Assessments must be submitted to CMS (i.e. status is Accepted) and are not Modified.

# of Residents Transferred to Hospital

# of Eligible residents

DENOMINATOR:

# of Eligible residents = count of all residents who satisfies the following conditions:

All Medicare admissions in a calendar month or 12 consecutive calendar month periods based on:

  • Entry date (A1600) falls within calendar month or the 12 consecutive month period AND

  • Medicare 5-day (A0310B = 01 or = 06 [where A2300 is before 2014/10/01] AND

  • Entered From acute hospital (A1800 = 03)

NUMERATOR:

# of Residents Transferred to Hospital = count of all residents who satisfies the following conditions:

All Medicare discharges in a calendar month or 12 consecutive calendar month periods based on:

  • Discharge Assessment (A0310F= 10 or 11) AND

  • Discharge to Acute Hospital (A2100 = 03) AND

  • Discharge Date (A2000) falls within 30 days of current admission date (A1600)

Only assessments with a status of ‘Accepted’ are considered for the calculations.

Description

Calculation

  • Number of residents who were discharged to an acute hospital (discharged or transfer to) within the past 30 days who had been admitted/readmitted to the community from an acute hospital during the same past 30 day period.

  • There are no other criteria when readmitted to the hospital (any reason and any payer).

  • Residents were readmitted to the hospital for any reason and any payer

  • Assessments must are submitted to CMS (i.e. status is Accepted) and are not Modified.

  • Payer information for the readmission can be obtained from the census line corresponding to the Admission date (A1600) of the admission assessment used. Where the assessment is a Medicare 5-day, this is considered a Medicare A readmission.

# of Residents Transferred to Hospital

# of Eligible residents

DENOMINATOR: # of eligible residents = number of residents having assessments with:

  • All admissions in a calendar month or 12 consecutive calendar month periods based on:

    • Entry date (A1600) falls within calendar month or the 12 consecutive month period AND

    • Entered From acute hospital (A1800 = 03) AND

    • Medicare 5-day (A0310B = 01 or = 06 [where A2300 is before 2014/10/01] IF NONE FOUND THEN

    • OBRA Admission (A0310A = 01) IF NONE FOUND THEN

    • Entry tracking form (A0310F = 01)

NUMERATOR: All discharges in a calendar month or 12 consecutive calendar month periods based on:

  • Discharge Assessment (A0310F= 10 or 11) AND

  • Discharge to Acute Hospital (A2100 = 03)

  • Discharge Date (A2000) falls within 30 days of current admission date (A1600)

Only assessments with a status of ‘Accepted’ are considered for the calculations.