A new study suggests that hospitals with higher nurse staffing levels may have lower odds of being penalized for readmissions.
The study, published in the October issue of Health Affairs and lead by Matthew McHugh, associate professor at the University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, examined nurse-to-patient staffing levels and readmission penalties data from 2,826 hospitals across the country.
As set out by the Affordable Care Act (ACA), hospitals that have excessive 30-day readmissions for Medicare patients admitted for heart attacks, heart failure or pneumonia are penalized by reduced reimbursement.
McHugh said and his research team found that those hospitals with higher nurse staffing levels had 25 percent lower odds of being penalized than similar hospitals with lower staffing levels. They also found that hospitals with higher nurse staffing levels have 41 percent lower odds of receiving the maximum penalty for readmissions, compared with hospitals with lower staffing. McHugh estimated that each additional nurse hour per patient day is associated with 10 percent lower odds of receiving penalties under the Hospital Readmissions Reduction Program (HRRP) mandated by the ACA.
McHugh told Healthcare Finance News that higher nurse staffing levels lower the already intense workload amounts for nurses, which enables them to do their jobs better, leading to better patient outcomes.
“I think it’s important to continue to target high-risk patients when it comes to readmissions, but it’s also important to realize that these patients are cared for by and large by the nurse workforce, so it’s important to look within and make sure nurses are able to do the basic parts of their jobs well,” he said. “Virtually all performance measures – not just readmissions – such as infection and mortality levels, see better outcomes at hospitals with higher staffing levels. Nurse staffing levels have a broader effect on all hospitals and now many of these quality measures have dollars tied to them.”