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Preventable vs. Unpreventable Re-Admissions: What Nursing Homes Need to Know

Written by Qsource | May 2, 2025 1:09:47 PM

Nursing homes face substantial obstacles from hospital re-admissions because these events affect patient wellness with facility financial stability and compliance with regulatory requirements. Re-admissions to the hospital are not always unpreventable. The occurrence of unavoidable health declines leads to some readmissions, but preventable care failures and improper discharge plans and medication management contribute to others.

 

Staff members and administrators of nursing facilities must recognize the distinction between unpreventable re-admissions and preventable re-admissions to take proper actions. A focus on preventable cases enables facilities to enhance care quality while saving costs and preventing penalties. The evidence-based strategies offered by Qsource as a Nursing Home Consultant help facilities track re-admissions while determining their root causes and developing prevention plans. 

 

Healthcare organizations including CMS use two categories to classify re-admissions according to the possibility of preventing these hospitalizations through proper interventions and planning.

Preventable: result from poor care coordination, missed early warning signs, medication errors, or inadequate discharge planning.

Examples: Medication mismanagement, untreated infections, fall-related injuries, failure to monitor chronic conditions.

Unavoidable Hospitalizations: occur because of acute medical conditions combined with sudden health deterioration and severe disease progression even when patients receive proper medical care.

Examples: Stroke, cardiac arrest, sepsis despite early intervention, unavoidable complications of advanced disease.

By understanding the differences between preventable/unpreventable hospital re-admissions, facilities can direct their efforts toward reducing preventable re-admissions but should also understand the necessity of hospitalization as an unavoidable outcome.

 

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Common Causes of Preventable Re-Admissions

Certain re-admissions result from avoidable gaps in care. The identification and resolution of these causes leads to substantial reductions in hospitalization frequencies and enhances resident healthcare outcomes.

Medication Mismanagement and Adverse Drug Reactions

  • Polypharmacy (taking multiple medications) increases the risk of drug interactions and side effects.
  • The failure to properly reconcile medications between transitions causes residents to receive incorrect drug amounts or essential prescription medications.
  • The lack of proper training for staff members to monitor medications causes them to delay recognizing medication side effects.

Prevention Strategy: By working together with Qsource’s medication safety programs the facility can guarantee accurate medication reconciliation. Pharmacist-led medication reviews help identify potential risks which facilities should implement for prevention purposes. The training program should focus on identifying early signs of adverse drug reactions for staff members.

 

Poor Infection Prevention and Early Detection

  • Many re-admissions result from infections which remain untreated such as urinary tract infections (UTIs), pneumonia and sepsis.
  • Delays in identifying infection symptoms result in increased unnecessary hospital re-admissions.

Prevention Strategy: Establish robust infection control protocols which emphasize hand hygiene and correct catheter management practices. The implementation of early-warning detection tools enables facilities to detect infections faster which can avoid hospital admission requirements. The QI initiatives Qsource provides for infection prevention help ensure facilities are always survey ready. 

 

Falls and Injury-Related Hospitalizations

  • The number one reason nursing homes send residents back to hospitals for additional care is because of falls.
  • Environmental dangers together with mobility problems and medicine-related dizziness make patients more likely to experience falls.

Prevention Strategy: Develop fall risk evaluation protocols with specific prevention programs that match them. The use of assistive devices and physical therapy sessions will enhance resident mobility. Staff must maintain constant observation and implement safety protocols for residents who face high risks.

 

Poorly Coordinated Transitions of Care

  • Transfers of care from hospitals to nursing homes without proper transfer paperwork/documentation & report results in complications for residents. 
  • Lack of post-discharge care follow-up or unclear discharge instructions can result in avoidable hospitalizations. 

Prevention Strategy: A nursing home should create detailed discharge planning protocols which hospitals need to use. Follow-up should include scheduled appointments combined with post-discharge monitoring. The post-hospitalization care expectations need to be explained to both residents and their families. Family members need clear details about care choices in order to make knowledgeable decisions. Nursing homes need to implement proper documentation combined with care coordination to ensure the facility manages all medical conditions as effectively as possible.

 

The following measures will help nursing homes decrease avoidable hospital readmissions, including implementation of proactive approaches with early intervention and care coordination alongside resident-centered planning will help facilities achieve successful reduction of hospital re-admissions.

Track and Analyze Re-Admission Data

  • The facility must track their re-admission statistics to detect recurring patterns among preventable cases.
  • The facilities can benefit from data-driven quality improvement programs provided by Qsource to track their performance and develop specific interventions. 

Improve Staff Training and Early Intervention Protocols

  • Staff members must receive training to detect initial signs of infections and dehydration together with worsening chronic conditions.
  • Nursing facilities should create quick-response nursing procedures to provide early medical interventions which help prevent hospital admissions.

Enhance Chronic Disease Management

  • The nursing home should operate specialized care programs to support residents with heart failure, COPD, and diabetes who are at high risk.
  • Residents must receive standard monitoring and proper nutrition and assistance with medication adherence as part of their care plan.

Enhance Communication with Families and Residents

  • Nursing home staff should educate families about end-of-life care options as this knowledge reduces unnecessary hospital transfers.
  • The healthcare staff must explain post-hospitalization care plans to residents and their caregivers so they can avoid developing complications.

 

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Leverage Qsource’s Quality Improvement Programs

Qsource delivers training together with clinical tools and strategic assistance to assist nursing homes in lowering their re-admission rates.

Their programs concentrate on medication safety and infection prevention as well as fall reduction and chronic disease management while delivering personalized solutions for individual facilities.

The distinction between preventable and unpreventable re-admissions serves to enhance nursing home operations and protect financial resources while delivering better care to residents.

Nursing homes can reduce preventable re-admissions and deliver appropriate care for unavoidable cases by implementing medication safety programs, infection prevention measures, fall reduction strategies, and proper discharge planning protocols.

Partnering with Qsource enables facilities to gain access to expert guidance and data-driven strategies as well as personalized interventions that help improve outcomes and decrease hospitalizations.