A breakthrough study has uncovered that up to 40% of nursing home resident trips to a hospital or emergency department (ED) are avoidable. These hospital visits can be distressing and harmful for the residents, many of whom are severely impaired or terminally ill. These potentially needless transfers also cost an estimated $14.3 billion annually to U.S. healthcare, particularly Medicare, according to a press release from Florida Atlantic University (FAU).

Among more than 6,000 severely impaired nursing home residents, one in three required hospitalization and more than one-third of those were potentially avoidable. Nearly 20% visited the hospital emergency department (ED) without even being admitted and 70% of those visits could have been avoided, said the researchers from FAU’s Schmidt College of Medicine and Christine E. Lynn College of Nursing. The most frequent causes of hospitalization were feeding tube complications, urinary tract infections (UTIs), seizures, and low blood pressure.

For the terminally ill patients, among the 5,800 patients who were hospitalized or visited the ED, nearly 90% of the visits could have been avoided, according to experts. Transfers related to trauma, mainly from falls, were common in this group along with pneumonia, UTIs, acute kidney failure and heart failure.

Infections, breathing difficulties and altered mental state were other frequent diagnoses for both groups according to the study that was published in the Journal of the American Medical Directors Association.  

Dr. Jospeh G. Ouslander, senior author and professor of geriatric medicine at Schmidt College of Medicine said, “These are conditions we know how to manage better in nursing homes, using existing guidelines, care paths and preventive strategies. With the right tools and staffing, many of these hospital transfers could be avoided, reducing both resident suffering and unnecessary healthcare costs.”

Many of these hospitalizations could be prevented through clearer care protocols, timely symptom management, and advance care planning by residents and their families to avoid costly and potentially harmful crisis-driven decisions.

“While nursing homes have had challenges with staffing, this is not the main issue driving hospitalizations of severely impaired residents,” Ouslander tells Newsmax. “Part of it has to do with lack of education, communication and documentation about the risks and benefits of hospital care between families and primary care providers to assist with decision making. Another part is that outside of managed care, in the regular fee-for-service Medicare program, there are financial incentives for the nursing home, hospital, and in some cases doctors, to hospitalize.”

Ouslander says that for this dire situation to change, “we need bold changes, like pragmatic national staffing standards, better resourced facilities for complex care, and payment models that truly support high-quality, person-centered care for the most vulnerable residents.”