What is the staffing secret to reducing unnecessary hospitalizations by nearly 50 percent? Advanced Practice Registered Nurses (APRNs), according to a Centers for Medicare & Medicaid Services (CMS) report based on research from the University of Missouri.
The findings are based on the Missouri Quality Initiative for Nursing Homes (MOQI), which began in 2012 as a joint state/federal program to improve care at 40 nursing homes in the St. Louis region. Facilities participating in the program saw a 48 percent reduction in unnecessary hospitalizations, tallying a savings of $1,376 per resident overall.
The program’s success has been attributed to having at least one full-time APRN in each participating skilled nursing facility, says Marilyn Rantz, head of the MOQI, in a university press release. "If APRNs were working in every nursing home in the state—helping residents and staff recognize and manage health changes early—this would save millions of dollars each year. There would be far more in savings than the initial cost of hiring these skilled nurses.”
While the MOQI shows promise as a model nationwide, differing state laws are still problematic, the CMS report notes: “Currently, a set of federal and state laws and policies regulate APRNs’ scope of practice, limiting the scope of services APRNs can provide independently. Progress toward full practice is uneven across states, with some states granting full practice authority, others adopting compromise legislation (e.g., APRNs applying for full practice authority after completing a defined number of supervised practice hours), and still others maintaining burdensome restrictions.”