When Leota Dumire entered Pebble Creek skilled nursing center in Green for rehabilitation after a recent hospital stay, she brought a host of health problems with her.
Along with recovering from a severe kidney infection and battling diabetes, the 81-year-old from Green deals with congestive heart failure — the most common cause of hospitalization and readmissions for elderly patients.
Dumire is exactly the type of patient Pebble Creek and its corporate parent are targeting in their ongoing efforts to better monitor chronic illnesses and prevent costly repeat hospital trips.
Pebble Creek is among the first nursing facilities in the country to adopt a new program called Cardiac 360.
The program combines close monitoring and observation by staff with a noninvasive testing device developed by an Israeli company that measures cardiac output.
About the Cardiac 360 technology
The technology with Cardiac 360 uses sensors to determine the amount of blood the heart is pumping and the resistance within the blood vessels, said Dr. Matt Wayne, chief medical officer for CommuniCare Family of Cos. The company, headquartered in suburban Cincinnati, operates 42 nursing facilities nationwide, including Pebble Creek.
“We’re able to predict an exacerbation of heart failure seven to 10 days before a patient has any symptoms,” said Ronald Wilheim a principal with CommuniCare.
The information can be used to adjust medications before the patient’s condition worsens and requires hospital care, Wayne said.
“It effectively helps us to know which medications to use and which medications to continue to adjust,” he said.
Cardiac 360 is run by Complex Care Partners, a division of CommuniCare that focuses on developing and administering chronic disease management programs.
CommuniCare’s Wyant Woods Care Center in Akron, Copley Healthcare and Kent Health Center also are among the first skilled nursing centers to adopt the program.
Complex Care Partners has the exclusive U.S. rights to the technology in the post-acute market, said Wilheim, the group’s chief executive.
The Trials to reduce re Admissions
In an earlier trial with 40 patients at two facilities, including Wyant Woods, participants in the program had no hospital readmissions over a four-month period, Wilheim said.
Typically, 20 percent to 25 percent of patients with heart failure return to the hospital within 30 days, said Dr. Arman Askari, a retired Cleveland Clinic cardiologist who is serving as cardiology medical director for Complex Care Partners.
The technology “takes the guesswork out of what you need to do for your patients,” he said.
CommuniCare plans to roll out the initiative at more of its facilities as well as to other customers that want to adopt the program, Wilheim said.
Nationwide, about 1 million patients are hospitalized each year with a primary diagnosis of heart failure at a cost of more than $17 billion to the Medicare program, according to an article in the American Heart Association’s professional journal, Circulation.
Cardiac 360 could help CommuniCare’s nursing centers attract patients from hospitals, which often serve as a major referral base.
Hospitals are under increasing pressure to reduce the number of patients who come back within 30 days after discharge.
Medicare can withhold a portion of inpatient payments to hospitals that have a “higher-than-expected” readmission rate for heart failure, heart attack, pneumonia and hip and knee replacement patients, as well as those admitted for lung ailments.
Wilheim estimates that the Cardiac 360 program costs about $23,000 for 100 patients during a one-month period.
But if 20 out of 100 heart failure patients are rehospitalized within 30 days at an average cost of $10,000 each, he said, the total price of the readmissions is $200,000.
Judy Lance of Green said she appreciates the extra monitoring for Dumire, her mother.
“Because she is such a balancing act to keep everything going the proper way, they really have to monitor her closely,” she said. “I think it’s wonderful.”