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Assisted Living Nursing

Hospital Readmissions


 The Issue

Hospitalization is disrupting to elderly individuals and puts them at greater risk for complications and infections. Hospitalization also increases the likelihood of reduced functioning on return to the assisted living community.

Hospital readmissions not only have the potential for negative physical, emotional and psychological impacts on assisted living residents, but also cost the Medicare program billions of dollars.

Preventing these events whenever possible is always beneficial to residents and has been identified by policymakers and providers as an opportunity to reduce overall health care system costs. The issue has become a top priority for CMS and managed care programs over the past several years.


 Ideas to Get Started

  • ​Start tracking your hospital readmission rates with LTC Trend Tracker
  • Access INTERACT for Assisted living
  • Monitor days and times residents are being sent to the hospital to look for trends
  • Implement consistent assignment to allow staff to detect changes in a resident’s status
  • Encourage all residents to have advanced directives, and make sure staff are aware of residents’ needs and wishes

 Track Your Progress





  • Partnering with Physicians and Hospitals

    Ann McMann of Boardman Lake Glens in Traverse City, MI talks about how they communicate with physicians and hospitals to help safely reduce hospital readmissions among their assisted living residents. Boardman Lake Glens was one of four assisted living communities to demonstrate it achieved all four of NCAL's Quality Initiative goals in 2017.


  • Using INTERACT

    Rachel Benda of The Kensington in Fort Madison, IA talks about how her team uses the INTERACT tools to help reduce hospital readmissions. The Kensington was one of four assisted living communities to demonstrate it achieved all four of NCAL's Quality Initiative goals in 2017.


​​DISCLAIMER: The AHCA/NCAL quality programs’ contents, including their goals and standards, represent some preferred practices, but do not represent minimum standards or expected norms for skilled nursing and/or assisted living providers. As always, the provider is responsible for making clinical decisions and providing care that is best for each individual person.​