Arnall Golden Gregory Attorney Explains Geriatric Emergency Department Care

Geriatric emergency department healthcare is a fairly recent development that’s bound to grow rapidly with the aging of the Baby Boomer population.

AGG Partner Jason E. Bring, who leads the firm’s Long-Term Care Defense Practice Team, discussed geriatric EDs at Building Owners and Management Association (BOMA) International’s 2012 Medical Office Buildings & Healthcare Facilities National Conference, held this month in Atlanta. He was on the panel “Emerging Modalities of Care, Evolving Facility Needs.”

Mr. Bring, who advises clients on certificate of need and regulatory issues, said geriatric EDs address special needs, everything from type of mattress to room paint colors.

Why is a particular mattress so important? Because aged residents of long-term care facilities are vulnerable to skin breakdown and other wounds. Facilities whose patients suffer from wounds run a greater risk of getting sued. Therefore, a mattress that reduces the likelihood of skin degradation is extremely valuable.

“Geriatric EDs can not only improve patient outcomes and lower liability risks, they can help improve hospitals’ bottom lines,” said Mr. Bring, a frequent writer and speaker on emerging healthcare issues and governmental regulatory initiatives. He blogs for the online magazine Long-Term Living.

Medicare is the biggest funding source for geriatric ED care, so facilities offering that service are subject to close government scrutiny.

Under the new Hospital Readmission Reduction Program, effective in fiscal year 2013, facilities with high readmission rates risk having their reimbursement rates cut by the government.

Successful geriatric EDs have been shown to lower hospital readmissions from 20 percent to 1 percent thanks to special staff training and focusing on getting certain important details right, Mr. Bring pointed out.

For example, geriatric EDs are sensitive to how light, color and sound affect the elderly.

A soothing blue might appear to be washed out gray to an aged patient, and therefore a poor choice for a room color, he said.

Dementia sufferers can grow agitated if there is too little light, Mr. Bring said, so artificial light is another important ingredient of proper care.

Going forward, geriatric EDs will be vitally important in easing emergency department crowding, he said.

Mr. Bring represents nursing homes, hospitals and other institutional providers in litigation, governmental investigations, regulatory compliance and administrative disputes.

In his litigation practice he defends nursing homes against liability claims; represents providers in certificate of need (CON) matters; defends providers in False Claims Act (whistleblower) cases; and pursues administrative appeals on behalf of providers to recover and maximize reimbursement under the Medicare and Medicaid programs.