Narcan and the tenacity of addiction

From SILive:

The fact is that once the victim — or the “aided” in police jargon — is brought to a hospital, he or she is on his own, free to make more bad decisions, if that’s the direction in which their addiction takes them. Emergency room doctors can offer treatment options, or suggest a consultation with a psychologist, but if the patient doesn’t want to go into treatment, that’s where this initiative ends. The addict who has come so close to death goes back out to the same old world where it’s only too easy to obtain more drugs, if that’s what they choose.

Rural, urban suicide gap widening among youth

From Reuters:

The gap in suicide risk between young people in rural U.S. communities and those in more urban areas is widening, a new study suggests.

Possibly due to differences in mental health services, isolation, firearm access and economic factors, suicide is twice as common among young Americans in rural communities as in urban areas, the researchers write in JAMA Pediatrics.

Previous studies found rural and urban difference, but what’s new here is that the differences are growing, said study leader Cynthia Fontanella, from the Ohio State University Wexner Medical Center in Columbus.

“Here we go again: HHS attacks rural hospitals”

From Rural Voices:

As rural hospitals rapidly close across the nation, the National Rural Health Association is appalled by yet another attempt by HHS’ Office of Inspector General (OIG) to limit rural patients’ access to health care by calling for even more payment cuts to critical access hospitals (CAHs).

NRHA calls upon the Administration and Congress to stop the flood of rural hospital closures and protect access to care for millions of rural Americans.

This morning (Monday), HHS’ OIG released a report suggesting the return of a failed payment system that led to the closure of 440 rural hospitals across the nation in the 1980s and ’90s.

In 1997, Congress created the CAH payment system to provide equitable payments to keep rural hospital doors open and preserve access to care. Now, OIG calls for a return to the failed Medicare reimbursement system (the prospective payment system) for post-acute care patients in swing beds, resulting in over a billion dollars in cuts to CAHs, the smallest of all hospitals.

Report: Rural hospitals get billions in extra Medicare funds

From the State Journal-Register:

A law that allows rural hospitals to bill Medicare for rehabilitation services for seniors at higher rates than nursing homes and other facilities has led to billions of dollars in extra government spending, federal investigators say.

Most patients could have been moved to a skilled-nursing facility within 35 miles of the hospital at about one-fourth the cost, the U.S. Department of Health and Human Services’ inspector general said in a report being released Monday. Hospitals juggling tough balance sheets have come to view such “swing-bed” patients as lucrative, fueling a steady rise in the number of people getting such care and costing Medicare an additional $4.1 billion over six years, the report said.

The authors wrote that the windfall helps to “support a hospital’s fixed costs and offset losses from other lines of business.”

EHR failure closes California hospital ED, nurses ask for investigation

From Becker’s:

Antelope Valley Hospital in Lancaster, Calif., shut down its emergency department Feb. 27 after the EHR and data system failed.

The failed systems led to issues with properly dispensing medications, verifying physician orders, reviewing patient labs, MRIs and other diagnostic procedures, and led to an inability for clinicians to review patient records, according to hospital nurses.

Additionally, the hospital did not have a backup plan in place after closing its ED. “How many hospitals are compromising the lives of their patients by not having a back up or plan of action in place for a catastrophic event as this?” said Maria Altamirano, RN, a nurse at Antelope Valley Hospital, in a release from National Nurses United/California Nurses’ Association.