County Meals on Wheels program aims to prevent hospital readmissions

0 | Hospitals, Nutrition, Prevention

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Photo courtesy Johnson County Meals on Wheels.

Liz Miller, a Meals on Wheels volunteer driver, delivered a meal to a client in Olathe in the summer of 2011. The client still receives meals, according to Johnson County officials.

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— Officials at Johnson County Meals on Wheels say they are hoping the program can become a national model for preventing hospital readmissions among senior citizens.

The program was one of seven nationally to be awarded a $50,000 grant by the Walmart Foundation, which officials plan to use to pilot a home nutrition program designed to get needy seniors seven frozen meals within 72 hours of their discharge from a hospital.

“It is all about trying to keep our seniors healthy and out of the hospitals,” said Nancy Tanquary, nutrition program manager with the county’s Human Services Department, “and nutritious meals play a huge part in that.”

The pilot is expected to serve about 400 seniors this year, she said, and it could provide the participants thousands more meals, if they continue on as regular Meals on Wheels recipients.

Tanquary said one goal of the initiative is to save money for hospitals and insurers by avoiding costly readmissions.

“If we are successful,” she said, “hopefully other hospitals in other counties and states will take a hard look at this.”

The aim is to start the pilot by the end of this month after hiring two part-time coordinators for it.

Johnson County’s grant was part of the final $400,000 that the national Meals on Wheels Association of America received through a three-year, $5 million commitment from Walmart, said Andrew Owens, special projects manager for the national Meals on Wheels association.

Forty applicants sought funding, he said. The grants are intended to spur innovation in local Meals on Wheels operations around the country.

The Mid-America Regional Council in Kansas City, Mo., also received a grant. The funding will allow the Guadalupe Center, a west-side senior center, to build a greenhouse on a nearby vacant lot. The greenhouse will be used to supply fresh produce for the center.

Coordinating with hospital discharge planners

Tanquary said Johnson County officials plan to coordinate their program with hospital discharge planners. Eligible patients must meet the general Meals on Wheels requirement of being homebound and at least 60 years old.

The county has established a Web portal where hospital workers can enter the patient’s name, date of discharge and meal preference.

Information from the discharge planner will show up as an e-mail so the coordinators can follow up with the patients, perhaps even before they leave the hospital.

In talking with the recipients, the coordinators will also inquire about potential issues that could lead to readmission such as availability of home care and if they have a history of falls. Additional assistance would be available from outreach nurses at the county’s public health department.

A University of Kansas Medical Center researcher will compare the health of program participants against a control group that is not part of the pilot.

Tanquary said she hopes the potential cost savings would entice hospitals to have their employees participate and to provide long-term funding.

“I really hope that when it is all said and done,” she said, “that we can really show a huge difference (in cost) and why it should be funded by insurance companies or the hospitals – or both.”

Improving quality of care

Readmissions are a key quality indicator for Medicare.

Under a program launched in October, Medicare reduces reimbursements to hospitals that exceed the national average for readmissions within 30 days for heart attack, heart failure and pneumonia.

According to data from Medicare’s Hospital Compare website, some of Johnson County’s larger hospitals all had rates in line with the national average. Those facilities include Menorah Medical Center, Olathe Medical Center, Shawnee Mission Medical Center, Overland Park Regional Medical Center and Saint Luke’s South Hospital.

“Good nutrition is essential for healing, especially wound healing,” said Sally Lundy, performance improvement supervisor for Olathe Home Health and Hospice, a division of Olathe Health System. “So, making sure people have adequate nutrition will definitely help reduce illness and readmission.”

She said the Meals on Wheels program could be particularly beneficial to seniors who need assistance but don’t qualify for the Olathe home health program whose patients must be homebound and require nursing help or some other skilled service.

Cindy Samuelson, spokeswoman for the Kansas Hospital Association, said it was “refreshing to see a community solution” to the problem of hospital readmissions.

Along with good nutrition, she said, other factors like access to medications, reliable transportation and insurance coverage play a role in readmissions.

“Whether it can generate savings would be a big question mark. I just don’t know that,” she said of the Johnson County program. “I do think it’s a neat idea.”



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