quality of service. 71 Fear of exposure to potential direct (corporate) 72 and/or vicarious liability73 (under either an apparent agency74 or a non-delegable duty75 theory) claims should encourage LTSS entities to exercise greater oversight and control regarding the quality of services being offered and delivered by the various providers who make up the larger enterprise. So, too, should the need to compete against other fewer, but still competitive, surviving providers for consumers’ lucrative business keep LTSS entities on their toes regarding their service packages. 76 In addition, recent changes in regulations implementing ACA77 provisions regarding Medicare reimbursement give hospitals a strong (and perhaps even an excessively strong) financial incentive to avoid too-fast hospital readmissions after discharge. 78 Thus, hospitals have a strong financial incentive to do better discharge planning and follow-up, including selecting and carrying on business with LTSS providers who are more likely to provide higher quality care that is less likely to result in a quick hospital readmission. 79 Furthermore, consolidation among disparate providers, each of whom is involved at some point in the care of the consumer, may facilitate better sharing of that consumer’s pertinent health and social information within the single parent service delivery entity. Such sharing of information, in turn, is
71. Browdie, supra note 69, at 64-65. 72. Strubhart v. Perry Mem’l Hosp. Trust Auth., 903 P.2d 263, 269 (Okla. 1995); see generally Whitney Foster, Negligent Credentialing and You: What Happens When Hospitals Fail to Monitor Physicians, 31 U. ARK. LITTLE ROCK L. REV. 321, 327-28 (2009). 73. Foster, supra note 72, at 328-30. 74. See generally Jane Elaine Ballerini, The Apparent Agency Doctrine in Connecticut’s Medical Malpractice Jurisprudence: Using Legal Doctrine as a Platform for Change, 13 QUINNIPIAC HEALTH L.J. 317 (2010). 75. See generally Ryan Montefusco, Hospital Liability for the Right Reasons: A Non- Delegable Duty to Provide Support Services, 42 SETON HALL L. REV. 1337 (2012). 76. Id. 77. Patient Protection and Affordable Care Act, Pub. L. 111-148, 124 Stat. 119, § 3025 (2010) (codified as amended in scattered sections of 42 U.S.C.). 78. See generally Qian Gu et al., The Medicare Hospital Readmissions Reduction Program: Potential Unintended Consequences for Hospitals Serving Vulnerable Populations, 49 HEALTH SERVS. RES. 818 (2014); Michael W. Sjoding & Colin R. Cooke, Readmission Penalties for Chronic Obstructive Pulmonary Disease Will Further Stress Hospitals Caring for Vulnerable Patient Populations, 190 AM. J. RESPIRATORY & CRITICAL CARE MED. 1072 (2014). 79. See Ronald Winters, LTCHs: Restructuring and Industry Consolidation Ahead, AM. BANKR. INST. J. 34 (2015) (speculating that changes in Medicare reimbursement may impact the relationship between acute care hospitals (“ACHs”) and long-term care hospitals (“LTCHs”)).
