Diagnosing Sleep Apnea in Patients Hospitalized With Heart Failure: A Role for Advanced Practice Nurses

Heart failure is a chronic condition associated with high morbidity and mortality and a significant economic burden in the United States. As the most common admitting diagnosis in Medicare patients, the greatest portion of this economic burden stems from the care delivered during hospitalization.¹  In 2013, the Centers for Medicare and Medicaid Services implemented a maximum 1% financial reimbursement penalty for acute care facilities with excessive readmission rates for heart failure, pneumonia, and acute myocardial infarction.²  Of importance, these penalties apply to all Medicare readmissions, not just the chronic conditions mentioned. Now in its third year with maximum penalties increased to 3% and expansion of the program to include chronic obstructive pulmonary disease and hip or knee replacements, a total of 2610 or 78% of all hospitals are being penalized for excessive readmissions, for an estimated total of $428 million.^3...