The Centers for Medicare and Medicaid Services (CMS) have recently designated certain injuries in hospitals “never events” – or injuries that should not happen. These injuries include Stage III and IV bed sores and falls with fractures. The penalty to hospitals when these injuries happen is that CMS will not pay for treatment rendered for these injuries. The result is that many hospitals are reporting the incidence of these events has gone down, and in some places tremendously.
According to the article, a recent study showed that 25% of nursing home hospital admissions may be preventable. A further congressional review panel estimates that 14% of hospital patients sent back to nursing homes return to a hospital for a preventable condition. The Obama administration wants to penalize nursing homes that have unnecessarily high hospital admissions for preventable conditions by reducing their Medicare payments.
So, why are these residents being sent to the hospital to be paid for with your tax money? The author of the article documents that, “I’ve seen hospital emergency rooms filled with very frail seniors on Friday afternoons. Why? Because nursing homes know they won’t have enough weekend staff to care for their sickest residents, so they simply send them back to the hospital. The new rules could stop those practices.”
Perhaps hitting substandard nursing homes in the pocketbook will force them to take better care of their residents.