According to a HHS’ Office of Inspector General report, approximately one out of three Medicare beneficiaries released from rehabilitation hospitals in March 2012 were medically harmed during stays at the facilities and nearly 46% of the incidents were preventable. The OIG also found that their latest findings for rehab hospitals are actually in line with harm rates at acute-care hospitals and skilled nursing facilities. A prior report by the OIG in 2010 found 27% of hospitalized Medicare beneficiaries experienced adverse events or temporary harm during their time at acute-care hospitals. And in 2014, the OIG found that 33% of Medicare residents in Skilled Nursing Facilities fell victim to the same issues. The OIG’s latest finding “confirms the need and opportunity to significantly reduce the incidence of adverse events in rehab hospitals, thereby improving the quality of care that patients receive.” The report points out that the similar rates of adverse events and harm at rehab facilities, acute-care hospitals and skilled-nursing facilities shows a need for research and interventions to reduce such problems which may apply across all three types of care providers.
In this latest report pertaining to rehabilitation hospitals, OIG studied 417 Medicare beneficiaries discharged in March 2012 (picked randomly), and of those, 158 experienced adverse events or temporary harm during their stays. OIG found that 18% of patients in the sample experienced temporary harm that required intervention. Another 8% experienced an adverse event that led to a longer stay in a rehab hospital or transfer to an acute-care hospital for observation, emergency treatment or inpatient care. Nearly 2% experienced an adverse event that required life-sustaining intervention. Fewer than 1% of patients were permanently harmed, and fewer than 1% of patients died. Medication-related issues (such a bad reaction to a medication) and issues related to care (such as a falls or bed sores) were the most common causes of harm, and infections were the lowest. Substandard treatment and failure to adequately track a patient’s progress were the most frequently cited factors in the instances of preventable harm. OIG estimated that 7% of all Medicare beneficiaries who were discharged from rehab hospitals in March 2012 went to an acute-care hospital for treatment because of harm sustained at a rehab hospital at a cost of $7.7 million. If that rate were to stay steady throughout the year, Medicare would spend $92 million annually on acute-care hospital admissions and emergency department visits for patients harmed at rehab hospitals.
The study focused on rehabilitation facilities that were not associated with hospitals. Rehab facilities generally require that patients be able to undergo at least three hours of physical and occupational therapy per day, five days a week. Patients at these facilities are presumed to be healthier than patients in a more typical hospital or a nursing home.
What did OIG recommend based on their findings? OIG proposed that the CMS and the Agency for Healthcare Research and Quality raise awareness of harm in rehab hospitals by creating and promoting a list of potential incidents. OIG noted that the two agencies have already been working together on such a list of potentially reportable events in acute-care hospitals and skilled nursing facilities. OIG also recommended the CMS include more information about potential harm in its quality guidance to rehab hospitals. That guidance should include a definition of “adverse events,” a list of potential events to educate staff, and strategies for finding and preventing adverse events.
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Click here to read the report: https://oig.hhs.gov/oei/reports/oei-06-14-00110.asp
The Agency for Healthcare Research and Quality and the CMS agreed with the recommendations.
If you or a loved one has been injured as a result of a medical neglect or medical harm at a rehab hospital, contact us at Edwards & Ragatz for a free consultation. (904)399-1609 or (866)366-1609. www.edwardsragatz.com
*An injury caused by medical management–rather than by the underlying disease–which prolongs hospitalization, produces a disability at the time of discharge, or both Etiology Drug effects, wound infections, technical complications, negligence, diagnostic mishaps, therapeutic mishaps, and events occurring in the emergency room. (http://medical-dictionary.thefreedictionary.com/adverse+event)