Medical Errors Affect One-Third of Nursing Home Patients

The Washington Times

March 4, 2014

One-third of all Medicare patients treated at skilled nursing facilities suffered some form of harm from medication errors, medical mistakes or infections, according to a government investigation that raises red flags about the quality of America's healthcare.

The investigation by the Department of Health and Human Services inspector general found that 59% of the adverse patient events were preventable and that more than half required patients to be admitted to care at a hospital or other facility.

Numerous patientsóabout 1.5% of those exposed to harmódied as a result of the mistakes, the report found.

The adverse events are harmful to taxpayers as well, costing an estimated $2.8 billion a year in additional hospitalizations, the report found.

Nursing homes are the most common type of skilled nursing facilities or SNFs, which are a growing part of America's medical system as the baby-boomer generation ages. President Obama's healthcare law envisions them continuing to play an important role going forward, raising the stakes for the problems unmasked in the investigation.

"Because many of the events that we identified were preventable, our study confirms the need and opportunity for SNFs to significantly reduce the incidence of resident-harm events," the inspector general concluded.

Investigators said 22% of Medicare patients developed serious medical problems as a result of their stay, many of which required hospitalization to treat.

The most common mistake investigators found had to do with medication, usually with nursing staff giving patients the wrong kind or wrong dosages, or patients having an allergic reaction to the meds.

Medicare, one of the largest government programs in terms of spending, has often drawn criticism from Capitol Hill lawmakers who say the program isn't doing enough to combat waste or isn't transparent.

"Taxpayers have a right to see how their dollars are being spent," said Sen. Chuck Grassley, Iowa Republican, a leading advocate for spending reform, last year. "There shouldn't be a special exception for hard-earned dollars that happen to be spent through Medicare."

Sen. Bill Nelson, Florida Democrat, said at a committee hearing last year that the government must be mindful of the cost of the program and how much mistakes can not only hurt patients, but cost taxpayers.

"As more and more baby boomers retire and healthcare costs continue to rise, Medicare spending could reach $1 trillion by 2023," he said. "Reducing hospital readmissions will not only save the Medicare program billions, it will save beneficiaries from potential infection and further out-of-pocket expense."

The Centers for Medicare and Medicaid Services (CMS) said they are compiling lists of the most common medical mistakes, and preparing better training for doctors on how to avoid the mishaps.

"CMS fully concurs with [the inspector general] on the importance of identifying avoidable adverse events among nursing-home residents and improving the quality of life and care for nursing-home residents," a response from the agency said.

The Affordable Care Act will require nursing homes and similar facilities to report their safety records to federal watchdogs. The inspector general said it's too soon to tell if this will have a noticeable impact on reducing medical mistakes.

In addition to the harm done to patients, inspectors said, the mistakes were a large financial burden on Medicare for having to pay for hospital treatment.

"Most of these residents died at hospitals rather than in the SNFs where the harm occurred, having been transferred back to the hospitals for higher-level treatment as a result of the event," the inspector general said.

Hospital trips owning to mistakes by medical staff cost taxpayers $2.8 billion in a single year, according to the report. But, the inspector general warned, "the full costs associated with these events are likely greater than our estimate."

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