More than half of Medicare recipients experience preventable injury in nursing facilities

An estimated 22% of Medicare beneficiaries experienced adverse events or injury during their time at a skilled nursing facility,  according to an HHS study from 2004–2012. An additional 11% experienced events that resulted in temporary harm that required medical intervention.

Physician reviewers determined that 59% of these events were preventable.

Using Medicare claims data, researchers selected 653 Medicare beneficiaries and generated estimates about injury based on three categories: national incidence of injury related events, preventability and Medicare costs associated with these events.

Factors that contributed to injury included substandard treatment, insufficient resident monitoring and staff failure to provide adequate care.

The beneficiaries had Medicare-paid stays in a skilled nursing facility (SNF) within 1 day of a discharge from a hospital and an SNF stay of 35 days or fewer. Length of stay averaged 15.5 days.

The majority (79%) of adverse events resulted in prolonged SNF stay, transfer to a different SNF or post-acute facility, or hospitalization. An estimated 1.5% of Medicare SNF residents experienced events that contributed to their death, while 4% experienced multiple related events.

More than half of the residents who experienced an SNF-related injury returned to a hospital, with an estimated cost of $208 million in August 2011; for the entire year, this equated to $2.8 billion spent on treatment for harm caused in SNFs.

“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 researchers concluded.

For more information:

Dept. of Health and Human Services. Office of Inspector General. Adverse events in skilled nursing facilities: National incidence among Medicare beneficiaries. Available at: Accessed March 10, 2014.

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