Imagine: You were hospitalized for some reason. Hospitalization costs a lot, and so ‘guidelines’ tell your doctor you can only stay in the hospital so long for that problem. If they let you stay one day past the guideline, the hospital eats the cost. So, whether you are medically stable or not, you go home or you get sent to a ‘skilled nursing facility’ for the rest of your recovery. Ready or not, you go.
And, why? It costs less to take care of a patient in a skilled nursing facility than a hospital. Why does it cost less? Because insurance don’t reimburse the facility as much.
We expect the ‘skilled nursing facility’ to have the funds to hire the staff and buy the monitoring equipment that is needed to provide ‘skilled nursing’ care despite low reimbursements paid to the facilities.
The inspector general of the U.S. Department of Health and Human Services (HHS) reviewed records for 653 randomly selected Medicare patients who were in skilled nursing care – treatment in nursing homes for up to 35 days after a patient was discharged from an acute care hospital – in August, 2011.
The findings are scary: 33 percent had a medication error, infection or some other type of harm. 2/3rds of those suffered events that caused lasting harm, and 1/3rd were temporarily harmed. In 1.5 percent of cases a patient who had been expected to survive died because of poor care.
The injuries and deaths were caused by
- substandard treatment,
- inadequate monitoring,
- delays or the failure to provide needed care
The deaths involved problems such as
- preventable blood clots,
- fluid imbalances,
- excessive bleeding from blood-thinning medications
- kidney failure.
Doctors who reviewed the patients’ records determined that 59 percent of the errors and injuries were preventable. More than half of those harmed had to be readmitted to the hospital at an estimated cost of $208 million for the month studied — about 2 percent of Medicare’s total inpatient spending.
Projected nationally, the study estimated that 21,777 patients were harmed and 1,538 died due to substandard skilled nursing care in that one month period.
My opinion: Something needs to change. If we can’t afford to keep patients in the hospital long enough to be stable when they leave, then we need to reimburse skilled nursing facilities enough that they can truly provide skilled nursing. Duh.
Read One Third of Skilled Nursing Patients Harmed in Treatment and follow their links to read the studies.