Medicare Takes Action against Never-Events
Medicare Attempts to Reduce Health Care Costs and Promote Patient Safety
Medicare Takes Action against Never-Events – Certain types of medical errors should never happen. According to the California Association of Health Plans, preventable medical errors are a leading cause of death in the United States, resulting in over $4.5 billion in additional health spending annually. Beginning in October 2008, in an attempt to increase and promote safety and wellness and to reduce health care costs, Medicare, Aetna, and other major health care insurers have banned payments for “never events.” Specifically, Medicare no longer provides an additional payment to hospitals unless the events were present at admission. Think about it, it makes sense – why should Medicare insure hospitals and nursing home facilities for events that should never have happened in the first place?
“Never events” are conditions that could have reasonably been prevented. There are 28 preventable adverse health events that are listed as “never events.” To be a “never event,” an event must be characterized as the following:
- Unambiguously identifiable and measurable;
- Preventable; and
- Resulting in serious injury or disability, or even death.
Not surprisingly, among the list of “never events” is stage 3 or 4 pressure sores acquired after admission to a healthcare facility. Pressure sores, also known as pressure ulcers or bed sores, are a result of hospital or nursing home neglect. When a person is bedridden or in a wheelchair for an extended period of time, circulation is cut off to parts of the body and the sustained pressure creates areas of damaged skin and tissue. Prolonged pressure on one area of the body can quickly develop into pressure sores.
So why are pressure sores listed as “never events”? Because all it takes is an attentive caregiver to reposition the patient to eliminate the risk of developing one, along with proper hydration and nutrition. Pressure sores are an unequivocal sign of neglect. They wouldn’t happen were it not for the hospital or nursing homes failure to reposition the patient. Period.
York Law Firm believes this is the first step of many steps to prevent nursing home abuse and neglect. We understand that pressure sores are extremely dangerous to elders, as they can rapidly progress and can become infected, causing systemic infection and even death. Unfortunately, too many of our nursing home clients have sustained bad pressure sores, and we have helped them understand their legal rights, held the nursing home accountable and have obtained compensation for their injuries.