According to a study done by Medicare’s inspector general of skilled nursing facilities, Nearly 22,000 patients were injured in a single month, and more than 1,500 died- a higher rate of medical errors than hospitals. In addition, the study found that one-in-three patients in a skilled nursing facility suffered due to a medical error, such as a medication error, infection, or another type of harm related to mistreatment.
The government report, released March 2014, found that an estimated 22 percent of Medicare beneficiaries experienced “adverse events” during their stay at skilled nursing facilities. 11 percent of patients also experienced temporary, harmful events during their stay. Much of the harm was attributed to “preventable harm, substandard treatment, inadequate monitoring, and failure or delay of necessary care.”
Doctors who reviewed the patients records confirmed that 59 percent of the injuries in nursing facilities were preventable. Of those, more than half of the patients had to be readmitted to the hospital within the month the study was performed. This cost an estimated $208 million, which translates to about 2 percent of Medicare’s total inpatient spending. Dr. Marty Makary, a physician at Johns Hopkins Medicine in Baltimore, says that the report “tells us what many of us have suspected- there are vast areas of health care where the field of patient safety has not matured.”
The study focused on skilled nursing care, treatment in nursing homes for up to 35 days after a patient was discharged from an acute care hospital. 653 random patient records were reviewed from more than 600 facilities.
In 1.5 percent of the cases where the patient died, it was due to poor care. Many of the patients did have various illnesses, but were reasonably expected to survive. The death involved problems like preventable blood clots, fluid imbalances, excessive bleedings, and kidney failure.
The study estimated that, projected nationally, 21,777 patients were harmed, and 1,538 died due to inadequate care in a skilled nursing facility. Sen. Bill Nelson, chairman of the U.S. Senate Special Committee on Aging, said Medicare patients “deserve better,” and that he would push for more thorough inspections of these facilities. “This report paints a troubling picture of the care that’s being provided in some of our nation’s nursing homes,” he stated.
On the bright side, the report did say that it is possible to reduce the number of patients harmed. It asks the federal Agency of Healthcare Research and Quality and the Centers for Medicare & Medicaid Services (CMS) to promote patient safety efforts in nursing homes. In response, CMS acknowledged the findings and noted that the Affordable Care Act requires nursing homes to develop Quality Assurance and Performance Improvement programs.
Richard Mollot, executive director of New York’s Long Term Care Community Coalition, says he was “flabbergasted” by the poor care identified in the report. Mollot also says the inspections of nursing homes, while done yearly, vary in effectiveness. “If they were enforced we wouldn’t have these widespread problems,” he said. Mollot says that about 40 percent of people over age 65 will spend time in a nursing home, and hopefully the inspector general’s report will show the public that work need to be done to improve care.