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 Inspector General Finds Nearly One-Third of Rehab Patients Suffer Adverse Events

Nearly one-quarter of Medicare patients discharged to nursing centers for rehabilitation suffered some kind of adverse event during their stay, a new report by the Department of Health’s Office Inspector General has concluded. 
 
Another 11 percent of those patients suffered “temporary harm” during their stay, and auditors project that up to 1.5 percent of patients died from the “adverse event,” according to the report, released Monday.
 
As first reported by ProviderNation, the report found a range of errors from sloppy paperwork to substandard care that resulted in everything from a longer-than-expected stay in rehab and even—in rare cases—patient deaths.
 
Auditors looked at a sample of 653 Medicare patients who were released from hospitals and into skilled nursing facilities (SNFs) for rehab in August, 2011. 

They then examined the adverse event records of those patients—from sloppy paperwork to lack of proper care—and extrapolated results. “We estimate that 21,777 post-acute Medicare SNF residents experienced at least 1 adverse event during stays that ended in August 2011,” the report says.
 
“Adverse events” are not abuse—in fact, the 69-page report doesn’t document a single case of abuse. And the prohibitive majority of cases—79 percent of the sample—resulted in a longer-than-planned stay in a nursing center, transfer to another center, or a trip back to the hospital, but no permanent damage to the resident, auditors wrote. 
 
Nonetheless, the findings in Monday’s report will likely provide splashy headlines and bullet points for critics of the post-acute care profession. Indeed, many partisans were quick to jump on the “adverse” percentages in Monday’s report, claiming that it demonstrates that nursing centers are more dangerous than hospitals. 
 
(A 2010 report by the inspector general found that 27 percent of patients in hospitals suffered adverse events. The death rate was the same for both groups, but because of the larger hospital population, the number of potential patient deaths in hospitals was nearly 10 times that of patients in nursing centers.)
 
Whatever the verdict of the news cycle, post-acute care advocates say they’re taking Monday’s report seriously.
 
“The recommendations in this report can help us strengthen our efforts to reduce adverse events and continue to improve patient safety,” says David Gifford, MD, senior vice president for quality at the American Health Care Association. “In recent years, skilled nursing care centers have taken unprecedented steps to continue improving quality of care: reducing hospital readmissions, reducing off-label use of antipsychotic medications and increasing the time nursing staff spends with patients Improving quality and patient safety is a top priority for the long term and post-acute care profession.”

Click HERE for a copy of the OIG report.

Follow Bill Myers on Twitter @ProviderMyers.

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