Federal watchdog: Nearly half of Medicare patients in long-term-care hospitals experienced harm

Nearly half of Medicare patients in long-term care facilities have experienced some type of harm as the result of their care, endangering their health and increasing Medicare costs, according to a report from a government watchdog.

The report, released Tuesday by the Office of Inspector General (OIG), part of the Department of Health and Human Services, found that more than 20% of Medicare patients who have received treatment in long-term care facilities have experienced serious harm resulting from medical care or lack thereof. That harm could have been from prolonged stay, necessitating transfer to another facility, up to requiring a lifesaving intervention resulting in permanent harm or contributing to death.

The findings were based on OIG's look at medical records for 587 Medicare beneficiaries admitted to long-term care hospitals (LTCHs) in March 2014.

In comparison, the OIG found that 27% of Medicare patients in hospitals, 33% of Medicare patients in skilled nursing facilities and 29% of Medicare patients in rehab hospitals experienced patient harm. 

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To be fair, the report points out that long-term care hospitals have more opportunities for patient harm because patient stays are longer, resulting in more medical interventions over time. The number of harm events per patient day was similar between LTCHs and other post acute-care settings and lower than in acute-care hospitals. 

But there is still clearly room for improvement, the OIG said. The report pointed out that more than half of the events were clearly or likely preventable and often related to substandard care (58%) or medical errors (34%). The other half of events were likely not preventable because the patients were highly susceptible to harm due to poor overall health. 

Nearly a quarter of the patients experienced more than one harm event.

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The report recommends that the Centers for Medicare & Medicaid Services (CMS) and Agency for Healthcare Research and Quality (AHRQ) take steps to raise awareness in several inpatient settings, specifically tailoring their ongoing efforts to improve patient safety to address the specific needs of LTCHs. They also recommended that the agencies disseminate a list of potential harm events in LTCHs and that CMS include information about patient harm in its outreach to LTCHs.

CMS and AHRQ concurred with the recommendations. Find the report attached below.