A new report from the Office of Inspector General (OIG) found that 21 percent of Medicare patients in LTCHs experienced adverse events, which are particularly serious instances of patient harm resulting from medical care. The four categories of adverse events included in the report – Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries – include outcomes such as prolonging a patient’s LTCH stay or necessitating transfer to another facility; requiring life saving intervention; resulting in permanent harm; and contributing to death. (Five percent of Medicare patients in LTCHs experienced adverse events that contributed to or resulted in their deaths.) An additional 25 percent of patients experienced temporary harm events, which are patient harm that required medical intervention but did not cause lasting harm.
The overall percentage of patients in LTCHs who experienced either type of harm (adverse events or temporary harm events) is 46 percent, higher than OIG found in hospitals (27 percent), skilled nursing facilities (33 percent), and rehabilitation hospitals (29 percent). Patient stays in LTCHs present more opportunities for harm events because the stays are longer, but the number of harm events per patient day was similar between LTCHs and other post acute-care settings and lower than in non-LTCH acute-care hospitals.
Over half of these adverse events and temporary harm events (54 percent of harm events) were clearly or likely preventable. Preventable harm events were often related to substandard care (58 percent) and medical errors (34 percent). Forty-five percent of harm events were found to be clearly or likely not preventable, often because the patients were highly susceptible to harm due to other health conditions or poor overall health.
- Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries. Office of the Inspector General. November 2018 (PDF)