One Third of Skilled Nursing Patients Harmed in Treatment

One-in-three patients in skilled nursing facilities suffered a medication error, infection or some other type of harm related to their treatment, according to a government report released today that underscores the widespread nature of the country’s patient harm problem.

Doctors who reviewed the patients’ records determined that  59 percent of the errors and injuries were preventable.   More than half of those harmed had to be readmitted to the hospital at an estimated cost of $208 million for the month studied — about 2 percent of Medicare’s total inpatient spending.

Patient safety experts told ProPublica they were alarmed because the frequency of people harmed under skilled nursing care exceeds that of hospitals, where medical errors receive the most attention.
“(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,” said Dr. Marty Makary, a physician at Johns Hopkins Medicine in Baltimore who researches health care quality.

The study by the inspector general of the U.S. Department of Health and Human Services (HHS) focused on skilled nursing care – treatment in nursing homes for up to 35 days after a patient was discharged from an acute care hospital. Doctors working with the inspector general’s office reviewed medical records of 653 randomly selected Medicare patients from more than 600 facilities.

The doctors found that 22 percent of patients suffered events that caused lasting harm, and another 11 percent were temporarily harmed. In 1.5 percent of cases the patient died because of poor care, the report said. Though many who died had multiple illnesses, they had been expected to survive.

The injuries and deaths were caused by substandard treatment, inadequate monitoring, delays or the failure to provide needed care, the study found. The deaths involved problems such as preventable blood clots, fluid imbalances, excessive bleeding from blood-thinning medications and kidney failure.

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One Third of Skilled Nursing Patients Harmed in Treatment

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Read the report from the Department of Human Health Services:  "Adverse Events in Skilled Nursing Facilities:  National Incidence Among Medicare Beneficiaries"