Who Pays for Patient Falls?

As of October 2008, the Centers for Medicare and Medicaid Services (CMS) will no longer pay for patient falls. The CMS ruled that hospitals and health care providers will no longer be reimbursed for preventable Hospital Acquired Conditions (HAC), which means that the CMS will not pay to treat conditions that were not present upon the patient’s admission.  CMS includes “Patient Falls” as one of 10 Hospital‐Acquired Conditions that is high cost, high volume, or both, and can reasonably be prevented through the application of Evidence Based Guidelines.

As a result, it is now the hospital’s responsibility to pay for resulting patient injuries, or required treatments, from a fall in a hospital setting.

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Understanding Bed-Exit Alarms

Most hospital bed falls occur when a patient enters or exits the bed without staff assistance. Many fall risk patients forget to use the nurse call button and overestimate their physical abilities, which can lead to a fall or trip out of bed. Maintaining constant patient supervision to eliminate this unassisted movement can prove to be a costly effort for hospitals, as the cost of around the clock sitters adds up.

To combat the high cost of patient sitters, bed-exit alarms were introduced to detect bed activity and to minimize the number of bed exits without staff assistance. Instead of using a sitter to observe patient movement, the bed-exit alarm was designed to alert the nurses’ station to bed exit activity based on a change in patient positioning. A nurse’s response to the alarm would enable her to reposition, or assist the patient out of bed, which would minimize the possibility of a fall.

A nurse using a bed-exit alarm

The use of a bed-exit alarm is recommended for use with patients with stability issues, on medication, with cognitive impairment, or with any patient identified as a fall risk. Bed-exit alarms can help prevent falls by alerting nurses to bed exit behaviour that is attributed to patient falls, and is recommended as an integral component of a hospital’s patient fall prevention program.

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Safe Patient Handling: Taking Care of Our Nurses

Day-to-day patient care can take a lot out of nurses. From bathing to weighing to repositioning patients sometimes multiple times throughout the day, patient transfers can add up. With the average weight of the United States adult population climbing to almost 180 pounds, it’s not hard to believe that nurses lift an upwards of 1.8 tons, or the equivalent of a mid-sized SUV, in an eight hour shift.^{1 2}

As a result of repetitive manual patient lifting at extreme weights, back injuries are the number one reported injury in healthcare. The primary cause of back injury is overexertion from lifting, pushing, or pulling, especially when moving heavy equipment or transferring patients. What’s thought of as routine tasks for nurses, such as transferring a patient from a bed to a chair or repositioning a patient, are actually considered high risk patient handling tasks according to the Occupational Health and Safety Agency (OSHA). It’s no wonder overexertion is 4.5 times more commonly cited in nursing injuries than in any other job category.¹

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The Impact of Baby Boomers on Healthcare

The next generation of senior citizens is posed to live longer and be larger than any previous generation. Starting in 2011, the first members of the baby boomer generation turned 65 years old, joining the existing population of 40.2 million seniors living in the United States. By 2030, the baby boomer generation is expected to contribute over 80 million seniors to the American population.¹

Given increased life expectancy rates, there could be an upwards of 120 million Americans aged 65+ by 2030.

Much like the baby boom forced public schools in the 1950s to increase their capacity due to demand, there will be a similar effect on the healthcare system in the years to come. Unlike public schools, however, the demand for healthcare will never stop and will actually increase as more seniors are living longer and with more chronic conditions.

Today’s seniors are said to already use hospital services at 4.5 times the rate of the younger population, which indicates that inpatient care will rise exponentially in the next 20 years as the senior boomers grow in numbers.²

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