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Medicare “never events” and patient safety

On Behalf of | Aug 18, 2022 | Accidents & Incidents

Many Illinois seniors are curious about Medicare and “never events.” People want to know what they are and how they affect their healthcare. Never events are care incidents that result in harm or death to a patient and that should never occur.

Medicare bears most of the cost-sharing for senior patients. The Center for Medicare and Medicaid Services (CMS) began to penalize healthcare for “never events” because patients and Medicare were still billed for these erroneous procedures. An example of a “never event” is operating on the wrong body part. The number of families seeking relief through medical malpractice suits increases due to faulty patient care.

Medicare ruling on never events

In 2008, penalties for never events later led to the Hospital-Acquired Condition (HAC) Reduction Program in 2013. This program shows the evolution of the CMS policies towards these events and how healthcare facilities must rectify these errors. CMS ruled that patients nor Medicare won’t pay for a never event.

Never events occur with seniors frequently, with CMS receiving billing for bloodstream infections from improperly placed central lines in patients. This example is just one of several recurring events that result in medical malpractice. The following list is common “never events” that happen during patient care:

  • Urinary tract infections from catheters
  • Pressure ulcers, also called bedsores
  • Patient falls
  • Transfusions of the wrong blood type
  • Not washing hands between and before touching patients

Another example of a never event is leaving an instrument in a surgical patient, administering the wrong medication or the wrong amount of medication. These events and others like them frequently happen in healthcare.
Many patients are harmed or die from their injuries. Medical malpractice claims like never events are challenging to prove, but the laws are taking a more severe approach to reduce and eliminate them.

Medicare and Patient Safety

The Medicare population can be more vulnerable to never events because these patients might also suffer from mental ailments and may not be able to advocate for themselves. CMS implemented these guidelines to ensure patients’ safety. Studies reflect a significant drop in certain never events since implementing these policies.