CMS to Put Pressure on Providers for Decubitus Ulcer Prevention

The CMS changes were authorized by Congress in the Deficit Reduction Act of 2005, and are meant to prevent conditions for which there are “widely accepted evidence-based guidelines,” says Ellen Griffith, a CMS spokesperson.

CMS is not asking hospitals to be guarantors against all possible adverse occurrences during a hospital stay, Griffith says.

“It is simply asking hospitals to make sure that hospital staff do what they should be doing anyway — like washing their hands before touching a patient, or observing other sanitary precautions,” she adds. “The underlying rationale is that neither Medicare nor the beneficiary should pay a hospital for the higher costs of treating a condition that was acquired during the hospital stay and that was determined to be reasonably preventable through compliance with widely accepted, evidence-based guidelines.”

Industry Reaction

The CMS reimbursement changes might encourage providers to further intensify their efforts, says Janet Corrigan, PhD, president and CEO of the National Quality Forum, a not-for-profit membership organization that develops national strategies to measure healthcare quality.

“Healthcare professionals want the best for their patients,” Corrigan adds. “I have no doubt they will embrace this as an opportunity to refocus and amplify institution-wide efforts to enhance safety.”