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Of course, these hospital guidelines are voluntary, so there's no guarantee that everyone will follow them.
But, Weissburg said, with insurers, medical groups and Medicare turning up the pressure, hospitals have no choice but to improve their game. "The culture is changing -- it's being forced to change."
What Medicare won't pay for:
- An object mistakenly left in a patient during surgery.
- A preventable air embolism.
- Complications from being given incompatible blood.
- Catheter-associated urinary-tract infections.
- Pressure ulcers (bedsores).
- A vascular catheter-associated infection.
- A surgery-site infection after coronary-artery-bypass graft surgery.
- Patient falls.
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Some hospitals won't charge for these never events:
- Surgery on the wrong body part.
- Surgery on the wrong patient.
- The wrong surgical procedure.
- Unintentionally leaving a foreign object inside a patient during surgery.
- A postoperative death of a normal, healthy patient.
- An infant discharged to the wrong person.
- A patient suicide or attempted suicide resulting in serious disability.
- A maternal death or serious disability in a low-risk pregnancy.
- A death or serious disability (brain damage) associated with jaundice in infants.
- Stage 3/4 pressure ulcers (bedsores).
- Artificial insemination with the wrong donor sperm or wrong egg.
- Any incident in which a line designated for oxygen or other gas to be delivered contains the wrong gas or toxic substances.
- Care ordered by someone impersonating a physician, a nurse, a pharmacist or other licensed health-care provider.
- Abduction of a patient.
- Sexual assault of a patient.
- A death or significant injury of patient or staff from physical assault.
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The same hospitals won't charge for a patient death or serious disability:
- Caused by contaminated drugs, devices or biologics.
- Linked to the use or function of a device other than as intended.
- Associated with an intravascular air embolism.
- Associated with a patient escaping or leaving without permission.
- From a medication error.
- Linked to a reaction to incompatible blood or blood products.
- Associated with hypoglycemia.
- Due to spinal manipulative therapy.
- Associated with electric shock.
- Associated with a burn incurred while hospitalized.
- Associated with a fall.
- Linked to the use of restraints.
Published March 7, 2008
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