By Nursing Home Law Center
Decubitus ulcer treatment is a big business! An estimated $1.3 billion is spent every year on wound care in the United States. In the past, hospitals were able to recover much of the expense related to pressure ulcer treatment directly from Medicare — even if the wound developed during a hospitalization at their facility.
New governmental regulations will make these reimbursements a thing of the past when the Centers for Medicare & Medicaid Services (CMS) deems the pressure ulcer to be avoidable. The result of this new regulation is that facilities now have an incentive to prevent pressure ulcers from developing in patients at their facilities or the facility pays for the treatment out of their own pocket.
“Preventing and managing pressure ulcers takes a very aggressive approach–one that requires facility wide buy-in and multi-disciplinary involvement,’ says Heather Hettrick, PT, PhD, a director at American Medical Technologies Inc.
Under the new CMS guidelines, facilities should begin the process of re-educating staff on common bed sore prevention measures such as: using off-loading boots, application of ointments, dressing changes and proper techniques to rotating patients to prevent them from laying in one position for too long.
Some facilities such as Regency Hospital, a long-term care facility in Minneapolis, have already taken steps to make pressure ulcer prevention a priority. Every suspicious area on residents skin is photographed on a regular basis to keep track of the wound over time and as it heals. Wounds are also regularly checked for surface temperature and skin color – the early signs of skin impairment.
Some of the pressure ulcer preventative techniques used at Regency Hospital are basic and can easily be applied at other facilities. For example , staff is instructed to use hourly rounds look for the ‘Three P’s’ positioning, pottying, and pain.
As a friendly reminder to staff and patients to re-position themselves, music is played every two hours to remind residents and staff they need to change positions. Other basic—yet effective devices such as ‘turning wheel’s’ are used in each resident’s room to demonstrate to all caregivers what position to change the resident to next. Would care nurse, Kathy Irons, says it best, “we take a very proactive approach where everyone is held accountable.”
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