Pleasant Law Blog (Insurance Claims, Medical Misakes, and Nursing Home Claims)

CMS "Never Events" Provide Some Insight For Those Hurt by Nursing Homes, Hospitals, Doctors

By Thomas Waitt Pleasant, North Carolina Injury and Wrongful Death Attorney. Toll Free 888.435.7156. CMS (Medicare) reimburses a huge portion of the cost of medical care for this nation's senior citizens and elderly, including medical care given by doctors/physicians, nursing homes, and hospitals. CMS has a list of what are known as "never events" for which it will not reimburse doctors, hospitals, and other healthcare providers. In other words, the cost to pay for the healthcare associated with a "never event" will not be reimbursed to that particular doctor, hospital or other healthcare provider. The list of "never events" provides some insight into whether a nursing home injury (or wrongful death) was the result of bad care. A recent article provides a quick list of these events, which include some things that pop up in many nursing home cases. For example, pressure ulcers or "pressure sores," catheter-associated urinary tract infections; and hospital-acquired injuries such as fractures, dislocations, and intracranial injuries. CMS considers these to be preventable/avoidable injuries, generally speaking. Although it is not clear that these "never events" apply to nursing homes specifically, this article is a good, quick read for families considering placing a loved one in a nursing home, so that these "red flags" are known. If nothing else, they may help those under the care of physicians, nurses, doctors, hospitals and other caregivers. If you have a loved one who has already experienced bad care, injury, abuse or neglect in a nursing home or hospital, feel free to contact my office. We generally provide a free consultation/evaluation for nursing home and medical negligence cases. Call Toll Free, 888.435.7156.