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Hip Fractures and Risk Management in Nursing Homes

The nursing home industry is brimming with all types of exposures that you, as an owner, must deal with on a daily basis. It is a very rewarding business as well, that of ensuring the safety and well being of your clients, many of whom are senior citizens in their golden years. It is an environment fraught with risk of all shapes and sizes. The pressures that drive these risks spring from regulations, the reimbursement system (Medicare and Medicaid) and many other factors and forces at work.

Hip Fractures a major concern

Keeping patients safe from injury is of the utmost importance and a high priority for nursing homes. There is, quite naturally on your part, the desire to sustain high levels of clinical care, but this goes hand in hand with the equally important need to protect patients from injury, from a financial point of view. There looms the potential adverse financial impact, which might result from the tarnishing of your reputation, which doesn’t bode well in the competitive environment of privately owned nursing homes. This type of damage can be significant, especially with hip fractures representing two out of every five fall-related injuries in nursing homes.

Therefore the prevention of hip fractures is understandably a critical and ongoing challenge for facilities and their caregivers. Given the limited success of fall-prevention programs, many facilities are increasingly turning to fracture-prevention strategies that include the use of hip protectors. External hip protectors are being considered for those elderly clients with higher-than-average risk factors for hip fractures, though some surveys are uncertain of their effectiveness.

Increased costs for inpatient care is a concern

A recent comprehensive study found the average cost for inpatient care for hip fractures occurring in nursing homes to have risen to an average of around $29,000 per episode (not including the significant additional costs associated with skilled nursing care). Of particular importance to risk managers, to say nothing of owners, is the likelihood that changes in Medicare payments that already disallow reimbursement for fall-related injuries that occur in hospitals may be extended to nursing homes in the future as well.

Given the overall economic challenges of managing long term care facilities, this should provide an even greater incentive for reducing the incidence of fall related injuries, in particular hip fractures, in nursing homes.

You rely on your staff to do their best to avert situations where falls are likely to occur. Proper safety training and constantly updating safety procedures and techniques is a proactive way to keep personnel apprised of what needs to be done in any given situation. Providing quality care is the cornerstone of any good risk management for nursing homes.

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