Who Pays When Elderly Patients Fall at the Hospital?

A hospital fall is a common problem, particularly with the elderly, and falls lead to injuries, longer hospital stays and potential lawsuits. In fact, the authors of a recent article published in the New England Journal of Medicine found that as many as one out of five patients fall at least once during their hospital stay. Those falls can result in as much as $4,000 in extra bills.

To remedy this problem, the federal government decided last October to stop payment on Medicare for extra hospital care if a fall is deemed preventable. Doctors feel that this unfairly forces them to use restraints to keep patients from falling, since falls still remain a problem despite their best efforts to prevent them. Many times, doctors argue, falls are caused by impairments that patients already have, or by the treatments or medications they receive.

Whatever the reason for hospital falls, doctors do no want to see a rise in using restraints, particularly since they are cited as the major cause for agitation or delirium in patients, as well as bedsores and breathing problems. The director of the Institute for Aging Research at Hebrew Senior Life has spent 20 years studying ways to prevent delirium and resulting hospital falls amongst the elderly. Her research has shown that minimizing certain medications that increase dizziness or wooziness, scheduling frequent bathroom trips, using lowered hospital beds, and maintaining regular movement, all helped to reduce hospital falls in patients and has kept the use of restraints to a minimum.

Other doctors corroborate her viewpoint, arguing for well-established guidelines to help prevent hospital falls, rather than resorting to restraints. A medical officer and senior adviser in the Center for Medicare and Medicaid stated that the non-payment policy on Medicare actually encourages doctors to use “best practices”, rather than forcing them to rely heavily on restraints to prevent hospital falls.