documentation and coding recoupment adjustment required by the American Taxpayer Relief Act of 2012.

The patient safety field has primarily focused on improving safety in hospital and ambulatory settings. There were more than 1.6 million residents long-term acute care hospitals admissions among Medicare beneficiaries have more than doubled over the past 15 years. Preventable adverse events are common in long-term care. A 2014 report by the OIG found that 22% of Medicare beneficiaries in LTACH experienced an adverse event during their stay, half of which were preventable. Patients in long-term care settings may be particularly vulnerable to safety problems in the course of their care. Patients requiring care in long-term care facilities are disproportionately older and chronically ill, and they often enter long-term acute care after an acute hospitalization.

The Center for Medicare and Medicaid Services (CMS) Nursing Home Compare website allows patients and providers to compare long-term care facilities on various quality metrics, including measures of patient safety. CMS has proposed new revisions to long-term care facilities’ conditions of participation in the Medicare and Medicaid programs, which explicitly emphasize a focus on ensuring the quality of care for long-term care facility residents. AHRQ is funding research to examine the epidemiology of adverse events in long-term care settings and identify effective preventive strategies. AHRQ has also developed many resources to examine and address safety in long-term care, including training programs for staff.


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