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.