California Hospital Pressure Ulcers

The prevalence of hospital-acquired pressure ulcers ranges from 3.5 percent to 29.5 percent.¹ Patients who develop pressure ulcers in the hospital are at greater risk for other medical problems—including infection—which can result in longer hospital stays. As part of the federal Deficit Reduction Act of 2005, the Centers for Medicare & Medicaid Services (CMS) has implemented a policy effective October 1, 2008, whereby hospitals will no longer receive additional reimbursement for care related to eight conditions, including stage 3 and 4 pressure ulcers, that occur during the incident hospitalization. These so called "never events" are the beginning of a campaign by CMS to mandate value in patient care as part of the reimbursement equation.

The eight "never events" include:

• Object inadvertently left in after surgery
• Air embolism
• Blood incompatibility
• Cather associated urinary tract infection
• Pressure ulcer (stage 3 and 4)
• Vascular catheter associated infection
• Surgical site infection – Mediastinitis (infection in the chest) after coronary artery bypass graft surgery
• Certain types of falls and trauma

HSAG will work with participating hospitals to implement evidence-based care processes that promote prevention and better management of pressure ulcers. This approach is in alignment with the CMS Hospital-Acquired Conditions and Present-on-Admission Indicator Reporting initiative.

1. Stewart S, Box-Panksepp J. Preventing Hospital-acquired Pressure Ulcers: A Point Prevalence Study. Ostomy Wound Management. Volume 50, Issue 3. Available at http://www.o-wm.com/article/2385. Accessed on June 14, 2009.