Never Events refer to the preventable care complications that the CMS announced that they would no longer be reimbursed via the federal payor programs. The CMS rules necessitated several changes in the care delivery models in the inpatient models. The first shift pertains to payment of complications that may arise in the process of receiving care. Before the rules, the federal payor programs would compensate the affected persons; however, the rules shifted the liability to the person providing care (Leonardi, Faller & Siroky, 2018). Hence, professionals in the facilities are required to take precaution to avoid liability in case patients suffer from preventable conditions. Secondly, in-patient facilities are increasingly implementing measures to minimize infections, injuries, or other complications that occur during hospital stays as the rules are focused on enhancing the quality of care that patients while hospitalized (O’Rourke & Hershey, 2009). The outlined never events that the facilities focus on include case management, medical products, and surgical events. Moreover, the rules have created the need for professionals in the facilities to clearly understand and adhere to the evidence-based guidelines that minimize complications affecting patients within the inpatient facilities (CastLight Health, 2018). The rules have made it nearly compulsory for professionals in the facilities to familiarize themselves with the complications that CMS is likely to deny reimbursement, and ensure regular review of the existing guidelines so as to establish the practices that eliminate or minimize the stated complications. As a result, the facilities are investing more on programs that allow for practice re-evaluation and update whenever new information emerges. One of the strategies that the facilities have adopted is implementing consistent systems for responding to and evaluating complications ( Austin & Pronovost, 2015) . The systems help the professionals to avoid liability in case complications arise despite a patient receiving the best care, whereby in such cases, the facility engages a lawyer to argue the case so that CMS can support reimbursement by the federal payor programs.
References
Austin, J. M., & Pronovost, P. J. (2015). “Never events” and the quest to reduce preventable harm. Joint Commission journal on quality and patient safety , 41 (6), 279-288.
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CastLight Health. (2018). Never events data by hospital on nationally standardized metrics. Retrieved from http://www.leapfroggroup.org/sites/default/files/Files/Castlight-Leapfrog_Never_Events_Final.pdf
Leonardi, B., Faller, M., & Siroky, K. (2018). Preventing Never Events Evidence Based Nurse Staffing [Ebook]. AMN Healthcare. Retrieved from https://www.amnhealthcare.com/uploadedFiles/MainSite/Content/Healthcare_Industry_Insights/Healthcare_News/Never_Events_white_paper_06.16.11.pdf
O’Rourke, P., & Hershey, K. (2009). Never-Event Implications. Retrieved from https://www.the-hospitalist.org/hospitalist/article/124081/never-event-implications
