Long-Term Care Survey Alert

Published on Fri Sep 26, 2008 PDF

CMS is also encouraging state Medicaid programs to adopt these.

Medicare won't pay the extra costs for these hospital-acquired conditions for patient discharges on or after Oct. 1, 2008:

• Stage 3 and 4 pressure ulcers;

• Falls and trauma;

• Surgical site infection after bariatric surgery for obesity, certain orthopedic procedures, and bypass surgery (mediastinitis);

• Vascular-catheter associated infection;

• Catheter-associated urinary tract infection;

• Administration of incompatible blood;

• Air embolism;

• Foreign object unintentionally retained after surgery;

• Deep vein thromboses and pulmonary emboli associated with knee and hip replacement;

• Certain manifestations of poor glycemic control.

The bottom line: "Medicare will no longer pay the higher MS-DRGs arising from these selected conditions if they arose in the course of an admission," states the Centers for Medicare & Medicaid Services in a recent letter to state Medicaid directors encouraging them to coordinate state Medicaid payment policies with Medicare's no-pay policy for never events.