Corporate Compliance

OIG makes alleged adverse events recommendations

Compliance Monitor, November 9, 2011

The OIG has found that Medicare’s system of hospital oversight missed opportunities to address patient safety in response to alleged serious adverse events, according to a report released November 1.

These adverse events include medication and surgical errors, physical abuse by hospital staff, and patient suicide, according to the report.

The OIG reported on a random sample of immediate jeopardy (IJ) complaints which Medicare responded to as a proxy for alleged serious adverse events. Data from CMS, state agencies, hospital accreditors, and the hospitals associated with the complaints were also reviewed by the OIG. The findings revealed that state agencies and CMS often performed little long-term monitoring to verify that hospitals’ corrective actions resulted in sustained improvements. Corrective action generally consisted of training, policy, and process changes.

The OIG report recommends that CMS do the following:

  • Require that all IJ complaint surveys evaluate compliance with the quality assessment and performance improvement module (QAPI) condition of participation (CoP)
  • Ensure that state agencies monitor hospitals’ corrective actions for sustained improvements
  • Amend disclosure guidance to explain the nature of complaints to hospitals
  • Improve communication with accreditors

Read the full report on the OIG website.

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