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Present-On-Admission Indicators

HealthLeaders magazine, October 13, 2008

Present-On-Admission Indicators

The Centers for Medicare & Medicaid Services has proposed expanding the list of conditions that are reasonably preventable through proper care and for which CMS will no longer pay at a higher rate if the patient acquires them during a hospital stay. Such conditions—including ventilator-associated pneumonia, deep vein thrombosis, certain surgical site infections, and others—can add considerable costs to medical care and result in significant deaths. One study estimates that under CMS rule changes regarding five preventable conditions, the total estimated reimbursement amount for all patients nationwide will be roughly $91 million for fiscal year 2009—an average decline per hospital of more than $23,000. Provider organizations clearly have much at stake as they develop processes for documenting conditions as present on admission.