But They Meant Well

(Image from verywell.com)

Staying in bed doesn't help recuperation; in fact, immobility harms: [bold added]

Numerous studies have shown that immobility increases the likelihood of muscle atrophy, blood clots, bed scores and delirium. For elderly or very sick patients, the danger is even greater: Being immobilized even for a few days can lead to a permanent functional decline, making it more difficult for patients to return home.

Why then, don't hospitals encourage mobility? Because hospitals are penalized for falls.

CMS [Centers for Medicare and Medicaid Services] may have inadvertently exacerbated the immobility problem in 2008 when it stopped reimbursing for fall-related injuries having decided that patients should “never” fall within a hospital. Two years later, the Affordable Care Act began financially penalizing hospitals with high fall rates.

...hospital administrators, focusing on reducing the number of falls, put pressure on nursing staff. The units and nurses under the most pressure ended up confining patients to beds or chairs and sometimes even monitored patients while they were on the toilet, lest they or their unit be seen as negligent.

The people who administer Medicare, Medicaid, and ACA meant well by trying to reduce patients' falls and instituted penalties into the compensation system in 2010.

But if the system is found to hurt rather than help, why does it take so long to change?