This document discusses the costs of nursing home wound care. It outlines five key costs: staffing/nursing costs, education/training, reputation impacts, resident morbidity/mortality, and supplies/medications. Modern dressings and algorithms can improve outcomes and lower costs by reducing healing times. An external wound care specialist can help lower costs by improving healing rates from 116 to 48 days on average, decreasing supply costs, and relieving burdened nursing staff. They provide wound care management and education to help facilities.

1. Steven Miller M.D.Steven Miller M.D.
Medical DirectorMedical Director
Advanced Wound Care Solutions Inc.Advanced Wound Care Solutions Inc.
The Costs OfThe Costs Of
Nursing HomeNursing Home
Wound CareWound Care

2. Five Clear Costs Of WoundFive Clear Costs Of Wound
CareCare
 Staffing and Nursing Costs
 Wound Care Education and Training of
Staff
 Cost of Reputation to State Inspectors
and Hospital Discharge Planners
 Resident Morbidity and Mortality
 Wound Care Supplies and Medications

3. Keys To Cost EffectiveKeys To Cost Effective
Wound CareWound Care
1) Prevent all wounds if possible
2) Prevent progression to Stage III
and Stage IV
3) Optimize modern wound care
dressings
4) Use wound care algorithms

4. Cost of Wound Care andCost of Wound Care and
Wound StagingWound Staging
Projected Costs for Average Pressure
Ulcer
Stage I ?
Stage II $443/ulcer in 1990’s
Stage III $700/ulcer in 1990’s
Stage IV $700/ulcer in 1990’s
These numbers exclude cost of hospitalization
and pressure management- ie. support surfaces
and patient repositioning. When hospital costs
were included total cost increased by 400%.
Mean cost of pressure management was $550 per
patient.

5. Cost of Wound Care andCost of Wound Care and
Wound StagingWound Staging
Projected Healing Times for Average Pressure
Ulcer
Stage I 2-14 Days
Stage II 7-45 Days
Stage III 90 Days
Stage IV 120 Days

6. Cost of Wound CareCost of Wound Care
According to one study of 30 long-term
care facility patients with 45 ulcers the
average length of treatment was 116
days. The average cost per ulcer was
$2,731 including hospitalizations for
complications and $489 excluding
hospitalizations.
Xakellis, GC. Frantz, R. Adv Wound Care 1996

7. Cost of Wound CareCost of Wound Care
In a recent study by Takehiko Ohura MD et al in
Wounds June 2004 it was concluded that clinical
outcomes improved with using modern
dressings such as Duoderm and Aquacel rather
than traditional dressings. It was also noted that
labor costs were significantly higher
than material costs. The study concluded
that the higher cost of modern dressings
when used in a proven and validated
algorithm can reduce costs and
improve outcomes and improve the
cost effectiveness of wound care.

8. Cost Savings Occur WhenCost Savings Occur When
Healing Rates ImproveHealing Rates Improve
Our average healing time for
pressure ulcers is 48 days
rather than 116 days. This is a
59% reduction.
(This is approximately 70% Stage III and Stage IV
wounds that can take 90 or 120 days to heal.)

9. 1) Staffing and Nursing1) Staffing and Nursing
Costs Of Wound CareCosts Of Wound Care
 Costs of educating nurses in wound care
 Cost of wound care planning and
communication
 Cost of nursing home wound care
meetings
 Cost of overworked staff
 Cost of weeks and months of dressing
changes

10. 2) Wound Care Education2) Wound Care Education
and Training of Staffand Training of Staff
 Wound care science and practice is
rapidly changing
 Changes in staffing require constant
monitoring and training of new staff’s
wound care knowledge
 Nurses, NP’s, and staff physician’s
have limited knowledge of constant
advances in wound care

11. 3) Cost of Reputation to3) Cost of Reputation to
State Inspectors andState Inspectors and
Hospital Discharge PlannersHospital Discharge Planners
 “When I see that a facility has brought in
an outside wound care specialist it makes
me believe that they are on top of things.”
- Local State Inspector
 Expert wound care can be an excellent
advertisement to Hospital Discharge
Planners
 Expert wound care can be an excellent
advertisement to physicians and the
community

12. 4) Patient Costs & Morbidity4) Patient Costs & Morbidity
 Cost of unhappy residents from preventable
wounds
 Depression
 Daily dressing changes for weeks or months
 Painful dressing changes
 Chronic pain at the wound site

13. 4) Patient Morbidity And4) Patient Morbidity And
MortalityMortality
 Early death
 Amputations and surgeries
 Sepsis and hospitalizations

14. 5) Wound Care Supplies,5) Wound Care Supplies,
Medications, and OtherMedications, and Other
CostsCosts
 Dressing and Supply Costs
 Labor Costs
 Complication Costs
 Pressure Management Costs

15. What Can AWCS Do ToWhat Can AWCS Do To
Help?Help?
1) Shorten length of treatment for wounds. Our
average healing time is 48 days rather than 116
days. This is a 59% reduction.
2) Decrease costs from average of $489/pressure
ulcer (according to 1990’s data)
3) Improve patient morbidity and patient
satisfaction
4) Relieve overworked nurses and decrease staff
turnover
5) Provide 2-3 dressing changes per week per
patient.
6) Develop your reputation for top quality wound
care
7) Improve wound percentages for state
inspection

16. When To Refer PatientsWhen To Refer Patients
 All Stage II or greater ulcers
 When a patient develops more than a
Stage I ulcer
 Sudden worsening of a wound
 When ordered by Primary Care
Physician
Ask us about Wound Care Contracts for
managing all wounds in your facility!

17. Our StrengthsOur Strengths
EducationEducation
& Service& Service
Expert Consults
& Liability
FrequentPatientVisits
StaffIn-Services
CostCost
SavingsSavings
Im
prove
HealingRates
Reputation
Patient
Satisfaction
Supply
Costs
Nursing
Costs
ExperienceExperience
Physician
Staffing
NP’s&PA’s
Expert W
ound
Care Training Worry Free
Wound Care