Testimony to
The Commission on Affordable Housing and Health Facility
Needs for Seniors in the 21st Century
September 24, 2001
by
Joel Guerin
President
Tempur-Medical, Inc

Honorable co-chairs, commissioners, Mr. Holder, I want to congratulate you for traveling here today to continue your work on the important assignment you've been given by our elected leaders in Washington.

I'm Joel Guerin, the President of Tempur-Medical. I am grateful for your decision to recognize me, and to listen to Tempur-Medical's ongoing success story.

Ensuring that health care facilities are providing the best possible care to older Americans is a noble and essential mission we share with you.

We at Tempur-Medical discovered years ago that our mattresses, made from a special foam formulation originally developed by nasa, had characteristics that distributed pressure over the average human body so effectively that it minimized the formation of pressure ulcers, or bed sores. These wounds, which are frequently predictable and usually preventable, are the result of the breakdown of a bedridden or immoble patient's skin. They inflict almost unimaginable suffering on the weak and vulnerable.

Here are some related facts:

• They cost the healthcare system an estimated $5 billion dollars or more per year. There are a million new ucers formed annually in this country.
• Pressure ulcers are a critical element in as many as 17,000 lawsuits claiming neglect each year, helping generate awards as high as $300 million.
• A well-respected nursing organization estimates there are 60,000 or more deaths per year directly attributed to pressure ulcers.

Of course, the know-how exists to prevent this costly scourge on senior citizens. Why, then, is our health care system letting so many health care recipients and their families down, and why is this problem important to the work of this committee?

Tempur-Medical's experience is that the problem is the result of a lack of accountability among the suppliers to those who actually deliver health care. In the late 1990s payments to nursing homes followed hospitals and were capitated under prospective payment. Unfortunately, all of their suppliers - my industry - were not. To this day, the more product or service a typical supplier can convince a provider to consume, the more that supplier can bill.

What's wrong with this system? A great deal. First and foremost, quality of care becomes a secondary consideration. Unfortunately, to this day, anyone, even with inferior product but good selling techniques, can still prosper simply by selling "things" without true accountability for the costs or clinical consequences of their actions.

What is our solution? We become an actual partner in the provision of care, and maintain a stake in the patients well-being. Our program, known as the "tempur-medical ultimate skin management program," or tusmap, creates a supplier-provider partnership that focuses on achiving positive outcomes. We do this by offering a fixed price for the delivery of all skin management and wound treatment products, protocols, staff training, and consultations. By focusing on how well our program works, rather than on how much product we can move, we not only improve outcomes for patients, but reduce wasted resources, including valuable staff time.

In order to keep everyone, including ourselves, focused on quality outcomes, we offer our clients an indemnity whereby we must reimburse them the first quarter of a million dollars of the costs of any judgement or settlement that results from litigation where pressure ulcers are a meaningful component.

Tusmap has faced the strictest scrutiny and review. It has received a favorable ruling from the HHS office of the inspector general. It has produced solid results in the best test of all - implementation in the real world with nursing home providers.

Our program forces us to focus on quality of care, not product. It forces us to be accountable, not just to our bottom line, but also to the residents who are the ultimate recipients of our goods and services. And most of all, it holds us accountable for the liability exposure generated through the use of those goods and services. The ultimate test of whether or not we deserve to stay in business is how much healthcare value we really provide, not how much product we deliver.

Tempur-Medical is a leader and an innovator that is helping senior citizens by creating a lasting paradigm shift in healthcare delivery. Through our tusmap program, the average nursing home in this country can obtain an incidence rate of pressure ulcer development of less than 1%, instead of the current averages ranging from 6% to over 20%, and all without congress enacting new laws or appropriating substantial new funding, and without new regulations from HHS and CMS. That said, we believe the government and this commission can do much to recognize and support positive change and new thinking in health care, particularly when it benefits our seniors. We offer our program as an example of the improvement that can result.

That was my message to Secretary Tommy Thompson when I met with him in his office over the summer. And, today it is my message to you. Thank you for the chance to deliver it, and to participate in this hearing.