Local hospitals penalized over patient safety

Posted at 6:12 AM, Dec 16, 2015
and last updated 2015-12-16 06:12:45-05

For a second year in a row, the federal government is tying hospital performance to payment, and nine local hospitals are paying the price.

“Whether this is a step in the right direction or whether it can significantly improve quality, it very much remains to be seen," said Max Mehlman, a professor of law and medicine and Case Western Reserve University.

Mehlman said the government's Hospital-Acquired Condition (HAC) Reduction Program, enacted under the Affordable Care Act, is the toughest sanction that Medicare has taken on hospital safety.

How it works is that hospitals with too many patient safety incidents lose one percent of their Medicare payment reimbursement over a fiscal year. That equals about $500,000.

“That may sound like a lot, and for some hospitals, it's not insignificant, but compared with the overall Medicare spending for hospitals, it’s a very small piece of that," said Mehlman.

Patient safety incidents include bed sores, blood clots, falls or any potentially avoidable infection or complication while in the hospital.

Out of the 758 hospitals penalized nationwide, nine are local: Akron General Medical Center, Summa Health Systems Hospitals, Samaritan Regional Health System, University Hospitals Ahuja Medical Center, Bellevue Hospital, Cleveland Clinic, Lutheran Hospital, MetoHealth System and St. Vincent Charity Medical Center

Mehlman said this is a starting tool to measure performance but it is a contentious policy as highest-quality hospitals tend to be penalized more often.

"Hospitals that measure these things more accurately, watch for these things more closely and therefore report them more completely and more accurately tend to be the ones that suffer this reduction in payment," he said.

The following hospitals sent a statement on the matter:

MetroHealth System:

Patient safety is our top priority and we are committed to continuous efforts in infection prevention.

Cleveland Clinic/Akron General Medical Center:

Cleveland Clinic health system is committed to continuous improvement in quality and safety. We identify and implement best practices for optimal outcomes, and work toward accurate documentation so measures used by CMS capture correct patient data. We fully support CMS reporting and transparency of quality and safety performance, designed to enhance patient care.

University Hospitals Ahuja Medical Center:

UH has an exceptional focus on quality and patient safety, led by the UH Quality Institute.

As a system, we are pleased with our overall performance; only one of our community hospitals was noted in the CMS/Medicare ranking.

It should be noted, the HAC program lags and does not reflect current performance.

It also is important to note that UH Case Medical Center is highly ranked in terms of quality and safety.

About 70 percent of large, urban, teaching hospitals reviewed by CMS were penalized by Medicare; UH Case Medical Center was not.  

This is the real story, and it speaks well to all the work our clinicians and especially our nurses have done to provide highest quality care in a safe environment.

Summa Health Systems Hospital:

Summa Health is aware of the data recently released by the Centers for Medicare and Medicaid Services and is reviewing the specifics of the report. Without question, a strong culture of safety is of paramount importance at Summa—as it should be at any hospital. Our leaders in Quality are dedicated to taking the necessary steps to ensure that this year’s numbers remain an isolated occurrence.

St. Vincent Charity Medical Center:

Patient safety remains a core focus for St. Vincent Charity Medical Center. Efforts around patient safety center on continuous improvement. We believe that our organization's efforts around patient safety have resulted in significant improvements since this data was reported.

Catheter Related Urinary Tract Infection (CAUTI) data in the report was from 07/01/12 through 06/30/14.  Our performance on this indicator was part of what caused us to be penalized. We have made improvement in the remainder of 2014 and 2015 with a focus on best practices for insertion and reassessing the patient’s Foley catheter daily to remove as soon as is no longer needed. We have reduced our infections significantly in 2015.

In the HAC Reduction Report, surgical site infections only include colon surgeries and hysterectomies. We have very low numbers of these procedures annually. Therefore, even one infection will cause our score to be high.

We were at the benchmark for PSI 90 for this report and continue to have an excellent score for that indicator.


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