The racial disparity between white and black cancer patients in accessing timely treatments has virtually disappeared in states where Medicaid expanded under the Affordable Care Act (ACA), according to a new study. Yale Cancer Center researchers analyzed more than 30,000 health records and found that, prior to Medicaid expansion, black adults with advanced or metastatic cancer were 4.8 percentage points less likely than white adults to begin treatments within 30 days of being diagnosed. But in states where Medicaid was expanded, in 2014 or later, the percentage of black patients getting timely treatment rose from 43.5 percent to 49.6 percent. There also was a small improvement in expansion states among white patients receiving timely treatment – from 48.3 percent to 50.3 percent – bringing the post-expansion difference between the two racial groups to less than one percentage point. “Our results suggest that Medicaid expansion led to improved health equity,” said study author Amy Davidoff, a senior research scientist at Yale School of Public Health and in Yale Cancer Center’s Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER).
Four nursing homes have been fined by the state Department of Public Health (DPH) for violations that hurt or endangered residents. The Springs at Watermark 3030 Park in Bridgeport was fined $6,960 after a resident fell onto the floor when being moved from a bed to a wheelchair by two nurse aides. The resident suffered a broken right tibia and fibula in the fall, which happened May 4, 2018, according to DPH. An investigation found the nurse aides were using a Hoyer lift to help with the transfer, as outlined in the resident’s care plan, but the resident slid out of the lift pad. The pad was “bunched up” and had been incorrectly put above the resident’s head when it should have been placed at the base of the resident’s neck, according to the citation.
Five nursing homes have been fined by the state, including a facility in Westport where money was taken from residents’ trust funds. Westport Rehabilitation Complex was fined $8,120 following the discovery of the thefts and another incident in which a resident was injured. An investigation found that 20 residents had money missing from their resident trust funds and a facility business office manager was responsible, according to the Department of Public Health (DPH). In total, $3,161 was taken from the residents’ accounts. According to the citation, the missing funds were discovered in November 2018 when an employee alerted the facility’s administrator of “concerns regarding the facility-managed residents’ trust funds.” Several withdrawal documents appeared to have been altered with Wite-Out.
Six nursing homes have been fined by the state Department of Public Health (DPH) for various violations in which residents were injured or endangered. Masonicare Health Center in Wallingford was fined $7,800 after a resident with dementia fell from an X-ray table to the floor. The resident fell on Aug. 22, 2018, and suffered a head laceration that required five sutures, according to DPH. A registered nurse had asked the X-ray technician whether straps should be used to secure the resident to the table, but the technician said none were available.
Fifteen Connecticut hospitals will lose 1 percent of their Medicare reimbursements this fiscal year as penalties for having relatively high rates of hospital-acquired conditions, data from the Centers for Medicare & Medicaid Services (CMS) show. The hospitals are among 800 nationwide being penalized – the highest number since the federal Hospital Acquired Conditions Reduction Program started five years ago, according to a Kaiser Health News (KHN) analysis of the CMS data. The penalties will be levied during the current fiscal year, which began in October 2018 and runs through September. Under the program, which was created by the Affordable Care Act, the government levies penalties based on hospitals’ rates of infection related to colon surgeries, hysterectomies, urinary tract catheters and central lines inserted into veins. It also reviews infection rates for Methicillin-resistant Staphylococcus aureus, or MRSA, and Clostridium difficile, known as C. diff, as well as rates of blood clots, sepsis, post-surgery wounds, bedsores and hip fractures, among other injuries.
Six nursing homes have been fined by the state Department of Public Health (DPH) for violations that resulted in residents being endangered or injured. Noble Horizons in Salisbury was fined $6,660 for incidents related to elopement risks. On Sept. 23, 2018, a resident with dementia left the facility when a WanderGuard sensor malfunctioned. A driver in a pickup truck found the resident walking down the facility’s driveway.
Five Connecticut nursing homes have been fined by the state Department of Public Health (DPH) for various violations, including several instances in which equipment wasn’t properly cleaned. In one citation, Apple Rehab Saybrook was fined $10,000 for two violations. On Sept. 4, 2018, two licensed practical nurses (LPNs) failed to properly clean and sterilize glucometers after drawing blood from multiple diabetic residents. One LPN who took blood from two residents and another who drew blood from four residents cleaned glucometers with alcohol wipes instead of germicidal wipes, the citation said.
Five Connecticut nursing homes have been fined by the state Department of Public Health (DPH) following lapses in care, including one incident after which a resident died. Jewish Senior Services of Bridgeport was fined $3,060 after a resident with multiple sclerosis died after falling from a bed onto the floor. On June 12, 2018, a registered nurse was applying protective dressings to the resident’s coccyx, turned away to dispose of the dressing wrappers and, when she turned back toward the resident, saw the resident was starting to fall, according to the citation. The RN tried to stop the fall but couldn’t. The RN had moved the patient without help, even though the resident’s care plan called for two-staff assistance with mobility, according to the citation.
Connecticut hospitals reported increases in patients suffering from pressure ulcers, as well as serious injuries or deaths associated with falls and burns in 2017, compared to 2016, according to a new state report. Overall, the total number of “adverse events” reported by hospitals dropped from 431 in 2016 to 351 in 2017, a 19 percent decline, the Department of Public Health (DPH) said. But most of the decline was due to the elimination of two categories in 2017: serious injuries or death resulting from perforations during open, laparoscopic or endoscopic procedures; and those resulting from surgeries. Together those categories accounted for 72 adverse events in 2016. The reporting requirement for the two categories was eliminated after a work group of the Quality in Health Care Advisory Committee concluded that the vast majority of perforations that occur during some procedures aren’t preventable, and that serious injuries or death resulting from surgery are already better captured by other categories, the DPH report said.
Stamford Hospital has been fined $55,000 by the state for allowing a phlebotomist to draw blood at a Southington facility before obtaining a certificate of approval to operate. A state Department of Public Health (DPH) inspection at Feel Well Health Center in Southington on or around Jan. 26 found that a phlebotomist who had contracted with Boston Heart Diagnostics in Massachusetts was conducting venipuncture, or puncturing a patient’s vein to draw blood, before Stamford Hospital obtained the necessary written certificate to operate the blood collection facility, according to a consent order signed Sept. 7 by the hospital and DPH. The phlebotomist was collecting and sending specimens to Boston Heart for laboratory analysis and was being paid by Boston Heart to do so, the consent order said.