Six Connecticut hospitals will lose 1% of their Medicare reimbursements this fiscal year under a federal program that levies penalties for high rates of hospital-acquired injuries and infections. It’s the lowest number of hospitals penalized since the program began leveling funding cuts in 2015, data from the Centers for Medicare & Medicaid Services (CMS) show. The hospitals are among 774 nationwide that will lose funding under the Hospital-Acquired Conditions Reduction Program, according to a Kaiser Health News analysis. The program was created by the Affordable Care Act. When assessing hospitals, the government examines how many infections and other potentially avoidable complications patients suffered – things like blood clots, sepsis, bedsores and hip fractures.
Felicia Tambascio’s first pregnancy was going fairly smoothly. But on July 20, at week 38, the 20-year-old Brookfield resident woke with horrible upper abdominal cramps, a searing headache, and vomiting. Her boyfriend took her to the hospital, but Tambascio was left to wait in a hallway alone. Per COVID-19 restrictions, no visitors were allowed unless the patient was admitted to labor and delivery. After it was discovered that Tambascio was suffering from the life-threatening condition preeclampsia, she was escorted to the labor and delivery ward and induced.
With no Wi-Fi or reliable internet access during the COVID-19 pandemic, Susana Encarnacion of New London had some trouble during doctors’ appointments for her 9-year-old son, Jeremiah, who has asthma and attention deficit disorder. The stay-at-home mother, who moved to New London from the Dominican Republic 16 years ago, said she and her husband used to have Wi-Fi, but it became too expensive. Phone appointments worked fine, but video doctor visits with only a phone hotspot often weren’t reliable. “There were issues with losing a connection in the middle of appointments,’’ she said in Spanish through an interpreter from the Hispanic Alliance of Southeastern Connecticut. This summer, Gov. Ned Lamont and philanthropists have focused attention on Connecticut’s digital divide in access to online education.
Fourteen Connecticut hospitals are being penalized by the Centers for Medicare & Medicaid Services (CMS), losing 1% of their Medicare reimbursements this fiscal year for having high rates of hospital-acquired infections and injuries, new data show. The hospitals are among 786 nationwide being penalized under the Hospital-Acquired Conditions Reduction Program, which was created under the Affordable Care Act, according to a Kaiser Health News (KHN) analysis. The program is in its sixth year and the latest Medicare reimbursement penalties are for the current fiscal year, which began in October 2019 and runs through September. When assessing penalties, CMS considers the number of infections, blood clots, sepsis cases, pressure ulcers, and other complications that may have been prevented. The 14 hospitals losing 1% of their Medicare reimbursements are: Waterbury Hospital, Stamford Hospital, Lawrence + Memorial Hospital in New London, Johnson Memorial Hospital in Stafford Springs, Charlotte Hungerford Hospital in Torrington, Midstate Medical Center in Meriden, Middlesex Hospital, and Windham Community Memorial Hospital & Hatch Hospital in Willimantic.
In West Haven, 24% of white residents reported their health as fair or poor, a rate worse than whites statewide and in New Haven. Fifty miles east, 19% of white New London residents reported feeling depressed or hopeless, higher numbers than statewide and in Bridgeport. And 39% of white New Britain residents reported that financially, they were just getting by or were worse off. That’s higher than in Hartford and statewide. A C-HIT analysis of the results from the recent DataHaven Community Wellbeing Survey found that residents in a number of midsize, blue-collar cities reported lower health ratings than residents of the state’s largest cities.
People struggling with hunger suffer from a disproportionate number of chronic illnesses and often rely on food pantries for their groceries. So, pantries are now being urged to undergo a sea change and abandon their traditional emphasis on calories and nonperishable items in favor of more nutritional food. In Connecticut, 440,000 people are food insecure, which means they have limited or uncertain access to sufficient nutritious food, according to 2017 U.S. Department of Agriculture figures, the latest available. They comprise 12.2 percent of the state’s population.People with food insecurity are 25 percent more likely to have heart disease and diabetes, and 50 percent more likely to have kidney disease, cites Feeding America, a national food bank network. “These issues can be prevented or managed better with a proper diet rich in fresh fruits and vegetables, lean meats and whole grains,” said Michelle Lapine McCabe, director of the Center for Food Equity and Economic Development, based in Bridgeport.
Nearly half of Connecticut hospitals – 14 out of 31 – will lose a portion of their Medicare payments in 2017 as a penalty for having too many patients who acquired preventable infections and injuries while hospitalized. The hospitals are among 769 nationwide that will lose one percent of their Medicare reimbursements this year as part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program. The CMS program, now in its third year, penalizes the lowest-performing hospitals where a relatively high number of patients got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also takes into account patients who suffered from blood clots, bed sores or falls while hospitalized. New this year, CMS also factored in the incidents where antibiotic-resistant bacteria – namely, methicillin-resistant staphylococcus aureus (MRSA) and Clostridium difficile (C.
The state Medical Examining Board fined a New London obstetrician $5,000 Tuesday for mistakenly cutting ligaments on the sides of a woman’s uterus instead of the fallopian tubes during a tubal ligation. The board also imposed a year of probation on the medical license of Dr. Jeffrey Simpson, who made the error on March 28, 2013 at Lawrence & Memorial Hospital in New London. Simpson did not contest the findings of the medical board and signed a consent order agreeing to the penalty on Oct. 24 of this year. Simpson also agreed to hire a physician to randomly review a portion of his patient records for surgeries he performed, the consent order said.
Hospital administrators in Connecticut who have been involved in the unprecedented streak of mergers and consolidations often tout the financial benefits and efficiencies of such moves. But as the number of independent hospitals in the state dwindles – with more than half of the 29 acute-care hospitals now operating in networks with other hospitals or out-of-state partners – experts and advocates worry that the consolidations will reduce competition in the market and give hospitals more leverage to raise prices. Adding to their concerns is a proposal by a private company to convert four non-profit hospitals to for-profit entities. Several studies, as well as data from the federal Medicare program, suggest that mergers and for-profit conversions may lead to higher prices. But the state has yet to study the impact of mergers on patient pricing, and has no requirement that hospitals try to hold patient charges steady after a merger or conversion. The state also has no comprehensive blueprint guiding hospital configuration or limiting the number of takeovers or networks it will allow.
As a practitioner at Yale-New Haven Hospital, Dr. Leora Horwitz has seen her share of patients who misunderstand medication changes made during their hospital stays. Just recently, one of her female patients, who was switched to a new beta blocker for high blood pressure during an inpatient stay, landed back in the hospital after discharge because she had taken both the new medication and her old beta blocker – a combination that lowered her heart rate and blood pressure to dangerous levels. “Every physician can tell you about these kinds of errors,” Horwitz said. “We do a relatively poor job of educating patients about their medications.”
As a researcher, Horwitz can now quantify those lapses. A recent study she led looked at 377 patients at Yale-New Haven Hospital, ages 64 and older, who had been admitted with heart failure, acute coronary syndrome or pneumonia, then discharged to home. Of that group, 307 patients – or 81 percent — either experienced a provider error in their discharge medications or had no understanding of at least one intended medication change.