Medicare Penalizes 25 Hospitals For Readmissions, But Fines Lower Due To COVID

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Twenty-five Connecticut hospitals will lose some of their Medicare reimbursement payments starting this month as penalties for having too many readmitted patients. Still, in most cases, the fines are much lower than in previous years, new data from the Centers for Medicare and Medicaid Services (CMS) show. In this year’s evaluation, CMS considered the COVID-19 pandemic and its impact on hospitals, excluding data for the first half of 2020 and Medicare patients readmitted with pneumonia, according to a report in Kaiser Health News. Nationally, Medicare is penalizing 2,273 hospitals, the fewest since 2014, with an average payment reduction of 0.43%, Kaiser reported. In Connecticut, 69% of all hospitals in the program face fines, but most are under 1%.

Inspection Reports: Hospitals Cited For Infant Injuries, Wrong Site Surgeries, Dusty Operating Rooms

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Infant injuries, wrong-site surgeries, objects left in patients following procedures, and a health care worker hitting an “unruly” patient were among the incidents cited in hospital inspections conducted by the state Department of Public Health. The new reports cover state inspections that were completed in 2021 with approved hospital corrective action plans. At William Backus Hospital, a pregnant woman suffering from drug abuse disorder delivered a baby who tested positive for fentanyl and buprenorphine.  During the time that the baby was under observation for neonatal abstinence syndrome (drug withdrawal), a parent holding the infant fell and reported “that the infant’s head may have touched the ground a little,” the report said. Following the incident, staff determined that the baby suffered a head injury and was transferred to a higher-level hospital. The state inspector said that the hospital “failed to develop a safe plan of care for the infant to prevent a fall with injury.”

The Hospital for Central Connecticut was cited for failing to identify that an infant was assessed when forceps were used in labor and delivery, which resulted in head injuries to the infant.

Fines & Sanctions

Medicare Penalizes 26 CT Hospitals For High Readmission Rates

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Twenty-six Connecticut hospitals will lose some of their Medicare reimbursement payments over the next year as penalties for having too many readmitted patients, new data from the Centers for Medicare and Medicaid Services (CMS) show. Nationally, Medicare is reducing payments to 2,499 hospitals, about 47% of all facilities, with the average penalty being 0.64%, according to a report by Kaiser Health News (KHN). This year’s penalties were based on tracking patients from July 1, 2017 through Dec. 1, 2019, so the influx of patient care during the pandemic is not included, CMS said. In Connecticut, 72 % of all hospitals in the program will face a loss in CMS payments, beginning October 2021 through September 2022.

Hospitals’ ‘Team Effort’ Reduces Number Penalized For High Infection Rates, Injuries

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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.

Women's Health

Efforts To Reduce COVID-19’s Spread Could Impact Health Outcomes For New Mothers And Infants

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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.

Disparities

Health Care And Education Suffer When There’s No Internet Access

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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.

14 Hospitals Penalized For High Infection Rates, Injuries

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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.

Disparities

Whites Living In Midsize Cities Report Poor Health Compared To Counterparts In Urban Centers, Survey Shows

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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.

Disparities

Food Pantries Urged To Stock Nutritious Foods To Encourage Healthy Eating

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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.

Fines & Sanctions

14 Hospitals Penalized For Infection Rates, Injuries

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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.