Most Connecticut hospitals will lose a percentage of their Medicare reimbursement payments over the next year as penalties for having high rates of readmitted patients, according to new data from the Centers for Medicare and Medicaid Services (CMS). Statewide, 26 of the 29 hospitals evaluated – 90 percent – will have their reimbursements reduced, by varying amounts, in the 2020 fiscal year that began Oct. 1, according to a Kaiser Health News analysis of data from CMS.
CMS began in the 2013 fiscal year to penalize hospitals that have high rates of patients who are readmitted within one month of being discharged. The penalties were enacted as part of the Affordable Care Act, intended to encourage better health care delivery. Nationwide, 2,583 hospitals will be penalized this year, according to Kaiser Health News.
Getting to the hospital quickly after suffering a stroke improves your chances of survival, but in Connecticut there are areas where access to the top level of stroke care is limited, health experts say. Two hospitals, Yale New Haven Hospital’s main campus and Hartford Hospital, are nationally certified as Comprehensive Stroke Care Centers, providing the highest level of stroke care available, which includes 24-hour access to neurological practitioners and the ability to perform complex endovascular therapies, including thrombectomies and endovascular coiling of an aneurysm, among other surgeries. Yale and Hartford hospitals are two of only 178 certified nationally as comprehensive stroke centers, according to The Joint Commission, which certifies hospitals. But when time is critical, traveling to New Haven or Hartford can be a risky commute from the northwestern and northeastern parts and other parts of the state, where hospitals certified in stroke care are sparse. In all, the state has 23 hospitals that are certified in some level of stroke care, up from 16 in 2013.
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.
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.
The state Board of Examiners for Nursing this week disciplined three nurses, including suspending the license of a Stamford Hospital nurse accused of stealing Dilaudid meant for 21 patients. The registered nurse, Kerrisha Stacy-Ann Hurd of Elmont, New York, took the painkillers meant for the patients but did not administer the doses to them between January and March while she worked in the Post Anesthesia Care Unit of the hospital, state records show. In March, she fainted while on the job, and a syringe with a bloody needle was found in her uniform pocket, records show. Then on April 26, she admitted that she gave herself a shot of Dilaudid while working, records show. She was taken to the emergency room and tested positive for opiates, records show.
In May 2017, Maura B. Gallagher entered Stamford Hospital for a Cesarean section for her unborn fraternal twins. According to a lawsuit filed by her family, Gallagher was 38 and an avid skier who was dedicated to her family, which included her fiancé, Max Di Dodo. There were signs that her pregnancy was challenging. At a little over 37 weeks, Gallagher, of New Canaan, showed signs of a low platelet count. The condition, known as thrombocytopenia, affects 7 to 12 percent of pregnant women.
As fertility rates fall nationwide, Connecticut continues to rank among the lowest in the country—a trend doctors attribute to women here delaying childbearing. In 2016, the most recent year for which state-level data is available, Connecticut had 53.4 births per 1,000 women ages 15 to 44, compared with a national average of 62 per 1,000 women, according to data from the Centers for Disease Control and Prevention (CDC). Just four states had lower rates than Connecticut in 2016, and all are in New England: Vermont at 50.3 births per 1,000 women, New Hampshire at 50.9, Rhode Island at 51.8 and Massachusetts at 51.9. The states with the highest fertility rates in 2016 were South Dakota at 77.7, North Dakota at 77.3, Utah at 76.2 and Alaska at 76.1, the CDC reports. Unlike birth rates, which take an entire population into account, fertility rates reflect the share of babies born to women of childbearing age. Connecticut typically ranks low on the list, along with other “high achievement, high education states,” said Dr. Harold J. Sauer, chairman of obstetrics and gynecology at Yale New Haven Health’s Bridgeport Hospital.
Depression is the leading cause of disability worldwide, according to the World Health Organization, and affects women at about twice the rate that it does men. In Connecticut, 21.4 percent of women report experiencing depression, compared with 13.4 percent of men, according to 2015 Department of Public Health data. Millennial women in the state experience depression four more days in an average month than their male counterparts, the Status of Women data project reported this year. Women are more likely to use mental health services than men, but studies consistently show that the majority of Americans with depression go untreated. In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses depression and pathways to better mental health with Yale’s Carolyn Mazure, and NYTimes best-selling author Luanne Rice.
Connecticut consumers were billed for more than $1 billion in facility fees for outpatient services in 2015 and 2016, documents filed with the state Office of Health Care Access (OHCA) show. Twenty-two of Connecticut’s 30 hospitals charged these fees, bringing in $600.7 million in 2015 and another $488.8 million in 2016, according to an analysis by Conn. Health I-Team. The state’s two largest hospital systems, Yale New Haven Health and Hartford HealthCare, accounted for almost half of the total facility fee revenue in 2016. Yale and its four hospitals billed $144.3 million; Hartford and its five hospitals, $80.9 million.