Who’s Guarding Our Reproductive Rights In Hospital Mergers?

Officials at St. Mary’s Hospital and Waterbury Hospital began negotiations in 2011 to merge and join a Texas-owned company. But the state Permanent Commission on the Status of Women—with MergerWatch, a hospital watchdog group—successfully argued against the merger by making the case that since the new hospital would honor Catholic religious directives, a significant portion of patients would be left vulnerable—because God help you if you are a woman and need emergency reproductive services at a Roman Catholic hospital. Medical professionals at Catholic-owned or -sponsored hospitals operate under directives—known officially as the Ethical and Religious Directives for Catholic Health Care Services. These directives come from the United States Conference of Catholic Bishops and take 43 pages (plus footnotes) to describe what constitutes appropriate Catholic health care.

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Patient and gurney

18 State Hospitals Penalized For High Infection Rates

Eighteen Connecticut hospitals will lose 1 percent of their Medicare payments in 2016 as a penalty for comparatively high rates of avoidable infections and other complications, such as pressure sores and post-operative blood clots, according to new federal data. The Centers for Medicare & Medicaid Services (CMS) announced this month that 758 of the nation’s hospitals – about 23 percent of all eligible hospitals — would be penalized for patient safety lapses in the second year of the Hospital-Acquired Condition Reduction Program, which was mandated by federal health care reform. The penalties are based on rates of infections and other complications that occurred in hospitals between 2012 and 2014. The 18 hospitals in Connecticut include larger urban institutions, such as Yale-New Haven, Hartford and Bridgeport hospitals, and smaller hospitals, such as Manchester Memorial and Windham. They are among hospitals in the worst performing quartile nationally on patient-safety measures including the frequency of central-line and catheter-related infections, post-operative sepsis and accidental laceration.

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Surgeries on wrong body parts increased from 13 to 15 in 2014.

Fewer Errors Reported By Hospitals, But Concerns Remain

Connecticut hospitals reported fewer numbers of patients killed or seriously injured by falls or perforations during surgery or suffering from severe pressure ulcers in 2014 than in 2013, but the incidence of such “adverse events” still remains higher than in 2012, a new state report shows. The report by the Department of Public Health (DPH) shows that the total number of hospital adverse events, or errors, dropped by 12 percent — from 534 in 2013, to 471 last year. Deaths or serious injuries from falls declined from 90 to 78; perforations during surgical procedures fell from 79 to 70; and life-threatening medication errors fell from six to one. The number of patients with serious pressure ulcers dropped from 277 to 245. Rates of all four of those incidents had climbed in 2013, in part because of an expansion of required reporting on pressure sores to include “unstageable” ulcers.

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Doctor Fined For Unknowingly Removing Uterus Of Pregnant Woman

A prominent Waterbury gynecologist was fined $5,000 by the state Medical Examining Board Tuesday for mistakenly performing a laparoscopic hysterectomy on a patient who he did not know was pregnant, state records show. In January 2011, Dr. Jonathan Foster, who is also an obstetrician, failed to detect the patient’s pregnancy before the operation, according to a consent order he signed in July agreeing to the punishment. He also relied on the patient’s statement that she was not pregnant and failed to follow-up a urine pregnancy test with a blood test or ultrasound before operating, the order said. State records do not indicate how far along the pregnancy was. After the incident, Foster completed a course to maintain his certification in his specialty.

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Yale-New Haven was among the hospitals reporting a large increase in patient hospitalizations for mental health disorders.

Mental Health Is Main Cause Of Hospitalizations in CT, New Data Show

Mental disorders surpassed respiratory problems and all other ailments as the leading cause of hospitalization in Connecticut in 2012 for children ages 5 to 14, teenagers and younger adults, according to a new state health department report. The report shows that the number of days that patients with behavioral health problems were hospitalized surged 5.3 percent between 2011 and 2013, to nearly 260,000 patient days. Other categories of hospitalizations, including cardiac and cancer care, declined during that time. The data show five hospitals had increases of more than 12 percent in the number of days that patients with behavioral health problems were hospitalized. The biggest increases were at Yale-New Haven Hospital, which saw the number of patients rise 61 percent, and inpatient days jump 51 percent; and Waterbury Hospital, with 26 percent more patients and a 37 percent increase in inpatient days.

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Hospitals Required To Tell Patients Of Observation Care Status

Starting Wednesday, a new state law requires Connecticut hospitals to tell all patients when they are being kept in the hospital for observation instead of being admitted and to warn them about the financial consequences. Anyone who goes to the hospital can be placed on observation status, so that doctors can determine what’s wrong, and decide whether the patient is sick enough to be admitted or well enough to go home. Observation patients may receive diagnostic tests, medications, some treatment, and other outpatient services. Depending on their insurance, they can be charged a share of the cost. “They are in a regular hospital bed in a hospital room, getting a hospital level of care, and they have no way of knowing they were not admitted,” said Rep. Susan Johnson, a sponsor of the legislation and co-chair of the General Assembly’s Public Health Committee.

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Restraints

State Restrains Psychiatric Patients At High Rate

As the state works to improve its mental health system, new federal data show that hospitals in Connecticut restrain psychiatric patients at more than double the average national rate, with elderly patients facing restraint at a rate seven times the national average. In addition, the state lags behind in providing adequate post-discharge continuing care plans for psychiatric patients, especially teens and the elderly. Connecticut’s 28 inpatient psychiatric units and hospitals developed continuing-care plans for fewer than 70 percent of patients they discharged from October 2012 to March 2013 – indicating that thousands of patients may have left facilities without adequate treatment and medication plans. A C-HIT analysis of the federal data, released by the Centers for Medicare & Medicaid Services for the first time, show that Connecticut ranks in the top fourth of states (11th highest) in the use of physical restraints in inpatient psychiatric facilities – and is the third highest state in restraining patients 65 and older. Two psychiatric units – at Bridgeport Hospital and Masonicare Health Center in Wallingford – have the 10th and 12th highest rates of restraint use, respectively, among the 1,753 psychiatric facilities nationwide that are included in the federal reports, which cover October 2012 through March 2013.

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Yale-New Haven, St. Raphael's Campus.

Hospital Mergers Raise Concerns Over Patient Costs

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.

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Lee Barrows of Canton is suing Medicare to eliminate  'observation care' designation.

Seniors Sue Medicare To Close Nursing Home Coverage Gap

Roberta Baxter, a 78-year-old retired instructional assistant for the Killingly school system, dislocated her kneecap after a fall in her bathroom last September. Following treatment at a local hospital, she spent seven weeks at a nursing home for rehab so that she could walk again. While she was recovering, she and her husband Bill received the first of several bills from the nursing home.  That’s when the couple learned Medicare wouldn’t cover the $16,000 cost because Roberta didn’t spend at least three consecutive days in the hospital as admitted patient, or inpatient, as Medicare requires.  Instead, the four days she spent in the hospital was for “observation care.”

“I thought it was surely a mistake,” she said. “Nobody ever said I wasn’t admitted.”

Last Friday (5-3), lawyers representing 14 seniors, including 7 from Connecticut, appeared in U.S. District Court in Hartford to ask a judge to eliminate the observation care designation because it deprives Medicare beneficiaries of the full hospital coverage they’re entitled to under Medicare, including coverage for follow-up nursing home care. The judge did not rule on the case.  The Centers for Medicare & Medicaid Services (CMS), which runs the Medicare program, pays for doctor visits, hospitalization, nursing home care, prescription drugs and other benefits for nearly 50 million older or disabled Americans, including about 586,000 in Connecticut.

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