Various violations that jeopardized patient safety, including two that preceded patient deaths and several involving the improper use of restraints, have taken place at Connecticut hospitals, according to the most recent hospital inspection reports released by the state Department of Public Health (DPH). The reports, which can be found in C-HIT’s Data Mine section, cover inspections that took place at hospitals between 2016 and this year. Some of the violations resulted in injuries to patients, while others showed lapses in protocols and procedures. Bridgeport Hospital was cited for 26 violations, including an incident in which a patient with a diagnosis of an ovarian mass suffered a burn during surgery. Hartford Hospital was cited for 60 violations, including two violations that preceded patient deaths.
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.
Connecticut’s acute-care hospitals saw gains from their operations tumble 35 percent in the last fiscal year, with seven of 29 hospitals reporting operating losses, according to a new state report. While hospitals still ended the year with $597 million in profits overall, the report by the state Office of Health Care Access (OHCA) raises concerns that non-operating revenue, such as income from investments, was masking the decline in operating revenue. “While hospitals’ operational financial performance weakened in FY 2013, they continued to generate significant non-operating gains, helping to keep overall hospital financial performance strong,” the report says. “However, a robust financial picture should rely more on patient and other operating revenues, and not on a less than reliable income source, such as investment performance.”
Hospitals’ profits from operations dropped to $333.6 million, from $513.5 million in the 2012 fiscal year. At the same time, hospitals earned $70 million more from investments, charitable contributions and other sources of revenue.
More than two-thirds of Connecticut hospitals will face Medicare penalties for lagging clinical-care measures in the fiscal year that began Oct. 1, with smaller hospitals including Johnson Memorial, Windham and New Milford losing the highest percentage of reimbursement. The penalties, under a federal program known as Value-Based Purchasing, average .26 percent nationally, with Connecticut’s hospitals losing an average of .23 percent, according to federal data compiled by Kaiser Health News. None of the state’s hospitals will lose the maximum possible penalty, 1.25 percent of funding, federal data shows. Johnson Memorial and Windham are the only two hospitals that will lose more than .5 percent of their Medicare payments – up slightly from the penalties they faced last year.
In more than half of Connecticut’s emergency rooms, the waiting time to see a health-care provider exceeds the national average of 28 minutes – a problem that experts say could get worse, as thousands more residents obtain health insurance. The average wait can stretch to an hour or more at Rockville General, Manchester Memorial, Bridgeport, Waterbury and Hartford hospitals, according to a C-HIT review of federal data. The statewide average waiting time is 30 minutes. The longest wait time is at Hartford Hospital, where patients were not seen for 82 minutes, on average; the shortest wait of 14 minutes is at Windham Hospital, the data compiled by the Centers for Medicare & Medicaid Services (CMS) through 2012 show. Officials at Hartford and Bridgeport hospitals claim shorter wait times than the federal data.
Connecticut’s acute-care hospitals ended the last fiscal year in slightly better financial health than in the prior year, with just five of 30 hospitals reporting losses, according to a new state report. Data filed with the state Office of Health Care Access (OHCA) shows that six hospitals had operating losses in the 2012 fiscal year – the same number as in 2011, but fewer than in 2010. When non-operating gains and losses are included, five hospitals had negative total margins, or deficits – down from eight in 2011. The annual OHCA report paints a positive picture of the overall financial health of hospitals, highlighting that Connecticut’s hospitals had a total gain from operations of about $513 million in the last fiscal year – a substantial increase, of close to 70 percent, over the prior year. Total hospital net assets also increased.
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.