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

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

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, which can be found in C-HIT’s Data Mine Section, cover state inspections that were completed in 2021 with approved hospital corrective action plans. (You can find the new reports here.)

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.

Med Board Fines Two Doctors After Bristol Hospital Patient Dies Of Sepsis

The state Medical Examining Board today issued $5,000 fines to three physicians including two Bristol Hospital Emergency Department doctors who failed to diagnose and treat a patient with sepsis who later died. Another physician was also disciplined by the board for failing to act on test results. Dr. Syed Hadi and Dr. Waile Ramadan both treated a man who was brought to the Bristol Hospital Emergency Department on Jan. 7, 2019 with a high fever and other symptoms of a bacterial infection but never prescribed antibiotics, according to state Department of Public Health (DPH) investigators. The man died of sepsis two days later, documents said.

Medicare Penalizes 26 CT Hospitals For High Readmission Rates

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.

Medical Board Fines Two Doctors $5,000 Each

The state Medical Examining Board agreed Tuesday to fine two doctors $5,000 each and issued a cease and desist order to a woman without a Connecticut medical license who performed a procedure that led to an infection. Dr. Bryan Boffi, of Avon, a psychiatrist at the Hospital of Central Connecticut, was fined $5,000 and his license was reprimanded after he issued a patient a prescription for Ativan, a sedative, without consulting with the person’s regular mental health clinician, documents said. Boffi cared for the patient while the person was admitted to HOCC’s psychiatric ward in May of 2016, but failed to talk to the person’s out-patient psychiatrist about the patient’s history or inpatient treatment strategy before prescribing the medication, a consent order said. The state Department of Public Health (DPH) began investigating Boffi after receiving a complaint from the patient’s family, papers said. Boffi has since completed 150 hours of continuing education in the treatment of depression, addiction and the use of Benzodiazepines, such as Ativan, DPH officials said.

26 Hospitals Penalized By Medicare For High Readmission Rates

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.

Hospital Errors Decline, But Reports Of Pressure Ulcers, Falls And Burns Climb

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.

Medicare To Penalize 27 Hospitals For High Readmissions

Most Connecticut hospitals will lose a portion of their Medicare reimbursement payments over the next year as penalties for having high rates of patients being readmitted, new data from the Centers for Medicare & Medicaid Services (CMS) show. Statewide, 27 of the 29 hospitals evaluated—or 93 percent—will be penalized in the 2019 fiscal year that began Oct. 1, according to a Kaiser Health News analysis of  CMS data. The Medicare program has penalized hospitals since the 2013 fiscal year for having high rates of patients who are readmitted within a month of being discharged.  Nationally, hospitals will lose $566 million in penalties, which were instituted as part of the Affordable Care Act to encourage better health care delivery.

Hospitals Bill More Than $1 Billion In Facility Fees Over Two Years

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.

15 Hospitals Penalized For High Infection Rates, Injuries

About half of Connecticut hospitals—15 out of 31—will lose part of their Medicare payments in 2018 as a penalty for having relatively high rates of patients who acquired preventable injuries and infections while hospitalized. The hospitals are among 751 nationwide that will lose 1 percent of their Medicare reimbursements in this fiscal year. The penalties are part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program, which is part of the Affordable Care Act. The program penalizes hospitals with the highest rates of patients who got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also tallies those who suffered from blood clots, bed sores or falls while hospitalized.