As cases of COVID-19 surged throughout Connecticut and the nation, “a perfect storm” of circumstances rendered nursing homes unable to handle the crisis, hastening the virus’ spread and deaths, experts say. “It’s just kind of this perfect storm. It’s just the nature of the beast. This is the worst situation for a virus like this,” said Dr. David Hill, professor of medical science and director of global public health at Quinnipiac University Frank H. Netter MD School of Medicine. Indeed, nursing homes care for an extremely frail population, many with underlying health conditions.
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.
The number of “adverse events” occurring at Connecticut hospitals rose 7% in 2018, compared with the previous year, with a growing number of patients suffering serious injury or death associated with falls, according to a new state report. Overall, the total number adverse events, or medical errors, reported by hospitals rose to 376, from 351 in 2017, according to the state Department of Public Health (DPH). Of the 29 categories tracked, tallies rose in 12, declined in seven and remained flat in 10. “I’m very discouraged by the report,” said Lisa Freeman, executive director of the Connecticut Center for Patient Safety. “Some of these numbers, they give me chills, they’re so frightening.
With tougher standards, 48% of the state’s nursing homes—104 facilities—received a four- or five-star rating for staffing, data from the Centers for Medicare & Medicaid Services (CMS) show. Thirty-nine nursing homes (19%) earned a one- or two-star rating for staffing levels. Nursing Home Compare’s five-star system (5 being “much above average,” 4 “above average,” 3 “average,” 2 “below average” and 1 “much below average’) examines quality of care delivered, staffing and overall performance, among other factors. It gives consumers the ability to compare quality among facilities. CMS updated the rankings in April, following the release of new payroll data that gives insights into nursing home staffing trends.
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.
Most Connecticut nursing homes will see their Medicare reimbursements reduced in the coming year for having high resident readmission rates to hospitals. Of Connecticut’s 224 nursing homes, 75 percent (168) are being penalized by Medicare based on how often their residents were re-hospitalized within 30 days of discharge. Twenty-five percent (56) in Connecticut are receiving bonuses for having few readmissions, according to a Kaiser Health News (KHN) analysis of data from the Centers for Medicare and Medicaid Services (CMS). This is the first time nursing homes are being penalized or rewarded based on how many of their residents are readmitted to hospitals for conditions that could have been prevented. Medicare has administered a similar program for hospitals since the 2013 fiscal year.
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.
Three years ago, Meredith Phillips’ mother, Georgia Svolos, fell and broke her kneecap, setting off a downward spiral that landed her in nursing homes on and off for a year. In one facility, she fell and broke her knee again, necessitating more surgery. All of the facilities were noisy and chaotic, and one smelled of feces. So, when Phillips learned recently about moves by the Trump administration to ease regulations and fines on nursing homes, she was alarmed. “I’m horrified and frightened,” says Phillips, who lives in Westbrook.
Out of work and addicted to the anti-anxiety medication Klonopin, Heather Delaney, a licensed practical nurse from Stratford, checked herself into Bridgeport Hospital in 2011 when she could no longer handle withdrawal without medical help. After a brief hospitalization following a suicide attempt the previous fall, Delaney spent two horrific months on her own in the throes of withdrawal. The corners of her eyes felt “chapped,” and “it felt like somebody had wrapped me up in a scratchy blanket of needles,” said Delaney, who had given up her nursing license after being caught altering her Klonopin prescription. Sara Kaiser, an LPN living in Manchester, stole morphine from the nursing homes where she worked and was addicted to heroin from age 18 to 24. She spent time homeless and in prison, ultimately going through 14 rehab programs before getting sober in 2010.