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

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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

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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 cover state inspections that were completed in 2021 with approved hospital corrective action plans. 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.

Fines & Sanctions

Medicare Penalizes 26 CT Hospitals For High Readmission Rates

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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.

Fines & Sanctions

Medicare Penalizes Hospitals For High Readmission Rates

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Most Connecticut hospitals will lose some of their Medicare reimbursement payments over the next year as penalties for having too many readmitted patients, according to new data from the Centers for Medicare and Medicaid Services (CMS). Statewide, 25 of the hospitals evaluated – or 89% – will have reimbursements reduced, to varying degrees, in the 2021 fiscal year that started Oct. 1, according to a Kaiser Health News analysis of CMS data. Nationwide, almost half of hospitals, or 2,545 of them, will have their Medicare reimbursements cut, according to Kaiser Health News. The latest penalties were calculated using data from June 2016 through June 2019, meaning the influx of patients to hospitals seen amid the pandemic didn’t factor in.

stroke care

Time Is Key To Stroke Treatment, But Gaps Exist In Connecticut

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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.

diabetes care

CT Startups Edge Into Cluttered Market With Diabetes Apps

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When Adam Berger, 29, who has Type 1 diabetes, decided to get a sandwich from a deli, he first ran it by his mobile application ezbds, which he launched in Stamford two years ago. The app told him that in the past when he’d eaten that particular sandwich from the same deli, he hadn’t experienced glucose spikes. “So I decided to stick with it,” Berger said. “An hour later when ezbds reminded me to check, my glucose was 123.” That’s a good number according to the American Diabetes Association (ADA), which suggests a target of less than 180 mg/dL an hour or two after beginning a meal for adults with diabetes. “By tracking what they eat, people can identify how certain foods affect their blood sugar,” said Nancy Salem, coordinator of the Diabetes Education Program at Danbury Hospital.

Fines & Sanctions

18 State Hospitals Penalized For High Infection Rates

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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.

Fines & Sanctions

Fewer Errors Reported By Hospitals, But Concerns Remain

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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.

Amy Evison

Mental Health Crisis Teams Bridge Service Gap To Stabilize At-Risk Youth

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The growing number of children and teens exposed to traumatic events in everyday life has forced the state’s crisis intervention teams to respond to a broader range of behavioral and mental health issues, and those teams often serve as a bridge until at-risk youth find appropriate outpatient or inpatient services. Sixty-four percent of Connecticut’s youth who use Emergency Mobile Psychiatric Services (EMPS), the state’s mobile crisis intervention team, have experienced one or more traumatic incidents, such as domestic violence, cyber-bullying, physical assaults, or gang warfare, experts report. Research shows childhood exposure to violence, physical or sexual abuse, and other traumatic events can cause chronic health and behavioral health problems, and such exposure is associated with increased involvement with the child welfare and criminal justice systems.

“The number of children who have been exposed to trauma is a significant concern. It’s a common occurrence among young people,” said Jeffrey Vanderploeg, vice president for mental health initiatives for the Child Health and Development Institute of Connecticut (CHDI). He is director of the EMPS Performance Improvement Center, which is housed at CHDI.

Affordable Care Act

Diabetes Takes Disproportionate Toll On Hispanics And Blacks

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Connecticut’s diabetes rate ranks lower than the national average, but Hispanics and African-Americans are more than twice as likely to have the disease compared with their white neighbors and are at greater risk of dying from diabetes-related causes. Approximately 250,000 Connecticut adults (8 percent) have been diagnosed with Type 2 diabetes and an estimated 83,000 state residents don’t realize they have the disease, according to 2011-13 data from the U.S. Centers for Disease Control and Prevention (CDC). Nationally, 29.1 million people (9.3 percent) have diabetes and 8.1 million people don’t know they have the disease, reports the CDC. Connecticut’s Hispanics (14.6 percent) and African-Americans (14.1 percent) have significantly higher rates of diabetes than whites (6.7 percent). In addition, adults with annual household incomes below $25,000 are 2.3 times more likely to have diagnosed diabetes compared with adults with household incomes over $75,000, according to the CDC.