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.
As the federal government renews tests to determine how much glyphosate is in America’s foods, Connecticut environmental groups, organic farmers and a U.S. senator say it’s time to limit the use of, or ban, the popular herbicide. Glyphosate, the active ingredient in the world’s top-selling weed killer, Roundup, is a suspected carcinogen that’s used in agriculture, on golf courses, ballfields and other public venues, and for lawn care, experts said. It can be found in more than 750 products sold in the U.S., reports the National Pesticide Information Center. Health concerns have been raised about Roundup for decades, concerns consistently disputed by its manufacturer, Monsanto. Earlier this year, a group of environmental health scientists called for the federal government to reassess whether glyphosate is a cancer risk.
Since 2011, Connecticut has issued more than 39,000 new Medicaid cards to prisoners returning to communities, connecting them to health care services with the goal of keeping them healthy and out of prison. This initiative, which gives ex-offenders the opportunity to see a primary care physician on a regular basis and access critical mental health and drug-abuse treatment programs, exists because of the Affordable Care Act (ACA), and Medicaid pays most of the costs. Recidivism data show that the initiative is working, state officials say. Yearly, the Court Support Services Division (CSSD) refers approximately 20,000 adults on probation to various behavioral health programs and tracks them for 12 months. In 2016, CSSD reported that 23.1 percent of adults who completed their referral program were rearrested, a five-year low since CSSD started tracking in 2012.
A Litchfield residential care home has been ordered to hire a new manager, improve resident care and pay a $2,000 fine, after findings that administrators left residents hungry, denied them information about their personal finances, and openly referred to them as “monkeys.”
Multiple residents of Fernwood Rest Home, Inc., a 68-bed facility, told inspectors from the state Department of Public Health (DPH) that administrators would tell them they had to “go shopping to feed the monkeys,” a state DPH report says. A staff member of the home confirmed complaints from residents that administrators would put a chain across the dining room while the staff was making a “gourmet breakfast for themselves,” and would instruct staff members to “keep the monkeys out” of the room while they were eating. At the same time, the facility, with a significant population of mentally ill residents, skimped on meals for residents, offering them eggs for breakfast only two days a week, with hot and cold cereal provided on other weekdays and donuts on Sundays, the report says. Residents told inspectors that the only snacks provided were granola bars, “with some residents indicating that they are still hungry and are told they cannot have any other snacks until the next day.”
The home was cited for eight violations, including failing to treat residents with dignity and respect; failing to give them quarterly statements or receipts pertaining to their personal financial accounts; and failing to provide “routine recreational activities” for them. In addition, no resident council was in place to allow residents to discuss their living conditions or push for improvements, the report says.
A pilot project to provide coordinated care to children insured by Medicaid resulted in more Connecticut children receiving preventive dental services, mental health care and well-child visits, according to a new report by the Child Health and Development Institute of Connecticut, Inc.
“Care coordination is especially important for children, as they benefit most when their needs are detected early and they receive intervention services,” the report says. “The primary care medical home is an ideal venue for detecting children’s problems at the earliest possible age and connecting families to helpful interventions and supports outside of the primary care site.”
The evaluation of the “Health Outreach for Medical Equality” project, dubbed “H.O.M.E.,” found that adding care coordinators to work with low-income children in the HUSKY insurance program boosted the percentage of Hartford children ages 2 and younger using dental services – 34 percent for those who received care coordination, vs. 25 percent of Hartford children overall. In addition, children who received H.O.M.E. services accessed behavioral and mental health services at a significantly higher rate than the overall Hartford HUSKY population. The increased access to dental and mental health care “pays off tremendously in the long run,” in terms of both health outcomes and cost savings, as problems are addressed earlier, said Lisa Honigfeld, vice president for health initiatives at the Child Health and Development Institute.
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.