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%.

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.

Hospitals’ ‘Team Effort’ Reduces Number Penalized For High Infection Rates, Injuries

Six Connecticut hospitals will lose 1% of their Medicare reimbursements this fiscal year under a federal program that levies penalties for high rates of hospital-acquired injuries and infections. It’s the lowest number of hospitals penalized since the program began leveling funding cuts in 2015, data from the Centers for Medicare & Medicaid Services (CMS) show. The hospitals are among 774 nationwide that will lose funding under the Hospital-Acquired Conditions Reduction Program, according to a Kaiser Health News analysis. The program was created by the Affordable Care Act. When assessing hospitals, the government examines how many infections and other potentially avoidable complications patients suffered – things like blood clots, sepsis, bedsores and hip fractures.

Medicare Penalizes Hospitals For High Readmission Rates

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.

Nursing Homes Prove To Be Ideal Breeding Ground For The Coronavirus Pandemic

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.

14 Hospitals Penalized For High Infection Rates, Injuries

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.

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.

48% Of Nursing Homes Rated Above Average For Staffing, Under New CMS Rankings

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.

Medicare Cuts Payments To 15 Hospitals For High Infection Rates, Injuries

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.

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.