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.

Hospital Errors Rose 7% In 2018

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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.

Fines & Sanctions

26 Hospitals Penalized By Medicare For High Readmission Rates

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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

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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.

I-Team In-Depth

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

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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.

Fines & Sanctions

15 Hospitals Penalized For High Infection Rates, Injuries

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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.

health care

Hospital Errors Decline 5 Percent, But Sexual Assaults More Than Double

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The overall number of “adverse events” reported by Connecticut hospitals declined in 2016, but sexual assaults more than doubled, according to a new state report. The Department of Public Health (DPH) report shows that hospitals reported a total of 431 medical errors in 2016, down about 5 percent from 456 in 2015. But there were 24 reports of sexual abuse or assault on a patient or staff member within or on the grounds of a health care setting last year, up 140 percent from 10 cases in 2015, the report said. A majority—22 cases—happened at acute care hospitals. St.

Fines & Sanctions

14 Hospitals Penalized For Infection Rates, Injuries

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Nearly half of Connecticut hospitals – 14 out of 31 – will lose a portion of their Medicare payments in 2017 as a penalty for having too many patients who acquired preventable infections and injuries while hospitalized. The hospitals are among 769 nationwide that will lose one percent of their Medicare reimbursements this year as part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program. The CMS program, now in its third year, penalizes the lowest-performing hospitals where a relatively high number of patients got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also takes into account patients who suffered from blood clots, bed sores or falls while hospitalized. New this year, CMS also factored in the incidents where antibiotic-resistant bacteria – namely, methicillin-resistant staphylococcus aureus (MRSA) and Clostridium difficile (C.