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%.

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.

children's health

ER Visits For Children In Crisis Up 20% Over Two Years

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The number of Medicaid-insured children treated in Connecticut emergency rooms for behavioral health crises rose 20 percent between 2014 and 2016, mirroring a national trend – despite efforts to provide non-ER treatments. In 2014, Connecticut ERs recorded 12,100 Medicaid-insured youth visits compared to 14,448 in 2016, according to a study of Medicaid-eligible patients ages 18 and younger commissioned by the Child Health and Development Institute of Connecticut (CHDI). Most of the children who go to emergency rooms with behavioral health issues go to one of five hospitals, according to data collected by consultant Beacon Health Options, which manages behavioral health care for the state’s Medicaid population. Connecticut Children’s Medical Center in Hartford saw the most behavioral health-related ER visits, with 3,962 visits by Medicaid-insured youth in 2016. Yale New Haven Hospital and Yale New Haven Children’s Hospital had a combined total of 2,263 visits, followed by St.

Hospital Inspection Reports Available On C-HIT; Bridgeport, Hartford Among Facilities Cited

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Various violations that jeopardized patient safety, including two that preceded patient deaths and several involving the improper use of restraints, have taken place at Connecticut hospitals, according to the most recent hospital inspection reports released by the state Department of Public Health (DPH). The reports, which can be found in C-HIT’s Data Mine section, cover inspections that took place at hospitals between 2016 and this year. Some of the violations resulted in injuries to patients, while others showed lapses in protocols and procedures. Bridgeport Hospital was cited for 26 violations, including an incident in which a patient with a diagnosis of an ovarian mass suffered a burn during surgery. Hartford Hospital was cited for 60 violations, including two violations that preceded patient deaths.

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.

Fines & Sanctions

New State Hospital Inspection Reports Available On C-HIT

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Various violations that jeopardized patient safety, including several before and after a newborn died, have taken place in Connecticut hospitals, according to the most recent hospital inspection reports from the Department of Public Health (DPH). The reports, which can be found in C-HIT’s Data Mine section, cover inspections that took place at hospitals between 2016 and first few months of 2017. Some of the violations resulted in injuries to patients, while others showed lapses in infection control standards and other protocols. The Hospital of Central Connecticut in New Britain was cited for several violations that preceded a newborn’s death in 2016. DPH found several errors were made during and after the baby’s birth.

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.

Women's Health

Who’s Guarding Our Reproductive Rights In Hospital Mergers?

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Officials at St. Mary’s Hospital and Waterbury Hospital began negotiations in 2011 to merge and join a Texas-owned company. But the state Permanent Commission on the Status of Women—with MergerWatch, a hospital watchdog group—successfully argued against the merger by making the case that since the new hospital would honor Catholic religious directives, a significant portion of patients would be left vulnerable—because God help you if you are a woman and need emergency reproductive services at a Roman Catholic hospital. Medical professionals at Catholic-owned or -sponsored hospitals operate under directives—known officially as the Ethical and Religious Directives for Catholic Health Care Services. These directives come from the United States Conference of Catholic Bishops and take 43 pages (plus footnotes) to describe what constitutes appropriate Catholic health care.

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

Doctor Fined For Unknowingly Removing Uterus Of Pregnant Woman

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A prominent Waterbury gynecologist was fined $5,000 by the state Medical Examining Board Tuesday for mistakenly performing a laparoscopic hysterectomy on a patient who he did not know was pregnant, state records show. In January 2011, Dr. Jonathan Foster, who is also an obstetrician, failed to detect the patient’s pregnancy before the operation, according to a consent order he signed in July agreeing to the punishment. He also relied on the patient’s statement that she was not pregnant and failed to follow-up a urine pregnancy test with a blood test or ultrasound before operating, the order said. State records do not indicate how far along the pregnancy was. After the incident, Foster completed a course to maintain his certification in his specialty.