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

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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

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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.

Fines & Sanctions

Stamford Hospital Fined $55,000 For Operating Blood Draw Facility Without Approval

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Stamford Hospital has been fined $55,000 by the state for allowing a phlebotomist to draw blood at a Southington facility before obtaining a certificate of approval to operate. A state Department of Public Health (DPH) inspection at Feel Well Health Center in Southington on or around Jan. 26 found that a phlebotomist who had contracted with Boston Heart Diagnostics in Massachusetts was conducting venipuncture, or puncturing a patient’s vein to draw blood, before Stamford Hospital obtained the necessary written certificate to operate the blood collection facility, according to a consent order signed Sept. 7 by the hospital and DPH. The phlebotomist was collecting and sending specimens to Boston Heart for laboratory analysis and was being paid by Boston Heart to do so, the consent order said.

Fines & Sanctions

State Disciplines Three Nurses, Two For Substance Abuse Violations

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The state Board of Examiners for Nursing this week disciplined three nurses, including suspending the license of a Stamford Hospital nurse accused of stealing Dilaudid meant for 21 patients. The registered nurse, Kerrisha Stacy-Ann Hurd of Elmont, New York, took the painkillers meant for the patients but did not administer the doses to them between January and March while she worked in the Post Anesthesia Care Unit of the hospital, state records show. In March, she fainted while on the job, and a syringe with a bloody needle was found in her uniform pocket, records show. Then on April 26, she admitted that she gave herself a shot of Dilaudid while working, records show. She was taken to the emergency room and tested positive for opiates, records show.

Mothers Are Dying In Childbirth; Why Isn’t Anyone Talking About It

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In May 2017, Maura B. Gallagher entered Stamford Hospital for a Cesarean section for her unborn fraternal twins. According to a lawsuit filed by her family, Gallagher was 38 and an avid skier who was dedicated to her family, which included her fiancé, Max Di Dodo. There were signs that her pregnancy was challenging. At a little over 37 weeks, Gallagher, of New Canaan, showed signs of a low platelet count. The condition, known as thrombocytopenia, affects 7 to 12 percent of pregnant women.

Women's Health

Connecticut Fertility Trends: Older Mothers And Fewer Babies

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As fertility rates fall nationwide, Connecticut continues to rank among the lowest in the country—a trend doctors attribute to women here delaying childbearing. In 2016, the most recent year for which state-level data is available, Connecticut had 53.4 births per 1,000 women ages 15 to 44, compared with a national average of 62 per 1,000 women, according to data from the Centers for Disease Control and Prevention (CDC). Just four states had lower rates than Connecticut in 2016, and all are in New England: Vermont at 50.3 births per 1,000 women, New Hampshire at 50.9, Rhode Island at 51.8 and Massachusetts at 51.9. The states with the highest fertility rates in 2016 were South Dakota at 77.7, North Dakota at 77.3, Utah at 76.2 and Alaska at 76.1, the CDC reports.  Unlike birth rates, which take an entire population into account, fertility rates reflect the share of babies born to women of childbearing age. Connecticut typically ranks low on the list, along with other “high achievement, high education states,” said Dr. Harold J. Sauer, chairman of obstetrics and gynecology at Yale New Haven Health’s Bridgeport Hospital.

Women's Health

Depression Affects Women At Twice The Rate As Men

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Depression is the leading cause of disability worldwide, according to the World Health Organization, and affects women at about twice the rate that it does men. In Connecticut, 21.4 percent of women report experiencing depression, compared with 13.4 percent of men, according to 2015 Department of Public Health data. Millennial women in the state experience depression four more days in an average month than their male counterparts, the Status of Women data project reported this year. Women are more likely to use mental health services than men, but studies consistently show that the majority of Americans with depression go untreated. In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses depression and pathways to better mental health with Yale’s Carolyn Mazure, and NYTimes best-selling author Luanne Rice.

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.

Female Surgeons Making Inroads In Male-Dominated Operating Rooms

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When the lights power on in the operating room at Bridgeport Hospital, more than a half of the acute care team of surgeons peering from behind the masks are women. That’s unusual, given that only 28 percent of all surgeons in Connecticut are female, according to the latest figures from the American Medical Association (AMA). Flexible work schedules and hiring more surgeons to ease the on-call burden has helped to lure more women to the trauma surgical team, said Bridgeport Hospital’s chief medical officer, Dr. Michael Ivy, a trauma surgeon. Hospitals statewide have launched initiatives to help boost the ranks of women surgeons. There’s been progress, but gaps persist.

Disparities

Yale Study: Minority Breast Cancer Patients Less Likely To Have Genetic Test

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A genetic test that helps doctors determine how best to treat breast cancer—and whether chemotherapy is likely to help—is significantly more likely to be administered to white women than blacks or Hispanics, a Yale study has found. The test, called Oncotype Dx (ODx), uses gene expression to gauge how early-stage breast cancer is affecting patients’ gene activity. It uses the information to determine how likely cancer recurrence would be, and physicians and their patients can use that knowledge to decide how to proceed with treatment. Yale researchers retrospectively analyzed a group of more than 8,000 Connecticut women who were diagnosed with hormone receptor positive breast cancer between 2011 and 2013, and found “significant racial and ethnic disparities in use of this new gene test,” said study leader Dr. Cary Gross, a member of Yale Cancer Center and professor of medicine and epidemiology at Yale School of Medicine. “It reinforces that, at the same time we are investing in developing new treatments and new testing strategies and we’re promoting them with great excitement, we really need to double-down our efforts to eliminate disparity,” Gross said.