Fines & Sanctions

State Hospital Inspection Reports Now Available On C-HIT

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Lapses in cleanliness, infection-control procedures and in the treatment of patients with behavioral health problems were among the most common violations found in Connecticut hospitals inspected by the state health department in 2015, reports collected by C-HIT show. Inspection reports from the state Department of Public Health, spanning 2013 through 2015 – posted in C-HIT’s Data Mine section — show a mix of citations for poor physical conditions, such as mold and fungus in pharmacy preparation areas, and inadequate patient care, including improper evaluation and treatment of psychiatric patients and use of restraints. The state DPH inspects hospitals, which are all Medicare-certified through the federal government, once every four years. Inspections also occur when the DPH receives a complaint against a facility or is following up to ensure compliance with a corrective action plan. C-HIT’s database, based on DPH records through late 2015, includes reports on all 29 acute-care hospitals.

childhood hunger

Pediatricians Will Screen For Hungry Kids

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Like all pediatricians, Dr. Lori Smith keep tabs on many aspects of her patients’ health, but until recently the Westport-based doctor didn’t always consider whether the children she sees might be going hungry. “It wasn’t something that was necessarily on our radar,” she said. While her practice treats some lower-income patients from nearby Norwalk and Bridgeport, most of the children Smith and her colleagues see come from relatively affluent families. But Smith, who has been a pediatrician for more than 16 years, and her colleagues recently began screening all patients—regardless of their household income—for food insecurity, part of a new effort doctors and advocates hope will help prevent childhood hunger. The American Academy of Pediatrics (AAP) in October recommended that pediatricians screen all patients for hunger at well visits.

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

Fewer Errors Reported By Hospitals, But Concerns Remain

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Connecticut hospitals reported fewer numbers of patients killed or seriously injured by falls or perforations during surgery or suffering from severe pressure ulcers in 2014 than in 2013, but the incidence of such “adverse events” still remains higher than in 2012, a new state report shows. The report by the Department of Public Health (DPH) shows that the total number of hospital adverse events, or errors, dropped by 12 percent — from 534 in 2013, to 471 last year. Deaths or serious injuries from falls declined from 90 to 78; perforations during surgical procedures fell from 79 to 70; and life-threatening medication errors fell from six to one. The number of patients with serious pressure ulcers dropped from 277 to 245. Rates of all four of those incidents had climbed in 2013, in part because of an expansion of required reporting on pressure sores to include “unstageable” ulcers.

I-Team In-Depth

Mental Health Is Main Cause Of Hospitalizations in CT, New Data Show

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Mental disorders surpassed respiratory problems and all other ailments as the leading cause of hospitalization in Connecticut in 2012 for children ages 5 to 14, teenagers and younger adults, according to a new state health department report. The report shows that the number of days that patients with behavioral health problems were hospitalized surged 5.3 percent between 2011 and 2013, to nearly 260,000 patient days. Other categories of hospitalizations, including cardiac and cancer care, declined during that time. The data show five hospitals had increases of more than 12 percent in the number of days that patients with behavioral health problems were hospitalized. The biggest increases were at Yale-New Haven Hospital, which saw the number of patients rise 61 percent, and inpatient days jump 51 percent; and Waterbury Hospital, with 26 percent more patients and a 37 percent increase in inpatient days.

I-Team In-Depth

Hospital Reports Of Surgical, Medication Errors Climb

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Connecticut hospitals reported record numbers of patients killed or seriously injured by hospital errors in 2013, with large increases in the numbers of falls, medication mistakes and perforations during surgical procedures, a new state report shows. The report, covering 2013, marks the first time that the number of so-called “adverse events” in hospitals and other health care facilities has topped 500 – double the number in 2012, when 244 such incidents were reported. Much of the increase was due to an expansion of reporting on pressure ulcers, which added a new category with 233 “unstageable” ulcers that were not counted before. Even without that category, however, reports of adverse events climbed 20 percent over 2012. The most significant increases were in the numbers of patients harmed by foreign objects left in their bodies after procedures – doubling from 12 to 25 in one year — or those harmed by perforations during surgical procedures – 79, compared to 55 the previous year.

I-Team In-Depth

Operating Profits Drop At State Hospitals: New Report

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Connecticut’s acute-care hospitals saw gains from their operations tumble 35 percent in the last fiscal year, with seven of 29 hospitals reporting operating losses, according to a new state report. While hospitals still ended the year with $597 million in profits overall, the report by the state Office of Health Care Access (OHCA) raises concerns that non-operating revenue, such as income from investments, was masking the decline in operating revenue. “While hospitals’ operational financial performance weakened in FY 2013, they continued to generate significant non-operating gains, helping to keep overall hospital financial performance strong,” the report says. “However, a robust financial picture should rely more on patient and other operating revenues, and not on a less than reliable income source, such as investment performance.”

Hospitals’ profits from operations dropped to $333.6 million, from $513.5 million in the 2012 fiscal year. At the same time, hospitals earned $70 million more from investments, charitable contributions and other sources of revenue.

I-Team In-Depth

Half Of State Hospitals Exceed Infection Rates, New Data Show

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State health inspectors visiting Stamford Hospital in late 2012 turned up several infection-control violations, including the improper drying and storage of endoscopes, instruments used to look inside the body. An inspection of Hartford Hospital in 2012 found an operating room with “dust and darkened debris” on top of pumps attached to IV poles, a container of syringes “overflowing” a protective cover, and brownish stains on the floor and underside of the operating table. These kinds of lapses, while not directly tied to patient infections, have contributed to Connecticut’s poor ratings on some federal measures of hospital-acquired infections. Newly released data show that more than 50 percent of the state’s hospitals had rates for at least one type of hospital-acquired infection that were worse than federal benchmarks, in late 2012 and 2013. No other state had a higher percentage of its hospitals exceeding the infection standards set by the U.S. Centers for Disease Control and Prevention, and most states had fewer than 20 percent, according to the data, compiled by Kaiser Health News.

Disparities

Federal Grant Targets Children’s Mental Health Access In New Haven

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The state will use a $4 million federal grant to launch a pilot program in a New Haven neighborhood that officials hope will be a statewide model for improving early identification and treatment of children’s mental health. The five-year grant, announced Tuesday by the state Department of Children and Families (DCF) and New Haven Mayor Toni Harp, will not add new mental-health services for children, but instead will embed care coordinators and clinicians in schools and pediatric offices, in an effort to catch problems early and improve access to existing programs.

The grant is targeted to children ages 8 and younger in the city’s Dwight neighborhood, which has a robust network of mental health providers, including Yale-New Haven Hospital. “This is all about making the existing services more effective and accessible,” DCF Deputy Commissioner Michael Williams said of the grant project, dubbed the Elm City Project Launch. He said the agency selected the Dwight neighborhood because it has a “tremendous array of services” to handle referrals to care resulting from increased mental health screenings. In other areas of the city and state, he acknowledged, “There clearly are a dearth of services” – a problem that the new grant does not address.

Breast Center - Smilow Cancer Hospital at Yale-New Haven

Medicare Costs For Breast Cancer Screenings Soar, But Benefits Remain Unclear

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Medicare-funded breast cancer screenings jumped 44 percent from $666 million to $962 million from 2001 to 2009, yet those added costs did not improve early detection rates among the 65 and older Medicare population, according to a Yale School of Medicine study published recently in the Journal of the National Cancer Institute. The increase was due mostly to the use of costlier digital mammography ($115 per screening) compared to film mammography ($73 per screening), along with newer and expensive screening and adjunct technologies, including breast ultrasound, magnetic resonance imaging (MRI) and biopsy. The study is the second from Yale since January 2013 to conclude that increased Medicare spending for breast cancer screening does not necessarily translate into better outcomes. The latest study has spurred debate about the cost and value of mammography in Medicare beneficiaries, particularly women 75 and older. Some physicians recommend continued screening, while others argue that it is unnecessary and only fuels anxiety among older women.