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724 Hospitals Have Lost Medicare Funding For Avoidable Complications: Is Your Local Hospital One Of Them?

Nationally, 724 hospitals have had their Medicare funding reduced after the Centers for Medicare and Medicaid Services found that each had high rates of potentially avoidable “hospital-acquired conditions,” including falls, bed sores, and certain infections, including ventilator acquired pneumonia and catheter-associated urinary tract infections.

The Charleston Gazette said that “each hospital received a score between 1 and 10 for each category, with 1 being the best and 10 the worst. Any hospital with a composite score greater than 7 fell into the bottom quartile and became subject to the penalty, according to Centers for Medicare and Medicaid Services (CMS).” That penalty is usually a 1 percent reduction in Medicare reimbursement, and that’s major money annually. If you consider the 724 hospitals nationwide, that loss of funding will account for a total reduction in spending of $373 million, although funding can be reinstated for hospitals whose scores improve in the targeted areas.

CMS scored hospitals on the prevalence of three risk factors to their Medicare population patients: central line bloodstream infections, catheter-associated urinary tract infections, and serious complications, a catch-all group made up of eight types of injuries, including blood clots, falls, and bed sores. The data used to generate these scores was gathered between 2011 and 2013.

Consumers can peruse their own hospital’s scores and use it to make educated decisions about the potential safety of their stay or visit to the hospital. While not all injuries are avoidable, a high number of hospital falls, catheter infections, or bloodstream infections could indicate things like insufficient staffing or poor technique, such as not washing hands often enough or using sterile gloves incorrectly.

Would you like to know how your hospital rates on these items, as well as patient satisfaction? You can visit this website and have a good idea of the overall quality of care at the hospital you are considering before you ever become a patient (or worse, a statistic) there. Simply type in the information for required fields and see your desired facility’s results. Consumers can make informed decisions before they ever leave their home.

In West Virginia, six hospitals lost a portion of Medicare funding because of their failure to meet CMS national standards. Charleston Area Medical Center was considered one of the riskiest while Berkeley Medical Center in Martinsburg, West Virginia, tied with Davis Memorial Hospital for the best scores in the state.

Not everyone is on board with this method of trying to improve quality care. Some feel that by reducing reimbursement, it is going to be even harder for hospitals to provide quality care, improve staffing, or train current staff. A commenter on the Charleston Gazette website feels the nurse to patient ratio is a primary problem, as do many others.

“Maybe look at nurse/patient ratios for improved quality care of care. How can you expect medical staff to improve with less!”

Readers, what are your thoughts? How does your hospital rank?