The federal government is cutting payments to 29 Georgia hospitals for high levels of infections and patient injuries in the facilities. The new Medicare...

The federal government is cutting payments to 29 Georgia hospitals for high levels of infections and patient injuries in the facilities.

The new Medicare crackdown on hospital-acquired infections and preventable injuries is similar to the existing federal penalties on excessive readmissions of patients within 30 days after discharge.

Overall, 721 U.S. hospitals are getting the new penalties, which means they will have their Medicare payments lowered by 1 percent.

WellStar Kennestone in Marietta

WellStar Kennestone in Marietta

The Georgia hospitals being penalized include some of the largest and best known in the state.

In the metro Atlanta area,  Emory University Hospital, Grady Memorial, WellStar Kennestone, Piedmont Hospital and Atlanta Medical Center are among those receiving cuts.

Also getting penalties are Athens Regional Medical Center; Memorial University Medical Center and Candler Hospital in Savannah; Georgia Regents Medical Center and Doctors Hospital in Augusta;  Coliseum Medical Centers and Coliseum Northside in Macon; and Southeast Georgia Health System’s Camden campus.

The penalties are hitting academic medical centers especially hard, Kaiser Health News reported. About half of them will be punished.

The Affordable Care Act requires the reductions for the quarter of hospitals that Medicare judged as having the highest rates of “hospital-acquired conditions.’’ These can include infections from catheters, blood clots, bed sores and other complications that are considered avoidable, KHN reported.

Three Surgeons Operating On A Patient

Dr. Eric Schneider, a Boston health researcher, told KHN that research has demonstrated that medical errors can be reduced through a number of techniques. But “there’s a pretty strong sense among the experts we talked to that they are not widely implemented,” he said.

Those methods include entering physician orders into computers rather than writing them on paper; better hand hygiene; and checklists on procedures to follow during surgeries. “Too many clinicians fail to use those techniques consistently,” Schneider said.

Still, a recent study found that improved patient safety and fewer mistakes at U.S. hospitals saved the lives of roughly 50,000 people from 2011 to 2013, the Obama administration reported earlier this month.

Incidents of hospital-induced harm – such as adverse drug events, infections, falls and bedsores – declined by 17 percent, or an estimated 1.3 million episodes, from 2010.

Is the process fair?

Exempted from the medical error penalties are hundreds of hospitals that provide specialized treatments such as psychiatry and rehabilitation or because they treat particular types of patients, such as children or veterans. Small “critical access hospitals” located in rural areas are also exempt.

Healthcare CostMedicare levied penalties against a third or more of the hospitals it assessed in Colorado, Connecticut, Delaware, Nevada, New Jersey, New Mexico, Rhode Island, Utah, Washington and the District of Columbia, the KHN analysis found.

Georgia’s percentage of 28 percent of hospitals penalized is just below that level.

Some experts say the new penalties will disproportionately hit hospitals that serve many poorer and sicker patients.

Hospital officials called the new penalties arbitrary. They said there may be almost no difference between hospitals that are penalized and those that narrowly escape falling into the worst quarter, KHN reported.

“Hospitals may be penalized on things they are getting safer on, and that sends a fairly mixed message,” said Nancy Foster, a quality expert at the American Hospital Association, told Kaiser Health News.

James Stephens, a health economics expert at Georgia Southern University, told GHN on Monday that the new penalties reflect a greater emphasis on patient outcomes and quality of care. “If there’s going to be payment, there’s going to have to be a focus on quality outcomes,” he said.

Hospitals are already acutely aware of their infection rates, he said.

A 1 percent pay cut is significant for a large hospital, Stephens said.  “It will be interesting to see if hospitals’ infection rates go down” as a result of the penalties, he added.

Here’s the list of all hospitals receiving penalties.


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

  • GraceD

    December 23, 2014 #1 Author

    So sad to see so many hospitals in Ga (and across the nation) that do not meet Standards of Care. It is certainly true that the bigger hospitals may be treating patients with more of the sicker, complex issues.
    But, that is by far, not the major cause. Much of the problems with infections have been ongoing & unresolved for many, many years.
    A refusal of hospitals to spend the time & money on training staff is one issue.
    A bigger issue is the refusal of the Medical Staff to comply with infection control recommendations. The Medical Staff both governs medical practice & are the “gate Keepers” to the numbers of patients a hospital has. (In other words, Drs control the money.)
    I am a retired RN with over 50 plus years of practice in Ga. Hospitals. Most of that in the OR setting. OR managers functioned as “infection control nurses” long before there was such a position in facilities.
    It really is a sad day to see what few steps we have made & just how many people have suffered & died because we did not effectively address these problems.

    Reply

    • Outraged

      December 23, 2014 #2 Author

      “A bigger issue is the refusal of the Medical Staff to comply with infection control recommendations.”

      Absolutely. My wife is studying to be a Registered Nurse and her clinical trials were at Grady. On the first day, none of the students were trained on hospital policies, procedures or protocols; they were only asked to go to a room and stare at a patient for 8 hours, besides of some extra shores. During that day my wife noticed a number of irregularities that didn’t match her classes, which ranged from people picking up pillows from the floor and giving them to other patients, to improper handling of needles, etc. My wife is pregnant and at some point she was asked to go into a patient’s room with another student to take out a tray or something. When she came out of that room she noticed a tiny sign with a mask, no labels, words or anything. When she asked what that sign meant, it turned out that a mask was required to go into that room and without it either the patient or my wife would have been at risk of infection. Later that day my wife wrote an e-mail to her instructor bringing up these situations, so the instructor could be aware of them. The response from the instructor was to write my wife up and threatened to fail her. In the report the instructor mentioned course-work (not related to Grady) that my wife had not followed, and even pointed out my wife’s e-mail as an admission of her guilt. It was evident that proper bureaucratic CYA was more important than actually creating a safe environment, as in developing proper and clearly understandable signage to begin with, followed by proper on-boarding training for first semester students not familiar with Grady’s policies.

      For the first couple of months my wife did develop a couple of colds, which is nothing bad, but this whole thing also happened as the Ebola crises was going on. In the days following the incident, clearly legible signs were added to these rooms, mainly because another nurse who actually works at Grady, became sick.

      I’m just thankful that my wife made it out of that hospital safely, and that she will be staying away from it for a while.

      You are right, policies, training and protocol are only there to protect the organization. Staff are there to actually protect the patients, and when the pride is taken on bureaucratic work, and not on actually helping patients, then we have a deeper public health problem.

      It’s not surprising that Grady and other academic institutions were hit…and I’m glad. I hope that makes them pay better attention to true patient care.

      Reply

      • GraceD

        December 23, 2014 #3 Author

        I am so sorry that your wife had to go through all of this! And so glad that she is doing ok. Be sure she knows that she is joining a profession that has once again, been recognized as the “Most trusted & respective Professionals.” Perhaps she will be one of the nurses who can influence change. It is coming, but oh, so slowly.!
        Hang in there!

        Reply

  • Margot Grummon

    December 24, 2014 #4 Author

    Both Coliseum Hospitals in Macon are excellent though parts are “dated” due to lack of funding. I will go to the floor for Grady Hospital in Atlanta. It is a TRAUMA Hospital which deals with the most extreme of the extreme cases and has lousy funding. The majority of patients are in life threatening conditions, have no insurance and are taken care of as if they are millionaires. GRADY should get the Congressional Medal of Honor for its miraculous work.

    Reply

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