The federal government is penalizing four Maine hospitals for high rates of “hospital-acquired” conditions, such as patients being sickened by an infection while in the hospital.
The U.S. Centers for Medicare and Medicaid Services withheld 1 percent of Medicare payments in fiscal year 2018-19 to Central Maine Medical Center in Lewiston, York Hospital, St. Joseph Hospital in Bangor and Aroostook Medical Center in Presque Isle. Hospitals receive large reimbursements from the Medicare and Medicaid programs to help pay for care for those patients covered by government programs instead of private insurance.
The programs to penalize hospitals for preventable hospital-acquired conditions were set up by the Affordable Care Act, which aimed to give hospitals financial incentives to limit infections and preventable readmissions. The conditions include infections, bedsores, blood clots and other health problems acquired in the hospital.
Eight hundred hospitals nationally were penalized this year. Central Maine Medical Center was the only hospital in Maine to be penalized for hospital-acquired infections for each of the past four years.
Dr. John Alexander, CMMC’s chief quality officer, said the federal penalties, even though they are being assessed now, reflect the 2015-17 time period, and the hospital has since made a number of improvements. For instance, the hospital has not had a “central-line acquired bloodstream infection” over the past year, thanks to new safety procedures, he said in a statement. A central line is a catheter inserted into a large vein to give fluids and draw blood.
Bedsores and pressure ulcers have “also been dramatically reduced” after the hospital introduced a new training program to prevent them.
“The high quality of care we provide at Central Maine Medical Center – and throughout the Central Maine Healthcare system – is not reflected in the assessments released (Friday), which look back as far as 2015. Recent improvements in safety and quality earned CMMC an “A” from the prestigious Leapfrog Group, and accreditations and certifications from both independent and government organizations,” Alexander said. “These government announcements often generate headlines, but don’t offer a complete picture of actual quality of care offered.”
Hospital-acquired conditions are often caused by sub-par conditions, such as not following proper hygienic procedures resulting in infections, or in the case of bedsores and pressure ulcers, not moving bedridden patients enough.
Overall, hospital-acquired conditions have declined 17 percent from 2010-14 and 8 percent from 2014-16, according to the Agency for Healthcare Research and Quality, an agency within the U.S. Department of Health and Human Services.
Jeff Austin, vice president of government affairs for the Maine Hospital Association, said hospitals have improved in reducing hospital-acquired conditions, and are “performing well across the board.”
“The ACA certainly has played a role as have commercial (insurance companies) and increased awareness among the general public,” Austin said.
In addition to the penalties for hospital-acquired conditions, four Maine hospitals were penalized at least 0.5 percent of federal revenue for having too many readmissions, including St. Joseph Hospital, York Hospital, Cary Medical Center in Caribou and St. Mary’s Regional Medical Center in Lewiston.
The list of hospitals was released by CMS and published into a sortable list by Kaiser Health News, a nonprofit health news website.
Joe Lawlor can be contacted at 791-6376 or at:
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