Local hospital readmission rates at, slightly above average
Community Hospital is the only area hospital in a new Centers for Medicare and Medicaid Services report that will not be financially penalized for its patient readmissions rates.
The Centers for Medicare and Medicaid Services report tracks readmission rates for more than 3,000 U.S. hospitals over three years. Only heart attack, heart failure and pneumonia patients who returned to the same hospital within 30 days of leaving the hospital were counted in the study. Hospitals with fewer than 25 pneumonia, heart failure or heart attack cases between July 2008 and June 2011 were left out of the report.
Each hospital was graded based on how its readmission rates for qualifying conditions compared to the national average. If the rates were at or below the national level, the hospital will continue to receive Medicare reimbursement dollars at the same rate it does now. About two-thirds of hospitals in the report, however, will have their Medicare reimbursements cut by up to 1 percent for having a readmission rate higher than the national average. The higher the readmission rate, the higher the penalty.
Community Hospital had a 0 percent penalty in the report, which was released last month after two previous attempts last fall failed to produce readmission rates that the Centers for Medicare and Medicaid Services felt were sufficiently accurate.
St. Mary’s Hospital will get a 0.12 percent deduction on its Medicare reimbursements, according to the March study, while Delta County Memorial Hospital and Montrose Memorial Hospital are getting 0.14 percent and 0.07 percent reimbursement reductions, respectively.
Family Health West in Fruita and Grand Junction Veterans Affairs Medical Center were not included in the report.
Community’s chief medical officer, Dr. Donald Nicolay, said nurses and case managers check on patients throughout their hospital stay, check their progress by phone after patients are discharged and have print-outs of care instructions. He said making sure patients fill their prescriptions, take them properly and perform other self-care techniques are key to avoiding readmissions.
Dan Prinster, vice president of business development for St. Mary’s, said a data service that tracks readmission rates for patients with more than 100 different diagnoses shows St. Mary’s has a below-average readmission rate overall. The rate goes up for the three conditions CMS tracks, which Prinster said is to be expected given St. Mary’s size in a rural region.
“We are the only facility between Denver and Salt Lake City with a full range of cardiovascular health care. A lot of times we will get referred from other hospitals their more complex heart patients, who are at highest risk of readmission,” he said.
Prinster said he feels the hospital is doing well with readmissions but could do better. Later this spring, St. Mary’s will implement an auto-dialing system that will call heart failure patients periodically after they are discharged from the hospital and ask if they are performing proper self-care tasks and recuperating. If not, a nurse will call the patient personally.
Montrose Memorial Chief Nursing Officer Joan Napolilli said the hospital has received professional advice on readmission avoidance, has nurses call patients after discharge and sends patients home with a notebook filled with personalized care information. Delta County Memorial Chief Clinical Officer Jody Roeber said her hospital doesn’t have a formal readmission program but tracks data and has staff make follow-up phone calls “with as many patients as we can.”
The fiscal impact for hospitals is unclear at this point, but it will make a dent in finances. Roeber said the patient impact is more important for hospitals than a monetary penalty. But the penalties may have “a minimal effect.”
“I think we’re cautious because it’s another potential area where they can penalize us financially but we feel confident in our staff avoiding readmission,” she said.