CMMC penalized for infections, patient safety

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LEWISTON — For the second consecutive year, Medicare will penalize Central Maine Medical Center for its high rates of infection and patient injuries.

The news comes just weeks after CMMC’s accrediting agency said the hospital was not doing enough in its policies and procedures to prevent infections. The agency gave the hospital 30 days to improve or risk its accreditation.

CMMC President David Tupponce said Tuesday the hospital is working on its issues.

“We’re not trying to hide the fact we still have opportunities to improve as an organization,” he said. “We’re striving toward zero harm to our patients and to our employees. That’s really what we’re striving for.”

The Centers for Medicare & Medicaid Services announced last week that it was fining 751 hospitals for their infections and injuries. In Maine, four hospitals are being fined, including Cary Medical Center in Caribou, Southern Maine Health Care in Biddeford and York Hospital.

CMMC is the only Maine hospital on the list for a second year.

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Medicare began penalizing hospitals four years ago to motivate them to cut down on infections and other complications that can hurt or kill patients and cost the federal insurer money. Medicare considered infections from a variety of surgeries and procedures, including hysterectomies, urinary tract catheters and central lines. It also looked at 10 kinds of inpatient injuries and complications, including bed sores, blood clots and sepsis.

Under the program, hospitals lose about 1 percent of their Medicare payments for the year, which can amount to hundreds of thousands of dollars, depending on how many Medicare patients that hospital sees.

Since the list was just announced last week, Tupponce said, it is yet unclear exactly how much money CMMC will lose.

Tupponce noted that Medicare’s infection and injury data is old — between a year and three-and-a-half years old. That’s a common complaint among hospital leaders, who say Medicare’s old data can highlight a problem that has since been fixed or can fail to show current problems.

However, The Joint Commission, CMMC’s accrediting agency, saw problems with the hospital’s infection work as recently as three weeks ago.

In early December, the commission performed its routine reaccreditation survey at the hospital. Such surveys are done about every three years, according to hospital spokesman David Landau.

The group found problems around infection control policies and procedures, and it gave CMMC 30 days to improve. According to Landau, the hospital was told it needs to work on three key areas:

• The processes involved in cleaning high-risk equipment.

• Using best practices to maintain a safe environment for patients and staff before, during and after care.

• Encouraging and empowering staff to identify and correct situations that could put patients or staff in danger.

Landau said the hospital is working on those issues and that CMMC leaders “fully expect our accreditation to be renewed.”

He noted that the commission made re-accreditation more rigorous in 2017, causing many hospitals in Maine and New England to fall short.

A spokeswoman for t commission said standards are always evolving and changes are not confined to one year. She could not confirm whether other area hospitals have had trouble keeping up with those standards.

Tupponce said CMMC has been working on infection control, including putting in place new protocols for urinary tract catheters and central lines.

He said the hospital will soon appoint a chief quality officer and it is working on changing the culture of the hospital to one “where safety and quality is what we’re thinking about every day, and that is where we really focus our resources, our time and our energy.”

Tupponce said the hospital is “raising the bar” and hopes to exceed expectations in the future.

“Even if we have one patient who doesn’t have an optimal outcome,” he said, “there are lessons to be learned there that we can use to continue to improve.”

In October, Leapfrog Group, a Washington, D.C.-based nonprofit that tracks health-care safety, quality and value, gave CMMC a grade of “B” for safety. It found the hospital performed well when it came to two types of infections, blood clots and surgical wounds staying closed.

It found the hospital performed poorly when it came to urinary tract infections during an ICU stay, surgical site infection after colon surgery, patients dying from treatable complications and staff working together to prevent errors.

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  • beyondtheprogramming

    No, you’re not working with OLD DATA! My beloved friend went in to CMMC the second week of December, 3 weeks ago, for “routine” colonoscopy and came out 24 hours later with C-Diff infection and sepsis. This is the direct result of Pharmaceutical educated doctors and staff, driven by for-profit health care.

  • sherflash32

    In 2009 I was sent home twice by CMMC when I had a Group A Strep infection and as a result ended up being hospitalized and having an emergency tracheotomy which could have been avoided if my Primary Care doctor would have treated me. I was first told that my swollen chin was just a “pimple” and when I went to the hospital the next morning with a fever of 104.5 degrees and a bright yellow blister on my lip I was told that I had the bird flu. If I hadn’t woken up in the night when my face swelled up like a monster (it also happened to be Halloween) and walked back to the hospital because my car wouldn’t start then i would have died in my bed. 45 minutes after I got to the hospital after many doses of Epinephrine, Benedryl, inhalers, etc. a trauma team brought me to the OR to intubate me but ended up giving me a trach. I was in the ICU on Vancomycin and Fentanyl, besides a bunch of other medications, and went home with a pic line in my arm because my teenage son was home alone. And all because one doctor was pompous and rude to me because it was late Friday afternoon and i can only guess at any other reasons why he was condescending to me. My case may be old data but it is also an example of how the medical system can mistreat and misdiagnose patients and cause the most worse case scenario in a patients life.

  • LauraCondon

    Expect this to get worse as more and more medical workers are being bullied into getting flu shots that are making them and their patients sick.