LEWISTON — St. Mary’s Regional Medical Center could lose a little more than $100,000 because of its high infection and complication rates.
The hospital was one of six in Maine and one of 721 nationwide to be penalized by the federal government, according to an analysis by Kaiser Health News. All will see Medicare payments cut by 1 percent for the next year.
Betsey Shew, director of performance improvement for St. Mary’s, estimated that 1 percent will be just over $100,000 for the Lewiston hospital.
The loss won’t financially devastate St. Mary’s, she said, but “it’s enough to get our attention.
“Every dollar counts for us right now,” she said.
St. Mary’s learned in June that it was on the preliminary list of hospitals that had infection and complication rates deemed too high. When the final list was released recently, the hospital had a score of almost 8.4 out of 10. Hospitals that scored above 7 were penalized.
To come up with those scores, the federal Centers for Medicare and Medicaid Services looked at eight types of patient injuries that can result from medical treatment, including blood clots, bed sores, accidental falls after surgery and collapsed lungs. It also looked at urinary tract infections from catheters and bloodstream infections in patients who had catheters, also called central lines, placed in major veins.
Shew said the actual number of infections at St. Mary’s was small, with none in 2011 and six during 2012 and 2013. A number of those patients battled infections not necessarily because their doctor did something wrong, she said, but because those patients were very sick.
“They all had great outcomes. They all were treated very well during the course of their stay and ultimately had full recoveries. But definitely their care was complicated by these infections,” she said. “Whether or not they were preventable in that particular population of patients, I’m not really sure.”
St. Mary’s also discovered coding errors that bumped up the hospital’s rate of complications. In some cases, an injury was written down as a complication when it wasn’t one. By the time the errors were discovered, she said, the deadline to correct the information had passed.
Shew said the hospital has since worked on validating such information.
“The quality staff, the doctors and the coders are all much more aware of this as a result of the penalty. So I think that our data is much more accurate,” she said. “That doesn’t mean that we still won’t periodically have some complications. I don’t want to to sound like, ‘Okay, you fixed all the documentation and it solves all the problems.’ We still look constantly at how do we improve our techniques.”
Among those improvements: Using catheters as little as possible and removing them quickly, replacing mattresses to reduce the bed sores, and working to prevent infections in patients who have been identified as high risk for contracting them.
Although the hospital was penalized by CMS for its infection rates and complications, Shew pointed out that other organizations have repeatedly recognized St. Mary’s for its quality care.
“We should be continuing to focus on it and pay attention, but I don’t want people to think that the six (Maine) hospitals that were undergoing this penalty are bad facilities, because I don’t think that’s the case,” she said.