Readmission Rates Revealed for 292 Worst Hospitals

Cheryl Clark, for HealthLeaders Media , September 1, 2011

In looking through the data, I noticed it's not necessarily just medium or smaller rural or community hospitals that are getting whacked with bad scores.

Beth Israel Deaconess Medical Center, with 631 beds in Boston, shows up as "worse" in its readmission rates in all three categories. So does Barnes Jewish Hospital, a 1,259-bed facility in St. Louis, MO and Brookhaven Memorial, a 306-bed hospital in Patchogue, NY.

Others on the list include Florida Hospital in Orlando, Franciscan St. James Health of Olympia Fields, IL, Our Lady of the Resurrection in Chicago, and San Juan VA Medical Center in Puerto Rico.

Also surprising is the number of well-known names in the list of 54 hospitals that were "worse" in two out of the three categories. They include Northwestern Memorial in Chicago, University of Massachusetts Memorial Medical Center in Worcester, the Cleveland Clinic, Henry Ford Hospital in Detroit, Johns Hopkins Bayview Medical Center in Baltimore and the University of Maryland Medical Center in Baltimore.

The penalties start at 1% for Medicare DRG discharges on or after Oct. 1, 2012, increase to 2% on or after Oct. 1, 2013 and to 3% on or after Oct. 1, 2014.

Which hospitals have the best, or lowest readmission scores, the ones that appear now to be least likely to get a payment cut? Pennsylvania-based Lancaster General Hospital and University of Pittsburgh Medical Center Hamot and Muncie, IN-based Ball Memorial Hospital all fell into the “better" range in all three disease categories. About 21 other hospitals scored "better" in two disease categories.

Now, with press reports shedding light on this obvious quality problem, hospitals are starting to react in an effort to thwart negative publicity.

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3 comments on "Readmission Rates Revealed for 292 Worst Hospitals"

Deb Fiscus (10/18/2011 at 6:44 AM)
I have always felt that readmission rate as a measure of success was blantantly unfair. A hospital can provide the best care and get the patient ready for homegoing and still the patient will be back because they have not followed the discharge instructions [INVALID]quit smoking,change diet patterns, exercise either because they are unwilling, unable or can't afford the changes. Our hospital provides nutrition counseling, ongoing support for diabetics, smoking cessation and community exercises that are free, but we still have over 50% of the county who are hypertensive, diabetic and/or morbidly obese. These are the people who are consistantly readmitted even with the best efforts of the hospital staff. They refuse to make the needed life changes to keep them out of the hospital and thus continue to be readmitted for the recurrent problems that could be alleviated by following the discharge instructions and availing themselves of the available community resources. They choose NOT to and there is no punishment for them, only for the hospital that continues to readmit them. I envision a list of "DO NOT admits for 30 days following discharge" in the hospital ERs in order to preserve the Medicare funding.

Mary Freebern (10/17/2011 at 8:33 AM)
I have worked as a nurse in both areas (acute care and long-term care). There is a huge difference in what kinds of information is required to give the patients the care they need. In acute care facilities the need is for the patient history, medications being taken, and the length of time the patient has suffered from the current symptoms. A long-term care facility needs to know what steps they can take to keep the patient healthy and what to watch for in the case of a re-occurrence of symptoms. These criteria are vastly different and require better communication between these facilities. Nurses at a long-term care facility need to be able to follow a defined care plan that will assist them in keeping their patients out of the hospital. Unfortunately, most acute care nurses don't know what kinds of information that the nurses at the long-term facility need to know. I feel that if the acute care nurses and the nurses that work in long-term care could get together and discuss the information that is needed by the long-term care nurses that the patient would definitely benefit. This could be in the form of a specific check sheet or a questionnaire that is used by each facility. In that way they could be certain that the after care provided by the accepting facility would be more conducive to assuring the patient gets the best possible care. This would greatly decrease the need for re-hospitalization. The main focus of each nurse is providing the best possible care for their patients.

Chris Zona (9/2/2011 at 9:37 AM)
when one looks at the scores they need to look at the population being severe. If these are end-stage patients with no resources, even the best care will result in readmission rates that are high. It is no surprise that even though well known hospitals which served these populations have the statistics. Until we have insurance that will pay for long-term care and more resources outside the hospital, these rates will not change substantially.




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