MMMC penalized again, Director says report is old

March 14, 2019

By Pat Maurer

Clare’s MidMichigan Medical Center is one of 24 hospitals across the state penalized by the Centers of Medicare and Medicaid Services (CMS) for “hospital acquired conditions,” a release from the Economic Alliance for Michigan (EAM) said.

This is the third time for the Clare hospital has been penalized by CMS. They lost funding for the same issues in 2016 and again in 2017. Clare is among 1,756 hospitals across the U.S. that have penalized at least once before.

Kaiser Health News reported March 1st that penalized hospitals will reduce payments to 800 hospitals nationwide by one percent of Medicare payments in the coming year. Larger hospitals’ losses could exceed a million dollars.

The goal is to hold hospitals accountable for hospital acquired infections such as blood clots, sepsis, bedsores and other adverse events that a patient may acquire during a hospital admission, part of the Hospital Acquired Conditions (HAC) Reduction program.

A release on March 8th from the MidMichigan Medical Center Newsroom said, “The report is part of a Medicare payment reduction program, the Hospital Acquired Condition (HAC) Reduction Program, with a goal to lower the number of reasonably preventable conditions that patients develop during hospital stays. The report referred to in the analysis was related to performance between January 1, 2016 to December 31, 2017.”

“While Centers for Medicare Services Hospital Compare or related public data is one of many ways to measure quality, we caution using these reports as the only mechanism to monitor quality,” said Ray Stover, president, MidMichigan Medical Centers in Clare and Gladwin. “First, the information for the HAC report is old. And, it is calculated by Medicare itself by using claims data, which do not fully reflect the details of a patient’s history, course of care and clinical risk factors. It also does not reflect today’s performance which is remarkably different than what is reported.”

Stover continued, “Quality in patient care refers to clinical outcomes and what we can do to make a difference in the lives of our patients. Whether it is new treatments, procedures or recalibrating our efforts in identified areas of weakness, we’re making continuous improvements in procedures and processes so we can always be as safe and effective as possible.”

The news release said, “Since the reporting period, MidMichigan Medical Center – Clare has improved its surveillance process resulting in more robust self-reporting of infection data. This has resulted in an overall decrease in infections. In fact, in calendar year 2017 and 2018, the Medical Center in Clare has had zero cases of MRSA, catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), C diff and SSIs. In addition to the increased surveillance, the following interventions have been implemented:

Electronic medical record (EPIC) – EPIC searches for certain pieces of information that may indicate the presence of infection. These cases are reviewed on a daily basis for next steps of intervention.

C-difficile – this is a type of infection that continues to be an issue nationally. The Medical Center has implemented a new test for identifying this type of infection; therefore, decreasing the number of cases. The Medical Center also has a strong antibiotic stewardship program.

Hand hygiene – the Medical Center has implemented a hand hygiene compliance program, resulting in a 10 percent overall improvement.”

“Raising the bar keeps our teams committed to reaching our ongoing goals. The hard work is paying off as our current data shows,” said Glenn King, R.N., vice president, MidMichigan Medical Centers in Clare and Gladwin. “These efforts have resulted in better outcomes for our patients and have helped improve our overall performance. In fact, we just received a four star rating by CMS for our Medical Center’s performance measures.”

With a commitment to its patients, MidMichigan Medical Center – Clare has several quality measures in place including monthly leadership safety rounds, ongoing physician engagement, support through the Medical Center’s affiliation with Michigan Medicine, the implementation of the electronic medical record and daily safety huddles with staff and leadership.

“We are committed to being transparent, and most importantly, when it relates to patient safety and the quality of health care we provide. We submit all reportable infections and complications on an ongoing basis, participate in patient safety improvement programs and work with staff to improve techniques and training,” said King. “We are very proud of our continuing and proactive efforts to reduce the incidence of hospital acquired infections.”

Stover concluded, “When you need medical care, you want confirmation that you are in good hands. We’re confident that we are making a measurable difference for our patients. They are the reason we focus on quality.”

McLaren hospitals in Bay City, Flint and Lapeer are also on the penalized list as well as Munson Healthcare in Cadillac and Flint’s Hurley Medical Center and McLaren in Flint. Four hospitals have been penalized for the past five years straight: DMC Detroit, DMC Harper University in Detroit; Hurley in Flint and McLaren in Flint.

Overall, hospitals in Michigan only accounted for 3 percent of hospitals penalized across the country; and 58 percent of the hospitals penalized in the state were located in the southeastern region of Michigan. Five of those are in Detroit and several more in the surrounding areas.

“In this report, it’s great to see the state, as a whole, performing above the national standard for patient safety,” said Bret Jackson, President of EAM, a non-profit group of Michigan employers and unions. “However,” he continued, “some facilities are harming patients, increasing their need for care, and adding to the high cost of healthcare. It is our hope to work with these hospitals to improve their outcomes.”

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