Four hospitals in the Charlotte region will be docked 1 percent of Medicare payments in 2016 because they exceeded federal standards for infections and other safety factors.
The penalty, in its second year, is part of the Affordable Care Act’s punishment-and-reward system created to keep down unnecessary medical spending and control health care costs.
Charlotte-area hospitals on the list are Novant Health Presbyterian Medical Center in Charlotte and Shelby’s Cleveland Regional Medical Center, which is owned by Carolinas HealthCare System. Both were also penalized last year.
Across the border in South Carolina, Chester Regional Medical Center in Chester and Springs Memorial Hospital in Lancaster will also be penalized in 2016. Neither was on the penalty list last year.
The second round of federal penalties, announced last week, will affect 758 hospitals nationwide – including 15 in North Carolina. Nationally, they will be fined by Medicare for a total of about $364 million in 2016, according to Kaiser Health News, an independent information service.
Last year, 721 hospitals were penalized for safety-related factors for a total of $373 million. That included 17 North Carolina hospitals.
The 2016 penalty averages about a half-million dollars per hospital, but hospitals with a heavy volume of Medicare patients could end up losing well over $1 million in Medicare revenue. Novant Health officials said the Presbyterian penalty will be about $900,000. Carolinas HealthCare declined to provide an estimate of the penalty for Cleveland Regional.
Novant Health officials said they’ve been “working diligently” to reduce hospital-acquired infections at Presbyterian in the past year and those results will be reflected in future Medicare reports. Data from the latest report “reflects performance from approximately 12 to 18 months ago,” officials said. “Novant Health is committed to reducing hospital-acquired conditions at all its facilities.”
Officials at Carolinas HealthCare said they take a systemwide approach to reducing hospital-acquired conditions and that, because of “reporting time frames,” data from Medicare “is not always reflective of the recent improvements we’ve seen from our efforts in multiple areas.”
Four hospitals in the Charlotte region are among 758 nationwide that will be penalized by Medicare for exceeding federal standards for infections and other safety factors.
The fines are based on the frequency of occurrence of infections and other complications between July 2012 and June 2014, according to Kaiser Health News’ analysis of the penalties. The penalties will lower Medicare reimbursements to the hospitals through the federal fiscal year, which ends Sept. 30, 2016.
The Affordable Care Act mandates penalties for hospitals that Medicare assesses as having the highest rates of hospital-acquired conditions, including infections from catheters, blood clots, bed sores and other complications that are considered avoidable.
In determining penalties, Medicare judged hospitals on three measures: the frequency of central-line bloodstream infections caused by tubes used to pump fluids or medicine into veins, infections from tubes placed in bladders to remove urine, and rates of eight kinds of serious complications that occurred in hospitals, including collapsed lungs, surgical cuts, tears and reopened wounds and broken hips.
Patient safety advocates worry the fines are not large enough to alter hospital behavior and that they only examine a small portion of the types of mistakes that take place. “I think the penalties are important,” Helen Haskell, a prominent patient advocate from South Carolina, told Kaiser Health News. “I think it’s the only thing that gets people’s attention. My concern is the measures stay strong or even be strengthened.”
The Kaiser Health News analysis showed that Medicare safety penalties affected some of the nation’s best-known health care systems, including hospitals within the prestigious Mayo Clinic Health System in Minnesota.
In addition to monitoring safety, Medicare also penalizes hospitals for excessive readmissions and pays bonuses for patient satisfaction and other performance measures.
Staff writer John Murawski contributed to this article.