KU hospital among 11 penalized in Kansas
Kansas University Hospital representatives say a study resulting in cuts to its Medicare payments relied on old data and flawed methodology, and was particularly unfair to academic hospitals.
“The academic medical centers get the sick patients that nobody else wants to or can take care of,” said Lee Norman, KU Hospital’s chief medical officer. “We get the sickest of the sick.”
KU Hospital is one of 11 hospitals in Kansas and 721 nationwide that will have their Medicare payments lowered by 1 percent over the fiscal year that began in October 2014 and continues through September of this year. A federal Centers for Medicare and Medicaid Services study released last month identified the hospitals as having the highest rates of hospital-acquired conditions, including infections from catheters, blood clots, bed sores and other complications considered to be avoidable.
Kaiser Health News, which analyzed the study, called it the federal government’s “toughest crackdown yet” on medical errors and noted that the penalties are falling especially hard on academic medical centers. Nationwide, roughly half of them will be punished, the news service reported.
Norman said that while the Medicare study has adjustments to account for differences in hospitals, they are insufficient and don’t “compare apples to apples.”
KU Hospital has the region’s only federally verified Level I Trauma Center and American College of Surgeons verified adult and pediatric burn unit, according to hospital officials.
The hospital also takes patients from across the state that need a higher level of care, and Norman said many come because of a serious hospital-acquired condition.
“We recognize, diagnose and treat it,” he said. “And we get dinged for it because we’re the ones that diagnosed.”
Norman said the Medicare study relied on data that is a year and a half or more old.
While the hospital takes all data seriously, he said, it relies heavily on its own data to identify problems and look for improvements.
“We manage these things real-time,” he said. “Nobody is more concerned about hospital infections than we are. We follow it day to day and week to week.”
In one example, Norman said, a year and a half ago KU Hospital changed its policy to require central lines — IV lines that go into large vessels as opposed to peripheral ones, usually only put in very sick patients — be left in only as long as they have to, because of the risk of infection.
He said the hospital also uses more expensive but less infection-prone silver-coated catheters and encourages patients to use the restroom on their own as soon as they are able so catheters can be removed.
Medicare evaluated 51 Kansas hospitals, 40 of which were not penalized after scoring below 7 on a 10-point scale for hospital-acquired conditions.
Hospitals that provide specialized treatment, such as psychiatry or rehabilitation, or cater to particular patients, such as children or veterans, were exempt from the inspections. Small “critical access hospitals,” mainly in rural areas, also were exempt.
Medicare studied the frequency of central-line blood stream infections caused by tubes used to pump fluids or medicine in to veins and frequency of infections from tubes placed in bladders between Jan. 1, 2012, and Dec. 31, 2013; and serious complications that occurred in the hospitals, such as collapsed lungs, surgical cuts, tears and reopened wounds and broken hips, between July 1, 2011, and June 30, 2013.
Such data can certainly be alarming, Norman said. He said KU Hospital encourages patients to ask questions.
“Transparency is important,” he said.
In addition to KU Hospital, the other Kansas hospitals penalized are Overland Park Regional Medical Center, Menorah Medical Center in Overland Park, Saint Luke’s South Hospital in Overland Park, Saint John Hospital in Leavenworth, Miami County Medical Center in Paola, Kansas Heart Hospital in Wichita, Sumner Regional Medical Center in Wellington, Hutchinson Regional Hospital, South Central Kansas Medical Center in Arkansas City and Coffeyville Regional Medical Center.
— The Associated Press contributed to this story.