A New Orleans hospital is contesting the results of a federal study that suggested patients at the facility suffered from high rates of potentially avoidable infections and other complications.
St. Charles Surgical Hospital, 1717 St. Charles Ave., was one of six facilities in the greater New Orleans area that were penalized this month by the U.S. Centers for Medicare and Medicaid Services.
Medicare is reducing payments by 1 percent for more than 750 hospitals nationwide that were cited in the review, which is now in its second year after being mandated by the 2010 Patient Protection and Affordable Care Act. The hospitals will receive 99 percent of what they would otherwise have received for full discharges.
St. Charles Surgical Hospital, which specializes in breast reconstruction surgery, contends that it filed for an exemption from part of the program’s scoring system because the hospital does not have an intensive care unit.
In calculating the hospital’s score, a default number was used when, in fact, that portion should have been marked “not applicable,” according to a hospital spokeswoman, Liz Bodet.
“Simply put, because St. Charles Surgical Hospital does not have any ICU beds, the agency automatically and incorrectly rated us at the highest infection rate level possible as a default,” said Bodet, who added that hospital officials are working with the federal agency to revise the published data.
In the latest government review, 758 out of 3,308 hospitals nationwide were penalized, including 20 in Louisiana. Total savings from the reduced reimbursements are expected to be about $364 million.
Last year, 724 hospitals were penalized.
The federal program has drawn ire from the Louisiana Hospital Association and other members of the hospital industry because it requires that 25 percent of hospitals face penalties, even if their performance improves, according to the LHA.
That means an individual hospital could improve significantly but still be penalized because it hasn’t caught up to its peers, the LHA said.
Hospitals that were penalized are allowed to raise issues about the scores they received.
Citing the American College of Surgeons’ National Surgical Quality Improvement Program, Bodet said the St. Charles hospital’s surgical site infection and urinary tract infection rate is less than 1 percent and has been below the national performance average since 2012.
The five other hospitals in the New Orleans region that face penalties are Touro Infirmary, Tulane Medical Center and University Medical Center in New Orleans; Lakeview Regional Medical Center in Covington; and Southern Surgical Hospital in Slidell.
Follow Richard Thompson on Twitter, @rthompsonMSY.