Castleview Hospital in Price was among five Utah hospitals recently penalized for having higher than average rates of hospital-acquired conditions (HAC), such as pressure sores and hip fractures after surgery. Several other measures are also used to determine a hospital’s total hospital-acquired condition score, including performance across five healthcare-acquired infections: bloodstream infection, catheter-associated urinary tract infection, surgical site infection, Methicillin-resistant Staphylococcus Aureus (MRSA), and Clostridium Difficile (C. diff).
The Centers for Medicare and Medicaid Services (CMS) HAC Reduction Program encourages hospitals to make patient safety better and reduce the number of hospital-acquired conditions by penalizing facilities that are above a certain threshold. Hospitals with a total HAC Score greater than the 75th percentile of all HAC Scores are subject to a 1 percent payment reduction.
Other Utah hospitals penalized for the current fiscal year include LDS Hospital in Salt Lake City, Alta View Hospital in Sandy, Jordan Valley Medical Center in West Jordan, and Mountain West Medical Center in Tooele.
In reacting to the HAC penalty, Castleview Hospital administration officials noted the hospital is being compared to much larger facilities across the country, such as Brigham and Women’s in Boston, Massachusetts, the Mayo Clinic in Cleveland, Ohio, and other top facilities that were also penalized by CMS.
Chief Nursing Officer Grant Barraclough said Castleview has a lot fewer cases of HAC, but just one or two cases can affect the ranking.
“When we say a bump, our bump is one patient in a year, where LDS (hospital) might be 50 or 60. And it goes off a percentage, so one for us is too many when it comes to our goal.”
Infection Preventionist Leslie Lauritsen characterized the ranking as kind of a scorecard.
“It’s just areas where you need to improve. And your rate depends on how everybody else is doing. One year you can have one number do really well, have the same number the next year and not do so well,” she said. “The ranking was based on really old scores, and this is not how we’re doing now.”
Barraclough emphasized the HAC Program is centered on the patient. “This isn’t about us not getting as much reimbursement,” he said. “This is about us making sure that we’re doing what’s right for the patient. That’s what the focus is—that’s what we focus on as well.”
“The ones that we’ve been on the list for were the C. Difficile. In 2015 we had a spike and then we haven’t really had spikes after that.”
Barraclough also pointed out Castleview Hospital is ranked high nationally among rural hospitals. “In the same year we get that HAC penalty, we’re a four-star CMS rating. We also were on Becker’s top 100 hospital list.”
According to the Becker’s Hospital Review website, Castleview was named among the top 20 rural community hospitals in the nation by the National Rural Health Association in June 2017 for clinical quality, operational excellence and economic impact on the surrounding community.
Castleview Hospital is part of Brentwood, Tennessee-based LifePoint Health, a company that provides healthcare services for rural communities in 22 states. The company also owns Ashley Regional Medical Center in Vernal.
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