In a painful cut to their bottom lines, six San Diego County hospitals are being punished by Medicare for poor ratings on patient-safety incidents, such as infections.
Hospitals being fined 1 percent of their Medicare reimbursement include well-known UCSD Medical Center, Tri-City Medical Center in Oceanside and Sharp Coronado Hospital and Health Center, according to data released Wednesday.
The county’s worst rating (9.0) was assigned to Scripps Green Hospital in La Jolla, which also was dinged last year. Nationwide, 758 hospitals are being penalized — up from a little over 400 medical facilities last year.
“The fines are based on the government’s assessment of the frequency of several kinds of infections, sepsis, hip fractures and other complications,” said a Kaiser Health News report. “Medicare will lower all its payments to the penalized hospitals by 1 percent over the course of the federal fiscal year, which runs through September 2016.”
The types of potentially avoidable complications involve blood clots, bed sores and falls.
Medicare calls it the Hospital-Acquired Condition Reduction Program and estimates the penalties will cost hospitals $364 million.
The penalties — Section 3008 of the 2010 Affordable Care Act — were called the toughest sanctions Medicare has taken on hospital safety.
“I think the penalties are important,” Helen Haskell, a prominent patient advocate, was quoted as saying. “I think it’s the only thing that gets people’s attention. My concern is the measures stay strong or even be strengthened.”
Also penalized were Scripps Memorial Hospital in Encinitas and Scripps Mercy Hospital in Hillcrest — the oldest hospital in the county, founded in 1890 by the Sisters of Mercy.
Hospital representatives didn’t immediately respond to requests for comment.
The government says the HAC Reduction Program requires the secretary of Health and Human Services to “adjust payments to hospitals that rank in the worst-performing 25 percent of all subsection hospitals with respect to HAC quality measures.”
Under the Affordable Care Act, also known as Obamacare, “these hospitals may have their payments reduced to 99 percent of what would otherwise have been paid for such discharges,” according to QualityNet.org.
Hospitals with a score of 6.76 and higher will feel the Medicare cuts. Besides Scripps Green, at least seven other California hospitals scored at 9 or above, with the worst being Rideout Memorial Hospital of Marysville, north of Sacramento (9.75).
El Centro Regional Medical Center was given a 9.25 score.
Here are scores of listed county hospitals.
- SCRIPPS GREEN HOSPITAL 9
- UC SAN DIEGO MEDICAL CENTER 8.75
- SCRIPPS MEMORIAL HOSPITAL ENCINITAS 7.75
- SHARP CORONADO HOSPITAL AND HEALTHCARE CENTER 7.5
- TRI-CITY MEDICAL CENTER 7.5
- SCRIPPS MERCY HOSPITAL 7
- PALOMAR HEALTH DOWNTOWN CAMPUS (ESCONDIDO) 6.75
- POMERADO HOSPITAL 6.75
- SCRIPPS MEMORIAL HOSPITAL LA JOLLA 6.5
- SHARP MEMORIAL HOSPITAL 6.5
- PARADISE VALLEY HOSPITAL 6.25
- SHARP CHULA VISTA MEDICAL CENTER 6.25
- KAISER FOUNDATION HOSPITAL 5
- SHARP GROSSMONT HOSPITAL 4.5
- ALVARADO HOSPITAL MEDICAL CENTER 2.5
This is the second year of the program. All but Tri-City were also penalized last year.
The penalties were based on the government’s assessment of the frequency of infections over the last two years in patients with lines inserted into veins, urinary catheters and incisions from colon surgeries and hysterectomies. The infection rates comprise 75 percent of Medicare’s evaluation.
The remainder includes things like surgical tears, collapsed lungs, broken hips and reopened wounds.
The law exempts hospitals that serve veterans and children — such as Rady Children’s Hospital, and those that are the only health-care providers in a particular area.
— City News Service contributed to this report.