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Infection rates cost Michigan hospitals fed funding

Karen Bouffard
The Detroit News

Three Detroit Medical Center hospitals were among 20 in Michigan that lost part of their Medicare funding this year due to high infection rates.

Harper University Hospital, Detroit Receiving and Sinai Grace were among those docked 1 percent of Medicare payments for their score in a federal ranking. All are part of the DMC and located in Detroit.

Hospitals with scores greater than 6.75 from the federal Centers for Medicare and Medicaid Services lost funding. The scores were created by comparing hospitals’ rates of hospital-acquired surgical site infections, central line-associated blood stream infections, catheter-associated infections and other conditions associated with health care. Hospitals scoring higher than 6.75 are among the worst-performing 25 percent of those participating in the federal HAC (Healthcare Associated Conditions) Reduction Program.

Interactive: Hospital acquired infection rates in Michigan

DMC hospitals Sinai-Grace (8.5), Harper (8.25) and Detroit Receiving (7.7) were among the state’s worst performers. Hutzel Women’s and Heart hospitals are included in Harper’s score.

But the DMC contends the ratings aren’t reflective of its current performance.

“The DMC has been involved in state and national health system initiatives to implement best practices, which have led to reductions in central line and catheter-associated infections. Additionally, our medical staff has implemented several local initiatives to reduce preventable conditions,” Melanie Moss, DMC market director of public relations and external affairs, said in a statement.

“Our medical staff has implemented several initiatives to reduce HACs, including enhancing training for staff, physicians and residents, and reviewing all hospital acquired conditions to improve and transmit learning across the system. We continue to work toward a goal of zero preventable conditions.”

Sparrow Carson Hospital, a 61-bed acute care hospital in Carson City, about 50 miles northwest of Lansing, was worst in the state with a score of 10. Sparrow Health System, which fully integrated the Carson hospital in 2015, wouldn’t comment on the score.

Among the other worst performers: Hurley Medical Center in Flint, which scored 9.25; McLaren Flint scored 8.75; Doctors Hospital in Pontiac, 8.0; Oaklawn Hospital in Marshall, 7.25; Genesys Regional Health Center-Health Park in Grand Blanc, 7.5; Henry Ford Macomb Hospital in Clinton Township, 7; and McLaren Macomb in Mount Clemens, 7.

Community Health Center of Branch County in Coldwater, McLaren Central Michigan Hospital in Mount Pleasant and St. Joseph Mercy Hospital in Chelsea were the best-performing, all with scores of 1.

Folding performance measures together, such as those for Hutzel and Heart hospitals into Harper’s score, is a common practice that makes it hard for consumers to differentiate between hospitals, said Erica Mobley, spokeswoman for The Leapfrog Group, a national nonprofit that provides hospital quality data for consumers.

“We have been advocating with CMS to try to encourage them to end that practice because it masks performance on both ends,” Mobley said Tuesday. “You’re not able to see the variation that we know exists.

“CMS may be reporting an average rate, but the hospitals within that are performing extremely differently. ... If there are two (hospitals) that both offer similar services it definitely would be worth looking at the one with the lower rate.”

Children’s was not rated on the CMS scale because children’s hospitals are not required to report quality data to any state or federal agencies because they do not receive federal Medicare payments.

Federal and state regulators are conducting on-site inspections this week at DMC and its Central Sterile Processing facility, located in the basement of Receiving. It cleans surgical instruments for the Harper and Detroit Receiving, as well as for Children’s, Hutzel Women’s and Heart hospitals.

A six-month Detroit News investigation published last week found DMC hospitals in Midtown have been plagued by dirty, broken or missing surgical instruments for more than a decade.

Sinai-Grace is not affected by the Midtown sterilization unit.

DMC has said no patients were infected as a result of the sterilization problems. Chief Medical Officer Dr. Suzanne White, in an open letter posted to DMC’s website, said “Nothing is more important to us than the safety of our care and the trust of our community.”

The hospital system’s for-profit owner, Tenet Healthcare of Dallas, has not responded to requests for comment.

In late May, the DMC signed a contract with Unity HealthTrust of Birmingham, Alabama, to take over management of sterile processing. The agreement came one day after The News first inquired about the situation. That deal, which began June 1, did not involve job losses and allows the company to recommend and implement changes.

Nationwide, 758 out 3,308 hospitals will receive a 1 percent payment reduction applied to all Medicare discharges occurring between Oct. 1, 2015 and Sept. 30, 2016. It’s part of the federal government’s HAC Reduction Program, which started in 2015 under the Affordable Care Act.

kbouffard@detroitnews.com