3 Borderland hospitals impacted by Medicare penalty

Three Borderland hospitals will have their Medicare payments reduced because of the number of patients who got hospital-acquired conditions while being treated.

University Medical Center, El Paso Specialty Hospital and Memorial Medical Center in Las Cruces will all be receiving 1 percent less in Medicare reimbursement payments this year. That’s the penalty imposed by the Centers for Medicare and Medicaid Services.

The list of what’s referred to as an HAC is on the CMS website. It includes: foreign objects retained after surgery, falls and trauma that happens to patients inside hospitals, catheter-associated urinary tract infections, surgical site infections, blood incompatibility and more.

ABC-7 reached out to all three hospitals for comment on this story, but only heard from UMC.

“Of course, this is not something that we are content with because even if we were to get one infection, or one HAC, that is one condition too many,” Chief Nursing Officer Joe Garcia said.

UMC was given the worst possible rating for hospital-acquired conditions by the CMS, a 10. The best, or lowest score, is 1. Nearby neighbor EPSH is rated the same at Las Cruces’ Memorial Medical Center, with a 9. That means the three hospitals will see a 1 percent decrease in Medicare payments in the current fiscal year, 2015. For UMC, that’s a loss of $350,000.

“These are the uninsured or under-insured patients. People without health insurance are less likely to receive timely and recommended health care,” Garcia said. “Now you have that unique state of being that when they come into the hospital, they’re sicker, which requires a prolonged hospitalization. Even the research has demonstrated that prolonged hospitalizations can and may lead to other complications.”

UMC officials say the decrease in Medicare payments will not affect the treatment patients receive, nor are they expecting lay-offs or hospital operations to be affected. They say only 18 out of nearly 34,000 patients developed serious complications while in hospital staff care within nearly a two year time span.

“We’re looking at every case that was identified as a HAC,” Director of Quality Management Javier Gonzalez said. “If we find that one case is not considered a HAC, we are looking into the process how to appeal this.”

UMC, EPSH and Memorial Medical Center are three of about 724 hospitals penalized this year. The total HAC score is determined by two categories: patient safety and healthcare-associated infections. The program is not only meant to improve patient safety, but is also expected to save Medicare $30 million a year.