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Northland facilities penalized for hospital-acquired conditions

The four penalized hospitals include St. Luke's in Duluth, Grand Itasca Clinic and Hospital in Grand Rapids, Essentia Health in Virginia and University Medical Center-Mesabi in Hibbing.

St. Luke's aerial photo
St. Luke's hospital in Duluth, pictured in July 2020.
Tyler Schank / File / Duluth News Tribune
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DULUTH — A dozen Minnesota hospitals, including four in the Northland, have been penalized by the federal government for falling within the bottom 25% nationally at preventing hospital-acquired conditions. The penalties are detailed in a database released by the Kaiser Family Foundation.

Nationally, 764 hospitals were singled out for poor performance on hospital-acquired conditions — conditions the patient develops while in a hospital being treated for something else — among patients discharged between July 2018 and the end of 2019. The adverse outcomes include blood clots, sepsis, bed sores, wound ruptures after surgery, and infections acquired after catheters, central lines and surgeries.

The hospitals named will receive a 1% reduction in their payments from Medicare for fiscal year 2022, according to the Centers for Medicaid Services. The Hospital Acquired Conditions Reduction Program penalties have been levied annually since 2015 as a condition of the Affordable Care Act.

Minnesota providers on the new list included independent facilities as well as regional outposts operating under the banner of Essentia, Fairview, CentraCare and Mayo Clinic.

The full list of Minnesota hospitals penalized are:

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  • Carris Health in Willmar.
  • Essentia Health St. Mary's in Detroit Lakes.
  • Essentia Health in Virginia.
  • Fairview Northland Regional Hospital in Princeton.
  • Grand Itasca Clinic and Hospital in Grand Rapids.
  • Mayo Clinic Health System Red Wing.
  • Ridgeview Medical Center in Waconia.
  • St. Cloud Hospital.
  • St. Luke's in Duluth.
  • University Medical Center-Mesabi in Hibbing.
  • University of Minnesota Fairview.
  • Winona Health System.

Mayo Clinic Red Wing, Fairview Northland in Princeton, and University of Minnesota Fairview in Minneapolis have all now received the penalty for a fourth straight year — and in the case of Fairview, a seventh time overall. Mayo Clinic Phoenix in Arizona has been penalized for a third straight year, as have Winona Health System and University Medical Center-Mesabi.
In a statement to the News Tribune on behalf of the University Medical Center-Mesabi and Grand Itasca, Fairview Health Services said: "Patient safety is our highest priority and we continue to work toward zero preventable infections at all of our hospitals."

Nick Van Deelen, co-president, co-chief executive officer and chief medical officer at St. Luke's, said the health care system has seen encouraging improvement in safety and quality of care, despite the "disappointing" penalty.

Van Deelen said St. Luke's has been recognized for its efforts this year as one of eight organizations in the country to receive the Guardian of Excellence Award from Press Ganey for excellence in clinical quality. The award is based on 2020 data and recognizes performance in the top 5%.

"This penalty, which affected a quarter of the participating hospitals in Minnesota, is based on data that is more than two years old," Van Deelen said. "Quality and safety are core values at St. Luke’s and we are constantly evaluating our performance and improving our processes to ensure that our patients receive the safest care available."

The penalties are designed to elevate the quality of care in the United States, which had witnessed steady improvement on the problem of hospitalization leading to new illness, only to witness a stark worsening of the metric amid the crush of new patients and loss of personnel during the pandemic.

Essentia Health said in a statement to the News Tribune that hospital-acquired infections are taken very seriously, and each case is reviewed by a committee to track and analyze data to implement best practices to keep patients safe.

"We have an engaged team of providers and professionals in infection prevention, pharmacy, quality and nursing who are dedicated to our aim of zero preventable harm," Essentia said in the statement. "The safety and well-being of our patients is Essentia’s highest priority."

Many of the hospitals penalized by Medicare have paradoxically also earned its highest five-star rating for overall performance, including the Mayo hospitals in Red Wing and Phoenix.

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Leading the state in consecutive years of under-performance on the metric was Carris Health in Willmar, according to a review of the KFF database filtered for hospitals in Minnesota. It faces a fifth straight year of docked Medicare payments for hospital-acquired conditions, its sixth designation over the eight years since the start of the penalty system.

According to a new analysis in the New England Journal of Medicine, a 31% decrease over five years in central line-associated bloodstream infections since 2017 has been "almost totally reversed" during the pandemic. That same paper cites a study from August 2021 reporting that central line infections rose 60%, catheter infections 43%, and resistant staph infection 44% during the first six months of the pandemic.

Children's Hospitals, VA facilities, psychiatric and critical access hospitals are all excluded from the quality control review.

"Mayo Clinic is committed to the highest quality patient care, which is reflected in our top quality and safety rankings," Mayo spokesperson Jay Furst said in a statement. "The Centers for Medicare and Medicaid Services have recognized Mayo Clinic Health System in Red Wing and Mayo Clinic Hospital in Arizona as five-star hospitals, the top ranking, which is especially notable because of the complex and serious medical conditions for which patients come to Mayo Clinic for treatment. We are dedicated to continuous quality improvements that benefit all patients.”

Representatives for Carris not return a request for comment in time for publication.

The results were first reported as part of a state-by-state database compiled by Kaiser Health News.

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Paul John Scott is the health reporter for NewsMD and the Rochester Post Bulletin. He is a novelist and was an award-winning magazine journalist for 15 years prior to joining the FNS in 2019.
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