Becker's Hospital Review

64 CMO / CARE DELIVERY CMS faults New Jersey nursing home for outbreak that killed 11 kids By Megan Knowles S tate health inspectors initially blamed poor hygiene for an adenovirus outbreak that killed 11 kids at a Wanaque, N.J.-based nurs- ing home and rehab center last fall. However, a CMS report found the bigger problem was that the facil- ity's leaders didn't respond fast enough when the outbreak hit, according to northjersey.com. e report said the pediatric medical director of the Wanaque Center for Nursing and Rehabilitation was so disengaged in his role that he did not know how many children were infected or what his job entailed. at physician, who is not named in the report, told inspectors he had been barely aware of the crisis. "I knew we had a problem aer the fourth death," he said, according to the report. But it took five more weeks — and seven more deaths — before the outbreak was controlled. ese leadership deficiencies "contributed to the delay in identification and containment of [the] ad- enovirus outbreak, affecting 33 residents [and] one staff, and resulted in 11 pediatric resident deaths," the report said. Adenoviruses usually only cause a cough, cold, con- junctivitis or urinary tract infection, but adenovirus 7, the strain that hit the facility, was particularly se- vere. And the children at Wanaque, who relied on breathing ventilators or tubes in their stomachs for nutrition, were especially vulnerable. No new adenovirus cases have been reported at the center since Nov. 12, but the state is still blocking new admissions to the pediatric ventilator unit, pending approval of the center's submitted infection control plan. e center's administrator, Rowena Bautista, RN, challenged CMS' findings, calling them "unfound- ed allegations." "We are infuriated that, aer a cursory review, fed- eral surveyors put together a report riddled with factual inaccuracies, disregard of medical judg- ment and blatant misstatements about how virus- es spread," she said in a statement. "e center has appealed the report's findings," she said, "and will vigorously dispute the allegations." n CMS cuts payments to 800 hospitals for patient safety incidents By Ayla Ellison CMS will trim 800 hospitals' Medicare payments in fiscal year 2019 for having the highest rates of patient injuries and infections. Four things to know: 1. Created under the ACA, the Hospital Acquired Conditions Reduction Program aims to prevent harm to patients by providing a financial in- centive for hospitals to prevent hospital-acquired conditions. Under the program, a hospital's total score is based on performance on six quality measures. Each year, Medicare cuts payments by 1 percent for hospitals that fall in the worst-performing quartile. 2. Eight-hundred hospitals will have their Medicare payments reduced for patients discharged between last October and this September, ac- cording to Kaiser Health News. The penalties will be applied as hospitals submit claims to Medicare for reimbursement. 3. The hospital industry has argued the methodology used for the HAC Reduction Program doesn't recognize improvement, because roughly 700 to 800 hospitals will lose money every year even if they improved their safety records. According to Kaiser Health News, 110 hospitals are being penalized in fiscal year 2019 for the fifth straight time. 4. The hospital industry also argues the HAC Reduction Program's de- sign causes hospitals that do the best job of testing for infections to appear among the worst based on statistics, while those with less thor- ough testing might appear better than they should, according to Kaiser Health News. n Oklahoma hospital operator ousted over 'immediate threat' to patient safety By Ayla Ellison I n a ruling issued Feb. 27, a district judge in Oklahoma determined Fairfax (Okla.) Community Hospital's financial troubles pose a threat to patient safety, according to the Pawhuska Journal-Capital. The judge's ruling came after the town of Fairfax filed a civil lawsuit in December against the hospital's owner, Kansas City, Mo.-based Empow- erHMS, seeking to have a receiver appointed to assume operational con- trol of the facility. The hospital is one of several EmpowerHMS hospitals that have expe- rienced financial challenges in recent months, including payroll issues and lack of funds for supplies. In January, Miami-based iHealthcare en- tered into a management agreement with Fairfax Community Hospital, but EmpowerHMS is still responsible for fulfilling the hospital's financial obligations, including payroll and other operating expenses. On Feb. 27, the court determined the hospital is insolvent and an "im- mediate threat to the health and safety of current and future patients ex- ists," according to the Pawhuska Journal-Capital. The court named Fairfax Healthcare Authority, a municipal trust authority, to be the receiver and assume operation of Fairfax Community Hospital. n

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