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48 HEALTHCARE NEWS CMS penalizes 2,583 hospitals for high readmissions: 5 things to know By Ayla Ellison I n fiscal year 2020, CMS will penalize 2,583 hospitals for having too many Medicare patients readmitted within 30 days, ac- cording to federal data released Sept. 30 cited in a Kaiser Health News report. is is the eighth year of the Hospital Read- missions Reduction Program. To determine penalties for fiscal 2020, CMS examined hospitals' 30-day readmission rates for patients who had originally been treated for the following conditions: heart failure, heart attack, pneumonia, chronic lung disease, hip and knee replacement or coronary artery bypass gra surgery. Scheduled readmissions were not counted. CMS used patient data from July 2015 through June 2018 to determine the penal- ties. e agency compared each hospital's reported readmission rate to national aver- ages for each of the conditions to determine the penalties. Here are five takeaways from the Kaiser Health News analysis: 1. Eighty-three percent of the 3,129 hospitals evaluated received a penalty. 2. CMS will cut payments to the penalized hospitals by as much as 3 percent for each Medicare case during fiscal 2020, which runs Oct. 1 through September 2020. 3. Fiy-six hospitals were hit with the maxi- mum penalty. e average penalty will be a 0.71 percent payment cut for each Medicare patient. 4. ough 64 hospitals received the same penalty as the year prior, 1,177 hospitals received a higher penalty and 1,148 hospitals received a lower penalty. 5. In fiscal 2020, CMS will withhold an esti- mated $563 million in Medicare payments to hospitals under the Hospital Readmissions Reduction Program. n Physician sues Kaiser Permanente over opioid- related patient satisfaction scores By Emily Rappleye A n emergency medicine physician filed a lawsuit Sept. 18 against Kaiser Permanente over its pa- tient satisfaction scoring methodology, which she alleged incentivized overprescribing of opioids and hurt her career at the Oakland, Calif.-based health system, The News Tribune reported. Eryn Alpert, MD, worked at Kaiser Permanente from 2012 to December 2017, when she was fired. The lawsuit al- leged her dismissal stemmed from her failure to accept patient satisfaction scoring tools. It alleged these tools were structured to incentivize physicians to prescribe opioids, even when medically unnecessary. The lawsuit said this pressure was greater in the emergency depart- ment, where patients often went seeking prescriptions and would leave poor reviews if they didn't receive them, according to the report. In the lawsuit, Dr. Alpert alleged her resistance to pre- scribing unnecessary opioids created a high standard deviation in her patient scores, which in turn prevented her from gaining shareholder status three years in a row, according to the report. Kaiser Permanente declined The News Tribune's request for comment. n Tennessee hospital halts admissions after staff doesn't show up By Ayla Ellison A shortage of nursing staff forced Big South Fork Medical Center in Oneida, Tenn., to stop admitting new patients Sept. 23, sources told the Indepen- dent Herald. Several employees reportedly stopped showing up for their shifts because of a delay in payroll. "Staff aren't showing up due to non-payment and patients can't be admitted because the staff aren't there to take care of them. We're in trouble," said an employee who spoke to the Independent Herald on condition of anonymity. Employees also told the Independent Herald their insur- ance was cut off July 1 but insurance premiums contin- ued to be deducted from employees' paychecks until September. West Palm Beach, Fla.-based Rennova Health, which owns the hospital, said employees would be reimbursed for the premiums that were deducted. Payment had not been made as of Sept. 23, according to the Independent Herald. Jellico (Tenn.) Community Hospital, which is also owned by Rennova, is in a similar situation. Employees said their paychecks were delayed several times and their insurance was terminated July 1, according to TV station WVLT. n