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Tue, April 23

KRMC responds to 'negative' Medicare report

KINGMAN - Brian Turney, CEO of Kingman Regional Medical Center, offered the following response to data recently reported by Medicare.

"You may have seen reports in the local and national media that our heart attack mortality rate was labeled 'worse than expected,'" Turney said. "The data reported was from the last half of 2005 and the first half of 2006, and examined 30-day heart attack mortality for Medicare patients. Unfortunately, CMS decided not to release actual numbers to the public. Their decision did a disservice to us and the public as well."

Turney said KRMC's Medicare patient mortality rates for heart attack are as follows:

"During CMS's test period year, our mortality rate for heart attack was 16.7 percent. KRMC's was the 7th-best rate of 49 hospitals in the state, while the national average was 17.8 percent," he said. "During the period of June 2005 to June 2006 that CMS rated us 'worse than expected,' our heart attack mortality rate was 22.2 percent, while the national average was 16.7 percent.

"In the nine months since CMS's reporting period since July 2006, our heart attack mortality rate was 12.05 percent," he said. "CMS will need to adjust this year's mortality rate for risk factors, but it gives a good indicator of our current mortality rate. There were no significant changes made at KRMC during the past three years (using the) same cardiologists and same processes."

Turney said this first attempt by CMS is clearly a work in progress.

In this recent release of mortality information, CMS leaders themselves describe this as a "go-cart" hoping at sometime to become a "race car."

"We believe a better analogy is the Wright Brothers trying to claim their first flight is commercial air service.

"The mortality numbers include deaths from any cause up to 30 days after discharge," Turney said.

"In other words, if a heart attack patient died from a car accident, cancer or any other cause, they are still included in the data."

CMS's risk-adjusting factors did not include the length of time from onset of heart attack symptoms to arriving at the hospital for care, one of the most important factors affecting heart attack mortality.

A senior scientist from CMS confirmed that the risk factor could significantly impact mortality rates, but they could not factor that in because CMS uses administrative claims data to develop mortality rates, Turney said.

"When we recently received this information from CMS, we felt the responsible thing to do was to thoroughly review all heart attack deaths," he said.

"Our internal review of all cases has shown many patients who had complex ailments unrelated to heart care were admitted for end-of-life care, chose 'do not resuscitate' status, etc.

"The review did not raise any concerns with care."

He said KRMC will have an independent, outside entity review the cases to confirm the hospital's initial findings.

Turney said Kingman Regional Medical Center is supportive of efforts by CMS and others to share quality information and will continue to support these efforts.

"We teach our employees that accurate and timely data generates improvement in the delivery of care," he said.

"Moving forward, we will continue to work on improving processes.

"We will also work with outside entities like CMS so they can provide accurate and timely information that will be of value in assisting healthcare providers in improving as well as helping patients in their decisions about personal healthcare."


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