SCH, Other Hospitals Affected By New Federal Rules on Medicare

Stephens County Hospital, along with most other hospitals, will see a slight payment reduction from Medicare under new pay for performance standards put in place by the federal government.

Hospital Administrator Ed Gambrell updated the Hospital Authority on the new standards at last week’s monthly Authority meeting.

Gambrell said the hospital will face a penalty for its readmission rates in a couple of areas.

“We are deficient in our readmission rate, especially for heart attacks and for pneumonia patients,” said Gambrell. “For example, we get penalized if a patient who was admitted here for pneumonia had to be hospitalized again for pneumonia within 30 days, either here or somewhere else. Medicare tracks all that now.”

Gambrell said that Stephens County Hospital follows up with patients after they are discharged to try to make sure they are following instructions from doctors.

However, he said sometimes readmissions are unavoidable.

“Sometimes people just have a relapse, or are weak, or fail to take their medication, or something,” said Gambrell.

Gambrell said that the hospital projects to lose a total of about $30,000 in Fiscal Year 2015 from Medicare as a result of these new standards.

He said the readmission rates were the only issue that the hospital was being penalized for.

“We get good patient survey scores,” said Gambrell. “We do real good on the quality measures. Our infection rates are very low. Those things are good.”

According to Gambrell, 44 percent of hospitals overall, including some in this area, had penalties in more than one area.

Meanwhile, he said only 14 percent of hospitals had no penalties at all.

Gambrell said this is the first year that the federal government has implemented this program.