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TRH explains conflicting grades

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Hospital gets four stars in CMS survey, ‘D’ grade in safety report from The Leapfrog Group

By John Moore

John L. Moore
reporter@cknj.com

Taylor Regional Hospital was one of 21 hospitals in Kentucky to be given a four-star rating (out of five stars) by the Centers for Medicare and Medicaid Services (CMS) in their 2019 report.

It was also one of five hospitals in Kentucky to be given a ‘D’ grade by The Leapfrog Group in their biannual safety report for the first half of 2019.

So, what gives?

The discrepancy between the two scores comes down to methodology —  the way each group calculates their scores — and how the information TRH did or did not give them factors into it.

When Taylor Regional received Leapfrog’s survey, part of it was marked as “optional.”

This part included statistics regarding hand washing, staff working together to prevent errors, tracking and reducing risk to patients, effective leadership being used to prevent errors and having enough qualified nurses. 

According to a statement given by hospital spokesperson Ann Dabney, TRH chose not to submit information for the optional part of the Leapfrog survey because they already report it to several other organizations, including CMS, as well as The Joint Commission, Anthem and the Kentucky Hospital Association.

“We successfully maintain our continual compliance with multiple accreditations which review measures, including the safety items [not reported to The Leapfrog Group], and just recently completed another Joint Commission survey receiving an updated certification in Sept. 2018,” it read.

Dabney also noted that CMS makes the data hospitals submit to them public, whereas Leapfrog only makes their scores public.

TRH is classified as an “acute care hospital,” meaning they offer both inpatient and outpatient care. Other acute care hospitals nearby include Spring View Hospital in Lebanon, TJ Health in Columbia and Hardin Memorial Hospital in Elizabethtown, each with three-star ratings in the CMS report.

One question Leapfrog’s report raised has to do with Taylor Regional Hospital’s intensive care unit (ICU).

In the category that measures whether or not the hospital has “specially trained doctors” to care for ICU patients, TRH scores a five out of 100, the lowest reported score.

Dabney noted that other hospitals have received the same score and that this metric does not make any attempt to rate the quality of care patients receive in a hospital’s intensive care unit.

Instead, it measures the number of specially trained “intensivists” who work there.

Dabney referenced a study by the Society of Hospital Medicine released in May of 2018, which reported a “well-documented shortage of intensivists in the US.” 

The report stated that, in rural hospital settings unable to recruit intensivists, hospitalists were often used to provide critical care instead.

Dabney went on to cite an article published in April of this year by Critical Care Medicine, which found 48% of acute care hospitals have no intensivists on staff.

“TRH is one of many rural hospitals unable to recruit intensivists,” read a statement from TRH. “However, we utilize well-trained hospitalists to take great care of our patients.”

The hospital also expressed disappointment with the grade they received from Leapfrog in a statement.

“We do not believe this [grade] adequately reflects the care that we provide to our patients,” it read. “We strive to provide the best care to our community and will continue to work diligently to demonstrate the high level of care that is synonymous with Taylor Regional Hospital.”