A recent Wall Street Journal investigation into “critical-access hospitals,” or small rural hospitals, revealed some frightening information about these facilities potentially performing surgeries that they are not qualified to perform for financial incentives, leading to some serious complications (and even death) for some patients.
Most of these hospitals are concentrated in the Midwest and South and have older patients. In addition, most are struggling to survive. In order to keep their doors open, they will sometimes merge with larger medical centers and/or other rural hospitals nearby. Still, around 60 have had to close since 2010, and another 300 or so are in danger of closing. And many have a difficult time recruiting doctors, as people are often afraid to live in these isolated, rural areas.
Inexperienced Rural Hospitals & Increased Risk of Mortality
Specifically, billing records indicate that they are performing more and more inpatient orthopedic surgeries, surpassing the growth of these procedures at other, more general hospitals that have more experience performing these surgeries (i.e. those that are used to doing more than 100 per year).
The result? A procedure that should be routine and involve very few complications could end up resulting in death simply because it was performed at the ‘wrong’ hospital. In fact, patients getting one of the more common orthopedic procedures done at the small, critical-access hospitals were approximately 34 percent more likely to die within 30 days between 2010 and 2013.
The reason? Medicare pays more for these surgeries at some rural hospitals, paying out actual costs versus set fees. And yet these small rural hospitals typically have fewer than 25 beds and are not necessarily equipped to properly manage patient safety during and after these procedures.
Financial Incentives
So why are these procedures (i.e. elective orthopedic surgeries) on the rise at these small rural medical facilities? In 1997, a program was initiated designed to keep these hospitals open and operating by reimbursing them (or providing special payments) for these types of surgeries at a higher rate than the larger rivals. And while some of the smaller hospitals indicate that they will improve as they gain more experience performing these surgeries, the mortality rates have actually stayed the same.
In addition, these small, critical-access hospitals are exempt from specific federal rules that require hospital facilities to report quality measures such as surgical complications. Thus, how are these facilities expected to improve?
Let Us Help You
When your medical care falls below the standard, you can hold those responsible for medical negligence or malpractice. A hospital should not take on a specific procedure unless it is qualified to do so, regardless of the financial incentives. If you have been the victim of medical negligence, contact the attorneys at Harrell & Nowak for a free consultation today so that we can help you.