Brooklyn hospitals fare abysmally in disputed federal rankings
Hospital group questions data’s reliability
New York State’s hospitals as a whole ranked last among the 50 states, according to a report card from the federal government. Shockingly, New York City’s hospitals were rated even lower than the state average – and Brooklyn’s hospitals scored lower than the city as a whole.
In July, the Centers for Medicare & Medicaid Services (CMS) released new ratings for roughly 3,600 hospitals across the country, assigning from one to five stars to each based on 64 quality measures.
The ratings are meant to provide consumers with a “snapshot” of local hospitals. They are based on data such as how often complications occur, the timeliness of care, the number of readmissions and deaths, and patients’ ranking of their experiences in the hospital.
According to an analysis of the federal database by the Empire Center for Public Policy, a non-profit think tank based in Albany, New York State’s average score was 2.26 stars, the lowest of any state. New York City’s 38 rated hospitals averaged 1.68 stars. (Some specialty institutions and VA hospitals were not rated.)
New York State ranked low despite having one of the most expensive health care systems in the U.S.
The Brooklyn Eagle’s analysis of the data found that Brooklyn’s 13 rated hospitals averaged just 1.38 stars. CMS ranked New York Community Hospital of Brooklyn on Kings Highway as the highest in the borough, with three stars. Three Brooklyn hospitals received two stars: Maimonides Medical Center, Woodhull and Lutheran Medical Center.
The other nine rated hospitals in Brooklyn received just one star.
Ratings not accurate?
These ratings don’t sit right with some, including the Greater New York Hospital Association (GNYHA).
“We strongly question their reliability. The star ratings vastly oversimplify the comprehensive patient care that New York City hospitals deliver 24/7 and do not accurately reflect the high quality of that care,” GNYHA spokesman Brian Conway told the Eagle on Tuesday.
“The results also make little sense when compared with US News & World Report’s recently released ‘Best Hospitals’ rankings,” Conway said. “With three New York City hospitals making the national Honor Roll and 10 other New York City-area hospitals receiving top-50 rankings across 16 specialties, the New York City region can justifiably be called the nation’s health care capital.”
He pointed out, “In terms of survival rates, patient safety, treating complications, reputation of specialists, and other factors that US News & World Report considers, the New York metropolitan area earned more commendations than any other area in the United States.”
A more specific critique issued by GNYHA and forwarded to the Eagle by a local hospital points out that among the best-performing (“5-star”) hospitals on the federal list, roughly 60 percent have fewer than 100 beds, 60 percent have virtually no poor patients, one-third have no emergency room (the portal for poor and uninsured patients), and half are missing data for at least one key element of care.
According to Kaiser Health News, Medicare did not consider the relative wealth of patients. Its analysis showed hospitals serving large numbers of low-income people tended to receive lower ratings.
Medicaid advisor: Controversial rankings can be useful
Despite the criticism of the new federal hospital report card, Ginalisa Monterroso, the CEO of Medicaid Advisory Group, a for-profit organization that assists clients in navigating the complex Medicaid system, says the ratings can help consumers better understand important indicators of a hospital’s quality.
The report card includes “very useful information, and it’s simple because it’s rated by stars,” she said. The ratings cover basic necessities, she said, such as a hospital’s staffing and the important health inspection component.
Monterroso said consumers should focus on indicators such as how the hospital treats pressure sores and urinary tract infections (UTIs).
“You never want to be put in a facility that scores a ‘one’ on bed sores or UTIs, or gives a high amount of psychiatric medications. You always want to go five stars, never a one star facility,” she said.
Given the lack of five star facilities (and the high number of one star hospitals) in Brooklyn, Monterroso recommends that caregivers use the ratings to get the best care possible.
“If they’re understaffed, advocate for the patient,” she said. “If the hospital is [rated as] dirty, make sure now it’s clean and healthy. The ratings are an indicator of what goes on internally.”
Monterroso feels the federal ratings reflect reliable data, as they derive directly from specifics such as health inspections, staffing and quality measures. Despite protestations from the hospital industry, CMS goes deeper into quality measures than US News & World Report, she said.
How should patients or caregivers use the database?
“To start, go onto the .gov website [www.medicare.gov/hospitalcompare/],” she said. “You’re looking for how well the quality of care is — the safety inspections, for example.”
In addition, she said, consumers can research their own local hospital by specialty.
“Every hospital has its own specialty, such as heart care. Look at the quality indicators of that specialty and make sure it gets a high ranking.”
The Eagle has reached out to CMS for a comment. Check back for updates.
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