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Medicare penalizes CHI St. Luke’s Health Baylor College of Medicine Medical Center over readmission rate

Well-known hospital was among the nation's worst performing hospitals for patients being readmitted soon after discharge

What’s in a name?

CHI St. Luke’s Health Baylor College of Medicine Medical Center (St. Luke’s Baylor) is quite a mouthful. It’s a joint venture of two of the most storied and well-known names in Houston’s Texas Medical Center, St. Luke’s Hospital and Baylor College of Medicine.

It's an academic or teaching hospital where St. Luke’s provides the nursing, therapy, technical, and administrative employees. Baylor completes the health care team by providing the physician medical staff, including attending physicians and professors, who are fully trained, and residents and fellows, who are doctors still completing their clinical training.

Although it’s located at 1001 Bates Avenue, in Houston, St. Luke’s Baylor is part of the Catholic Health Initiatives (CHI), which is headquartered and operated out of state. With the loss of local leadership in this important hospital several years ago, it’s my opinion that there’s been a change in culture and some new quality of care concerns.

When it comes to quality of care, St. Luke’s Baylor has had some high-profile problems in recent years. For example, Painter Law Firm represented two different clients who had surgical towels left inside their abdomens after surgeries at the St. Luke’s Baylor flagship hospital.

These serious sentinel events led to the patients having to undergo the risks and pain of second surgeries to remove what should’ve never been left there in the first place.

CHI St. Luke’s Health Baylor College of Medicine Medical Center was back in the news for more quality of care concerns. This time it was when Medicare announced its undistinguished list of hospitals with the lowest performance for readmission rates. St. Luke’s Baylor made the list.

The Affordable Care Act created a program that requires Medicare to collect data on hospitals nationwide, including readmission rates. Medicare studies the percentage of patients who have to be readmitted to the hospital within a set period of time. Of course, one of the points of quality care is to see patients discharged from the hospital. The lower the readmission rate, the better.

There are a variety of factors that can influence hospital readmission rates. Poor discharge planning is one. When a patient is pushed out the door without hospital assistance to set up necessary home health, home nursing, prescriptions, and durable medical equipment, the patient’s condition can rapidly plummet. That can lead to readmission.

Sadly, this isn’t the first year that Medicare named CHI St. Luke’s Health Baylor College of Medicine Medical Center as an underperforming hospital in terms of readmission rates. In fact, it’s made the undesirable list every single year since 2015.

As a result, in fiscal year 2022, just like each of the past seven years, Medicare will penalize St. Luke’s Baylor by reducing its reimbursement or payment rate. In other words, Medicare hits the lowest performing hospitals where it hurts—their financial bottom line.

As a former hospital administrator, I know that financial sanctions and penalties get the attention of hospital leadership. I’m surprised that an institution like St. Luke’s Baylor continues to struggle with this issue year after year.

If you’ve experienced poor medical or health care at Houston’s CHI St. Luke’s Health Baylor College of Medicine Medical Center, then contact a top-rated experienced Houston, Texas medical malpractice lawyer for a free consultation about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.

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