Why Hospital and Nursing Home Rankings Rarely Matter

As a Medical Malpractice Lawyer, I am often asked; “What is the safest hospital in Miami”?  To which I respond None!!

Yes, some hospitals are generally safer than others.  For example, Baptist Hospital is generally regarded safer than Palm Springs Hospital.  That being said, Palm Springs General Hospital may be safer for certain medical conditions or procedures.  Obviously, If you are an Emergency Room patient you may not have the opportunity to research, where you want to go.  It may be good planning to discuss in advance with family members where to go in case of Emergency.  For instance, In case of stroke, make sure family members know to go to an accredited stroke center.

With regard to a planned medical procedure, do your research in advance, and look at the criteria used in formulating rankings.  Going in for a cardiac catheterization?  You may want to check which hospital ranks highest in that particular procedure, but then you want to take a look at factors were used in reaching that conclusion.  As reported in the Fort Lauderdale Sun Sentinel, the key is to understand that each report — like each patient — is individual, with its own panel of experts, its own set of data and its own criteria for what makes a hospital best or safer, according to Avery Comarow, Health Rankings editor for U.S. News & World Report.

For example,  U.S. News & World Report’s 2014-15 Best Hospitals report, named Memorial Hospital West in Pembroke Pines the 21st best hospital in Florida — with high marks in cancer care, geriatrics and nephrology. A 2013 report from The Joint Commission, the leading U.S. health care inspection and accreditation agency, named it a “top performer” in heart attack, heart failure, pneumonia and surgical care.  Yet the facility got a “C” in safety in a fall 2013 report from The Leapfrog Group.  The difference is in the data.  To that end, U.S. News,  is meant for patients with high-risk illnesses or facing risky procedures. That’s why it evaluates how hospitals fare in delivering innately complex specialty care, like cardiology, cancer and pulmonology, using measures like discharge rates, available technology and the quality of patient services.  Alternatively,  Leapfrog’s Hospital Safety Score is all about how hospitals do in avoiding preventable errors, accidents and injuries.   From a Medical Malpractice standpoint, the data points from Leapfrog are a more predictive indicator  of future medical malpractice.

Again, if you have an opportunity do your research in advance, and use the websites in conjunction with one another.  I would start with safety rankings like those from Leapfrog and Consumer Reports, and from there, research a specific procedure and compare the  performance lists like the ones from U.S. News or The Joint Commission to see how a hospital is ranked in that specialty.

Nursing Home rankings are no more accurate.  You can look up nursing home rankings on Medicare’s website, yet we have sued a number of the facilities on the site that have a 5 star ranking, and found serious violations of patient’s rights.  So lets look at the criteria used.  A home’s rating is based on three criteria: its performance on annual health inspections, its staffing levels, and its performance on quality indicators that are collected for every patient. But only the health inspections are performed by the government; the other two are reported by the homes.  Thus, the unreliable data.

A provision of the Affordable Care Act of 2010 requires Medicare to use payroll data to verify the accuracy of staff levels, but the agency has not begun to follow the requirement.   As reported by the New York Times,  the other major part of the ratings that is not checked by Medicare, the so-called quality measures, is also susceptible to manipulation. The score in this area is based on data collected by the home about every patient, such as whether bedridden or wheelchair patients are developing bedsores and how many residents experience serious falls.

Again, you can start your research on Medicare’s website, then visit the potential nursing homes, check the court registry for filings against a specific nursing home-even call a lawyer that specializes in nursing home cases for his/her opinion.

 

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