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| GAO Asked to Justify Nonprofit Hospitals' Tax Exempt Status
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U.S. Sen. Chuck Grassley (R-Iowa), a longtime opponent of specialty hospitals, has begun to focus on the practices of the nation's not-for-profit facilities. In a letter to the Government Accountability Office, Sen. Grassley has requested an investigation into how nonprofit hospitals benefit the communities they serve in order to justify their tax-exempt status.
In the written request, Sen. Grassley asks the GAO to report the community benefit standards established by each state and the Internal Revenue Service as well as the guidelines used by the hospital industry to interpret those standards. He requests that the GAO examine how nonprofit hospitals define and report uncompensated care, charity care and bad debt.
Sen. Grassley is also calling for an investigation into the salaries of nonprofit hospital executives, those executives with lavish lifestyles and the business ventures that generate them individual profits at the expense of the hospitals they run.
The request includes the suggestion to examine the hospitals based on each facility's size, geographic location, teaching status and level of state legislative requirements on the facility's charity care and other community benefits.
"This is part of a continuous effort to help ensure that exempt hospitals do their share of charity care," says Scott Becker, JD, CPA, co-chairman of the healthcare department at the law firm of McGuire Woods in Chicago, "and is probably more concerned with some exempt hospitals being used improperly by their boards and executives."
Writes Sen. Grassley, "The current reporting practices may contribute to inconsistent reporting of charity care to external parties. Although there have been recent attempts to clarify guidance on accounting and reporting uncompensated care, I believe that much still needs to be done."
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| Lawsuit: Anesthesia Awareness Prompted Patient's Suicide
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The family of a 73-year-old West Virginia man who shot himself to death two weeks after he had allegedly experienced anesthesia awareness during an exploratory laparotomy has filed a wrongful death lawsuit against the anesthesiology group involved in the surgery. The case is believed to be the first in the United States to link a suicide to an incident of anesthesia awareness.
In the lawsuit, the family of Sherman Sizemore claims that an anesthesiologist and a CRNA from Raleigh Anesthesia Group of Raleigh, W.Va., gave Mr. Sizemore paralytic agents before his surgery at Raleigh General Hospital on Jan. 19, 2006, but neglected to administer inhalational anesthesia for 16 minutes after the first incision was made.
The plaintiffs argue that Mr. Sizemore's behavior in the days after the procedure — which included an inability to sleep, difficulty breathing and fears of being left alone or being buried alive — stemmed from his consciousness, but inability to move or speak, during surgery and ultimately led to his Feb. 2, 2006 suicide.
"One would be hard pressed to imagine a more disturbing scenario than having one's body cut open while totally awake and alert, but totally helpless to move, scream or alert others to the situation," says the complaint, filed last month in Raleigh County Circuit Court. The plaintiff's lawyer didn't return phone calls seeking comment.
"Raleigh Anesthesia Group denies the claims contained in the complaint," says defense lawyer William Foster of the Foster Law Firm in Charleston, W.Va. "The allegations contained in the Sizemore complaint are inconsistent with the facts known at this time. As such, Raleigh Anesthesia Group intends to defend the claims. Privacy regulations prohibit us from referencing any specific information relative to Mr. Sizemore's medical treatment."
According to published reports, the issue of anesthesia awareness came to light after Mr. Sizemore's death, when a doctor's condolences prompted nurses in Mr. Sizemore's family to take a closer look at the medical records. Raleigh Anesthesia Group no longer performs services at Raleigh General Hospital.
The complaint describes how, 16 minutes after the first incision into Mr. Sizemore's abdomen, the anesthesia providers discovered that they had failed to turn on the inhalational anesthesia. After they did, it continues, they also administered Mr. Sizemore a drug to induce amnesia of the event.
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| Study: Hospital Errors Jump in Most Categories
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Between 2003 and 2005, there were 1.16 million patient safety incidents among Medicare patients - that's an overall increase of 2.86 percent — according to the fourth annual HealthGrades Patient Safety in American Hospitals Study. HealthGrades, an independent health care ratings company, examined over 40 million Medicare hospitalization records at almost 5,000 hospitals for the report.
Some highlights:
- Ten of the 16 types of patient safety incidents tracked by HealthGrades increased over the three years of the study by an average of almost 12 percent.
- The greatest increases were in post-op sepsis (34.3 percent), post-op respiratory failure (18.7 percent) and selected infections due to medical care (12.2 percent).
- The gap in care quality remains wide: Top-rated facilities had 40 percent lower error rates than the poorest-performing hospitals.
- There were 247,662 potentially preventable deaths. If all hospitals had performed at the same level as the top-rated hospitals, about 206,286 patient safety incidents and 34,393 Medicare patient deaths could have been avoided.
"The cost of medical errors at American hospitals in both mortality and dollar terms continues to be significant (about $8.6 billion for the study period), and the 'chasm in quality' between the nation's top and bottom hospitals, which HealthGrades has documented in this and other studies, remains," says Samantha Collier, MD, the study's primary author and HealthGrades' chief medical officer, in a statement. "But the nation's best-performing hospitals are providing benchmarks for the hospital industry, exercising a vigilance that resulted in far fewer in-hospital incidents among the Medicare patients studied."
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| News and Notes
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Between 2003 and 2005, there were 1.16 million patient safety incidents among Medicare patients - that's an overall increase of 2.86 percent — according to the fourth annual HealthGrades Patient Safety in American Hospitals Study. HealthGrades, an independent health care ratings company, examined over 40 million Medicare hospitalization records at almost 5,000 hospitals for the report.
Some highlights:
- Ten of the 16 types of patient safety incidents tracked by HealthGrades increased over the three years of the study by an average of almost 12 percent.
- The greatest increases were in post-op sepsis (34.3 percent), post-op respiratory failure (18.7 percent) and selected infections due to medical care (12.2 percent).
- The gap in care quality remains wide: Top-rated facilities had 40 percent lower error rates than the poorest-performing hospitals.
- There were 247,662 potentially preventable deaths. If all hospitals had performed at the same level as the top-rated hospitals, about 206,286 patient safety incidents and 34,393 Medicare patient deaths could have been avoided.
"The cost of medical errors at American hospitals in both mortality and dollar terms continues to be significant (about $8.6 billion for the study period), and the 'chasm in quality' between the nation's top and bottom hospitals, which HealthGrades has documented in this and other studies, remains," says Samantha Collier, MD, the study's primary author and HealthGrades' chief medical officer, in a statement. "But the nation's best-performing hospitals are providing benchmarks for the hospital industry, exercising a vigilance that resulted in far fewer in-hospital incidents among the Medicare patients studied."
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