Trump administration backs off plan to reduce reporting on hospital infections, safety

Federal health officials reversed course on a plan to withhold public disclosure of hospital infection and safety problems that are the third leading cause of death in the U.S., a new rule announced late Thursday shows.

The Centers for Medicare and Medicaid Services (CMS) said they will publicly report the errors, injuries, and infections the agency proposed removing from one of the public reporting programs. The information will now be published on the federal Hospital Compare site and in a downloadable database and will include the dates and details.

USA TODAY reported on patient advocates' concerns about the proposed rule in June, which was instrumental in getting CMS to reconsider public disclosure, says Leah Binder, CEO of the hospital rating organization Leapfrog Group.

CMS met with Leapfrog after the the USA TODAY article to "reassure of their full commitment to publicly reporting on hospital safety," Binder says. She added that the article also prompted hundreds more people to sign the official comment letter Leapfrog sent to CMS protesting the move.

"The final rule, while not perfect, lives up to that commitment," says Binder. "They took a bold stance to protect the public, and we appreciate that.”

The Inpatient Quality Reporting Program, which contains the safety data that was at issue, was established in 2005 during the George W. Bush administration. That's also when Hospital Compare began disclosing some hospital safety measures.

Consumers, businesses, some health care providers and policymakers pushed the moves as a way to increase transparency by paying hospitals through Medicare to report on errors, injuries, and infections.

"Even just knowing that this data is publicly available and can be publicly used in critiquing hospitals' performance increases the vigilance hospitals have in controlling infections," says Kevin Kavanagh, a physician who heads the safety advocacy group Health Watch USA.

The American Hospital Association (AHA) had urged the Trump administration to make the change in the proposed rule, which surprised Binder who told earlier USA TODAY the agency was going further than even hospitals would recommend.

In a December 2016 letter to President-elect Trump, however, the association asked him to remove measures added to the programs in the previous two years as part of his overall commitment to regulatory reform. AHA CEO Richard Pollack also recommended the measures be taken out of CMS programs that hit hospitals with financial penalties for safety problems.

Now, the new rule says CMS will collect the safety data from the hospitals through two Obamacare payment programs, even though it doesn't currently have a way to collect and public report data through the programs.

CMS held in an earlier final rule that it couldn't post so-called "never events" – the safety problems such as leaving instruments inside patients that are so serious they should never occur in hospitals – on Hospital Compare. Groups including Leapfrog do post them after analyzing the data and hospital-specific codes in the downloadable database.

The data that will remain on Hospital Compare, thanks to the new rule, include infections such as Clostridium difficile (C. Diff.), Methicillin-resistant Staphylococcus aureus (MRSA) and the rate of sepsis after surgery.

More than 600,000 hospital patients a year contract an infection and sepsis alone kills about 270,000 people a year.

"These kill a lot of people and patients deserve to know how hospitals are doing in preventing them," says Binder.

In the new rule, CMS also said it is making changes to improve transparency related to other survey reports including for hospital accrediting organizations.

Kavanagh described the secrecy surrounding problems found by the Joint Commission and other agencies as a "huge problem," and said his group has repeatedly complained about it to CMS. It was also the topic of recent congressional hearings.

"It's amazing that anyone would allow the hospitals to become less transparent," says Gene Leonard, whose wife Carol died after contracting a strep infection and then sepsis while at Medstar Washington Hospital Center early last year.

Publicity surrounding infection rates and other patient safety information "needs to be more pronounced," says Leonard.

WJAX