Last Friday’s top headline from another local paper declared “CEO: Rehoboth McKinley Improves to 3-star quality rating,” and went on to describe a surprising improvement in the CMS hospital star rating.
The fact is: RMCH still has a one-star CMS hospital rating, and that has not changed. These ratings are determined once a year, and will not be announced until next spring. Mr. Smithburg [Don Smithburg RMCHCS interim-CEO] in reporting a “3 star rating” was likely referring to the HCAHPS score, a patient survey used at the time of hospital discharge, for which results are reported on a quarterly basis. Measures from this survey comprise one-fifth of the CMS score. It is simply not the CMS overall hospital rating. (1)
This information matters to the hospital’s financial health. The CMS hospital rating constitutes the primary quality measure for hospitals. Further, the CMS hospital rating impacts the hospital’s bottom line, as how the hospital performs on its particular metrics may earn the hospital incentives or result in a reduction of Medicare payments.
More importantly, this information provides a basis to dialogue with the community about quality metrics. We want to understand what metrics are being used to evaluate quality at our hospital, where the hospital is focused on improvement, and how improvements are being made.
For this conversation to be fruitful, information about quality needs to be presented with accuracy, nuance, and context.
Our Board of Trustee members can support this dialogue by maintaining an attitude of curiosity about quality measures. Quality metrics are most useful when we interrogate their meaning for our community, understand when they are tied to compensation, and how they are a public indicator of hospital quality. This is part of the board of trustee’s fiduciary responsibility to our community’s hospital, and it is a critical aspect of building trust with the community.
The community can be a powerful partner in addressing quality issues at the hospital. The RMCH Community Assessment performed in 2019 proves as much, as this assessment of community needs and its subsequent implementation plan could only be performed with active engagement of local partners. Since this was developed with input from community members, it considers community values on health care. We hold this to be the gold standard for community engagement with hospital leadership.
The McKinley Community Health Action Group will continue to advocate for transparency, accountability, and community engagement, because that is what will build trust. We invite the Board of Trustees and hospital leadership to be partners with us as we advocate for the health care our community needs, and deserves.
By McKinley Community Health Action Group
Connie Liu, MD/PhD
Kathy Mezoff, MD
Sara Pikaart, RN
Gwen Wilson PA
JP Philips, JD
