​For the past seven years, Medicare has been imposing penalties for hospitals who allow patients to suffer from avoidable issues. The purpose of the penalty program is to incentivize hospitals to develop policies and procedures to ensure not only that good care is provided, but that patients do not undergo additional risks simply because they are in a hospital. This year 774 hospitals were fined for medical mistakes by Medicare. Notably, this is for care provided pre-COVID.

​Many of the hospitals penalized this year are being penalized for the first time, and 1,978 hospitals have been fined at least once. But 77 of the fined hospitals have been fined each year of the program. Included this year are the University of Miami hospital, the University of Michigan Health System, and Mount Sinai Hospital in New York City.  

​What is surprising is that many of the hospitals which have triggered multiple penalties through the program so far are generally considered “super hospitals,” such as the Cleveland Clinic, UCLA Medical Center, Northwestern Memorial Hospital in Chicago, and Brigham & Women’s Hospital in Boston. Harborview Medical Center in Seattle is one of the hospitals that have been fined each year of the program.

​The “avoidable” conditions include infections (such as MRSA and clostridium difficile), falls, blood clots (DVTs), and bed sores. These are conditions that Medicare has determined should not occur if a hospital has stringent policies and procedures in place to avoid them.  

​Hospital infections are a major focus. A patient may be admitted for a procedure that is not infection-related, but then suffer a hospital acquired infection. As one commentator said “sometimes hospitals are the last place you want to be if you are sick.”  Additionally, many hospitals resent the program because it does not recognize the high acuity and complexity of cases some hospitals, like academic medical centers, are more likely to see.

The Hospital-Acquired Condition Reduction Program determines whether penalties will be imposed, considers the rates of infections from hysterectomies, colon surgeries, urinary tract catheters, and central line tubes. Although infections carry the most weight in imposing penalties, Medicare also takes into account patient falls, the frequency of bed sores, and blood clots.