Bart Pfankuch, SD News Watch
RAPID CITY, S.D. – After two years with the lowest possible health and safety rating from the federal government, Monument Health’s score will rise from a 1-star to a 3-star rating when the new results are released publicly in July, the Rapid City hospital said Wednesday.
“These achievements demonstrate the effectiveness of our ongoing quality initiatives, and we will continue to strive for excellence in all aspects of patient care,” Jill Tice, Monument Health vice president of quality, safety and risk management, said in a news release.
The Centers for Medicare and Medicaid Services ratings range from the lowest, a 1-star overall rating, to the highest, a 5-star rating, based on dozens of criteria in five major medical safety and quality categories.
Monument also said its hospital in Spearfish will receive a 5-star rating. Its Rapid City hospital will also see an increase from a “C” grade to a “B” grade when updated ratings are released this summer by the Leapfrog Group, a national nonprofit hospital evaluation firm, it said. Leapfrog rates hospitals on a scale of A-F, with “A” the highest and “F” the lowest qualify ratings.
South Dakota News Watch recently reported that Monument Health’s Rapid City hospital received the lowest federal quality rating possible over the past two years, according to CMS, which evaluates hospital safety and quality of patient care.
No other hospital in South Dakota or within a 200-mile radius of Rapid City had a 1-star rating in 2023, the latest year the ratings were released, and only about 8% of U.S. hospitals reviewed by CMS received a 1-star rating last year.
Among the 14 South Dakota hospitals in the state that received a CMS quality and safety rating in 2023, no hospital had a 2-star rating, two had a 3-star rating, four had a 4-star rating and seven had a 5-star rating, according to the CMS Care Compare website.
Improvement programs appear to pay off
Monument said the CMS ratings are based on data that is often a year or even several years old, and that the poor CMS ratings in 2022 and 2023 did not fully reflect the outcomes of a broad, ongoing effort to improve patient care and quality.
In 2019, Monument implemented daily staff huddles to highlight challenges and successes, and a 5-tier improvement program that seeks to document and address any issues or problems in a systemic and immediate way.
“Monument Health reinforced our commitment to high-quality, safe patient care in 2019,” Tice said in the release. “While the CMS star rating is still based on information dating back to 2019, it shows progress on our quality journey and using the same measurement with today’s data would result in higher ratings.”
While updated CMS ratings are not yet available for other state hospitals, a spokeswoman from the Leapfrog wrote to News Watch in April noting that no hospital in either South Dakota or North Dakota will receive an “A” grade in the 2024 ratings that will be released soon.
Past ratings reveal quality concerns
According to the latest public CMS review of Monument, updated in October 2023, the hospital was at or above national averages in several key areas, including in mortality rates for patients with strokes, heart attacks and chronic pulmonary disease.
The hospital also scored well in regard to patients not requiring readmission for any reason after discharge, a low rate of “central-line” catheter infections and it had a low rate of complications following surgeries. Costs for many procedures were also in line with national averages.
However, Monument was below state and national averages for percentage of patients receiving appropriate care for severe sepsis, in regard to length of time of visits to the emergency room, in the rate of surgical site infections after colon surgeries and in percentage of patients that received advanced breast screening after an initial mammogram.
Leapfrog, in its last publicly available rating, noted that Monument performed above average in quality of nursing care, safe medication administration, and organization leadership and staff cooperation to prevent errors.
But Leapfrog scored Monument below national averages in several areas, including in sepsis infections after surgery, accidental cuts and tears, dangerous blood clots, surgical wounds splitting open, site infections after colon surgery, patient falls and injuries and “deaths from serious treatable complications.”
Monument: Infection rates have fallen
In the news release, Monument said the hospital has seen safety improvements in at least three areas:
- A 37% drop in colorectal surgical site infections in 2022, with a 74% drop in the same infections from 2022 to 2023.
- A 92% reduction in central-line catheter bloodstream infections in 2022-2023, and two years without that type of infection reported.
- A 75% decline in hospital-onset Methicillin-resistant Staphylococcus aureus (MRSA) infections over the past nine months.”While these scores provide valuable insight, Monument Health acknowledges that they are just part of the story. There will continue to be a delay in reporting from CMS and Leapfrog,” Jay White, Monument executive medical director of quality and safety, said in the news release. “Over time, these scores will accurately reflect the dedicated and quality care Monument Health physicians and caregivers provide today, and every day.”
Monument added that the health group will soon launch a public quality dashboard to inform the public about future quality improvement initiatives and results in real time.