State: Hospital Chain Reporting Inaccurate Infection Diagnoses
A state investigation has found that three hospitals run by Prime Healthcare Services have inaccurately diagnosed several patients with the blood infection septicemia, California Watch reports.
The California Department of Public Health examined records from 2008 and 2009 at four hospitals owned by the health system.
The investigation is the latest to focus on Prime Healthcare's Medicare billing practices. HHS also is investigating the hospital system to determine whether it overbilled Medicare for treating septicemia. In addition, a California Watch investigation released in February found that Prime Healthcare was billing Medicare for unusually high rates of malnutrition among seniors.
The septicemia investigation began last year in response to a study released by the Service Employees International Union. The study found that Prime Healthcare's hospitals reported septicemia rates that were more than tripled the national average.
Medicare pays several thousand dollars in bonus payments per case for the treatment of elderly patients with septicemia.
The state investigation found that 22 out of 120 patients diagnosed with septicemia at Prime Healthcare hospitals showed few symptoms of the condition.
DPH identified the 22 patients after examining data at four Prime Healthcare hospitals and finding that:
- At San Dimas Community Hospital, 17 out of 29 reported septicemia patients did not have bacteria in their blood or at least two other symptoms of the infection;
- At Chino Valley Medical Center, three septicemia cases were identified as problematic;
- At West Anaheim Medical Center, two septicemia cases were identified as problematic; and
- At Desert Valley Hospital in Victorville, no septicemia cases were identified as problematic (Jewett/Williams, California Watch, 5/7).
Prime Healthcare Response
Prime Healthcare disputes the investigation's findings, saying the septicemia diagnoses were appropriate. The hospital chain also said the SEIU study was part of a campaign to "extort" labor gains for its workers (United Press International, 5/8).
Mike Sarrao, Prime Healthcare's general counsel, said the hospital system "is confident that [DPH's] initial findings will be reversed after [the department] has reviewed all of the facts and reviews the matters using correct standards" (Prime Healthcare release, 5/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.