Longview Regional Medical Center and Christus Good Shepherd Medical Center-Longview’s ratings dropped in the latest hospital quality and safety ratings issued by the federal Centers for Medicare and Medicaid Services.

Each hospital received two stars out of five in the new Hospital Compare ratings. A year ago, Longview Regional received a four-star rating, while Good Shepherd received three stars.

The ratings do not affect the hospitals’ reimbursements from Medicare and Medicaid.

“We are disappointed that our rating dropped, because we know that Longview Regional Medical Center provides better patient care than what the currently public data shows,” Longview Regional CEO Casey Robertson said in a statement. “No rating system is perfect, but this is the rating system that all hospitals operate under. We are supportive of transparency of information that helps patients make informed choices about their health care.”

William Knous, spokesman for Christus Health Northeast Texas, echoed Robertson’s statement.

“We support the concept of providing an easier way for patients and communities to understand quality data. However, we remain concerned about the way the CMS star-rating system oversimplifies the complexity of delivering high-quality care based on data that in some cases lags behind for up to five years,” Knous said in a statement.

“Christus Good Shepherd Health System has received numerous quality and safety awards and accreditations from national organizations like the American Heart Association, the American College of Surgeons and Joint Commission. These recognitions single out excellence in heart care, patient safety, stroke care and overall quality, among many more services,” Knous said.

Robertson said, “Our hospital performs in line with the national average in many areas that comprise the star ratings – safety, mortality, effective care, timely care and imaging efficiency.

“Two areas we’re focused on strengthening are readmissions and patient experience. Readmissions relies on data from July 2017 to June 2018 while the patient experience relies on data from calendar year 2018. Our hospital has implemented best practices in both areas since then,” he continued.

At the Hospital Compare website, people can look up the overall rating of hospitals by location or zip code. They also can compare hospitals based on criteria such as clinical outcomes, customer satisfaction and patient safety.

Individual measures of hospital performance — such as how often patients get infections after surgery, how long patients wait in the emergency department before seeing a doctor or nurse and how likely patients are to get readmitted to the hospital after a heart attack — are used to create a snapshot of the hospital’s overall quality of care.

About the data

The latest Hospital Compare data cover 4,586 hospitals nationwide, according to the Advisory Board, a for-profit firm that uses research, technology and consulting to improve health care organizations’ performance.

Of those hospitals, 407 received the highest rating of five stars, 1,136 hospitals received four stars, 1,119 received three stars, 710 hospitals received two stars and 228 hospitals received one star, according to the Advisory Board website said. CMS did not rate 986 hospitals.

The hospital data consist of more than 100 measures divided into seven categories: mortality (death rate), safety of care, readmission, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging.

Data were collected over one, two or three years. For example, most of the death rate data were collected from July 1, 2015, to June 30, 2018. Data on safety of care were collected primarily from Jan. 1, 2018, until the end of that year, though data on serious complications were collected from July 1, 2016, until June 30, 2018. None of the data are from 2019 or 2020.

Complications and deaths

Good Shepherd’s rates of patient complications and deaths were no different from either the national rate or national benchmark in most categories.

However, in the category of surgical complications, it scored better than the national benchmark in two areas: catheter-associated urinary tract infections in intensive care units and select wards, and Clostridium difficile intestinal infections. C. difficile can cause serious hospital-acquired infections.

Longview Regional’s rates of complications and deaths were no different from the national rate or benchmark in all categories.

Readmission rates

Good Shepherd and Longview Regional’s hospital-wide readmission rates were worse than the national rate of 15.3%, according to the Hospital Compare website.

Good Shepherd’s readmission rates for chronic obstructive pulmonary disease and heart failure patients were worse than the national ones, which are 19.5 % for COPD and 21.6% for heart failure.

However, the hospital’s ratio of unplanned hospital visits after hospital outpatient surgery is better than expected, the website said.

Longview Regional’s readmission rates tracked the national average in all categories, but patients with heart failure and pneumonia who were readmitted spent more days in the hospital on average than patients nationwide.

This category tracks the number of patients who had to be hospitalized again within 30 days of their initial stay and how long they were hospitalized during return visits.

These rates can indicate if hospitals effectively prevent complications, give patients clear instructions about care after they leave the hospital and help patients smoothly return to their home or another facility such as a nursing home, the website said.

“Many factors can influence whether a patient will return to the hospital after discharge, including compliance with care plans, support from family and friends, and underlying health issues,” Longview Regional’s Robertson said.

He listed steps his hospital has taken to reduce readmissions. These include:

■ scheduling patients’ next physician visit before they are discharged;

■ working with local health care providers to ensure patients receive a “seamless continuum of care”;

■ identifying patients at high-risk for readmission when they are initially admitted;

■ improving communication with primary care providers for patients with chronic or acute illnesses;

■ regularly reviewing readmissions to identify factors that caused them;

■ developing more tools to help patients, families and caregivers provide appropriate care after discharge;

■ creating a process for monthly audits and data collection to track trends and implement new processes; and

■ providing staff with diagnosis-specific toolkits and best practices to help prevent complications.

Patient experience

In the overall patient experience category, Good Shepherd received a three-star rating, while Longview Regional received two stars.

Fifty-eight percent of Longview Regional patients who filled out a survey said they always received help as soon as they wanted it; the average for Texas hospitals is 72%, while the national average is 70%. Good Shepherd scored slightly higher at 63%.

When asked if their rooms and bathrooms were always clean, 64 % of Longview Regional survey participants said yes. Seventy-nine percent of Good Shepherd patients answered yes to the same question; the average for Texas hospitals is 78%; nationally, it is 76%.

Finally, 70% of Longview Regional patients surveyed said they would recommend the hospital to others; the figure for Good Shepherd was 62%. The average for Texas hospitals is 75%; nationally, it is 72%.

“We have a designated patient advocate coordinator who (visits) our patients and listens to their concerns. Our leadership team also performs patient (visits) and encourages patients to speak up about what we can improve,” Robertson said.

Timeliness and efficiency of care

In this category, CMS evaluated nine areas: sepsis (blood infection) care, cataract surgeries, colonoscopy follow-up, heart attack care, emergency department care, preventive care, cancer care, pregnancy and delivery care and use of medical imaging.

Both hospitals did well in recommending appropriate follow-up screening colonoscopies — Longview Regional did this for 100% of patients and Christus GSMC for 92% of patients. The figure for hospitals in Texas and nationwide is 89%.

One hundred percent of Longview Regional’s patients with a history of colon polyps received follow-up colonoscopies in the appropriate timeframe; for Good Shepherd, that number was 93%. Both bested the Texas and national averages of 92% and 93%, respectively.

While heart attack care data were not available for Longview Regional, the average number of minutes before outpatients with chest pain received an electrocardiogram (ECG) at Good Shepherd was 2 minutes, below the 7 minute-average at hospitals in Texas and nationwide.

The Longview hospitals also performed well at providing critical care to emergency room patients with stroke symptoms. Eighty-four percent of Good Shepherd patients with stroke symptoms received brain scans within 45 minutes of arrival. At Longview Regional, that figure was 80%; the Texas average is 73%, and nationwide, it is 72%.

Christus Good Shepherd is committed to “providing patients and their family members with a truly unique healing experience that respects the individual and serves the community with dignity, compassion and excellence,” Knous said.

Robertson said, “We will continue working to improve, and as newer data is published, (Longview Regional) will have a rating that better reflects the quality, compassionate care that we provide to patients in East Texas.”