Texas County Memorial Hospital, Leapfrog Group clash over safety score data

In exclusive interviews, leaders from both organizations debate fairness, accuracy of quality reporting data
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A conflict is heating up between Texas County Memorial Hospital and the Leapfrog Group over a failing grade for hospital safety--and leaders from both organizations shared their side of the story in interviews with FierceHealthcare.

After investigating Leapfrog's methodology and numbers, TCMH claimed Leapfrog used incorrect and incomplete data from inappropriate sources.

Although Leapfrog withdrew the hospital's F score pending further review, the nonprofit quality rating organization dismissed TCMH's report, sending a letter to CEO Wes Murray defending its scorecard, as well as highlighting inaccuracies on the hospital's website about the "grade change."

"They are entitled to their own opinion, but they're not entitled to their own facts--and the facts are incorrect in their report," Leapfrog CEO Leah Binder told FierceHealthcare.

Contrary to TCMH's report, Leapfrog doesn't charge fees for survey participation or access to its data and has no intention of changing TCMH's F grade, Binder said.

But TCMH isn't seeking a new safety grade, Murray told FierceHealthcare. Rather, the hospital wants an apology and wants off the scorecard altogether, he noted.

According to TCMH, the real issue is Leapfrog holding hospitals responsible for verifying its data--a process that takes time and resources the 66-bed rural hospital can't afford, Murray said.

"I don't submit data to them, but yet they have put the burden of proof on my shoulders to confirm their data."

Leapfrog told FierceHealthcare that most of TCMH's information came from the Centers for Medicare & Medicaid Services, and hospitals are ethically bound by their community and stakeholders to verify data provided to CMS, Binder said.

Moreover, this is the first time a hospital has claimed there were errors in CMS reporting, she said.

If the CMS claims data is inaccurate, Binder said, "The question becomes why are hospitals not reporting data correctly when the taxpayers are paying for the data that they're reporting?" 

According to Murray, the questionable data stems from Leapfrog's methodology: If a hospital doesn't submit to Leapfrog or the American Hospital Association, they are exempt from scoring for certain measures. But even though TCMH doesn't report to either group, it still received scores, he said.

Leapfrog stands by its scoring methodology, pointing out that when hospitals are missing information on one of the 26 measures, the weight for that measure is zeroed out so it won't hurt their score.

But TCMH maintained that missing information did hurt its grade. Hospitals that voluntarily report to Leapfrog get a more in-depth analysis of quality and safety, whereas hospitals without Leapfrog survey information only get broad assumptions, Murray noted.

And those assumptions fail to capture the whole story, he added. For example, three of the process/structural measures for Surgical Care Improvement Project were based on two patients, which he said doesn't indicate a hospital-wide trend.

TCMH also claimed the measurement for intensive care unit staffing was misleading because a small, rural hospital with a four-bed ICU does not need intensivists--a fact Murray said shouldn't be held against them.

The disagreement over the methodology emphasizes the difficulty in providing fair and accurate comparisons across all hospitals. While both sides support making quality data available to patients, hospital ratings should consider certain factors, such as the type and size of a hospital, to help patients make informed decisions.

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