Caribou hospital given D grade for patient safety

1 month ago

CARIBOU, Maine – A national watchdog group has given hospitals in Caribou and Fort Kent low to average patient safety grades.

The Leapfrog Group is an independent nonprofit organization that publishes twice-a-year rankings giving hospitals an overall safety grade based on individual category scores. The data for calculating grades largely comes from what hospitals have self-reported to the Centers for Medicare and Medicaid Services and from a Leapfrog Hospital Survey that hospitals voluntarily take part in.

Cary Medical Center in Caribou received a D grade in the latest survey published this fall, its lowest mark in the last three years. Cary’s past grades were Cs as recently as spring 2024. The hospital’s last A grade occurred in spring 2021.

Northern Maine Medical Center in Fort Kent received a C grade this fall. It last received a B in spring 2022. Leapfrog’s grading system penalized NMMC for not reporting data in some categories.

In the fall 2024 report, Cary Medical’s worse than average scores were in patient safety problems, handwashing, clostridium difficile infections and for not providing specialty-trained physicians for intensive care patients.

Clostridium difficile, or C. diff, is a bacterium that can cause diarrhea, abdominal pain, fever and loss of appetite. The infection is difficult to treat and can spread through contaminated medical equipment or by providers who do not properly wash their hands.

The hospital’s safety problems score pertained to patient falls and injuries, dangerous bed sores and harmful events in general, according to Leapfrog.

Bed sores are wounds or sores that can form on the skin when a patient lays or sits in one position too long without being moved. If untreated, the sores can become infected. Cary Medical’s score was 1.58 compared with the average hospital score of .58 based on the number of times patients experienced bed sores for every 1,000 people discharged.

Cary Medical Center CEO Kris Doody said that the hospital’s score has changed over the years as Leapfrog has changed how different categories weigh into the final score, but the hospital’s ratings on the Centers for Medicare and Medicaid Service remain competitive.

The hospital maintains a rating of three out of five stars from the Centers for Medicare and Medicaid Service, based on various areas of quality, including safety, readmission rates and treating certain illnesses, according to the latest data.

“We take the findings seriously and we continue to approach specific areas where improvements can be made,” Doody said. “This one survey [from Leapfrog] does not reflect the quality of care provided by our exceptional staff.”

Northern Maine Medical Center’s ranking included low scores for handwashing, safe medication administration and having specialty-trained ICU physicians. 

Leapfrog’s website states that NMMC did not provide data for those categories, so the hospital was assigned scores that reflected a lack of information.

Since NMMC is moving toward a “critical access” hospital designation, that will affect which categories they are required to report data for, said Sue Devoe, the hospital’s director of quality. Currently, the hospital is an acute care facility. 

Critical access is a designation administered by the Centers for Medicare and Medicaid Services that helps rural hospitals stay financially viable by providing fewer services. 

Leapfrog is unable to assign grades to critical access hospitals, as well as facilities for veterans, children and outpatient services but is working on developing ways to rate those facilities, according to its website.

Devoe noted that Leapfrog’s current data reflects a time period from 2020 to 2023, which largely includes when staff were responding to intense patient demands during the COVID pandemic.

Based on the hospital’s own data, NMMC has not seen a C. diff infection since July 2023 and its handwashing cleanliness rate has gone up to a 95 to 100-percent range based on 350 to 400 staff observations per month. The hospital has new technology for medication administration that has greatly reduced those errors, with only one error occurring this month, Devoe said. 

“COVID basically turned everything upside down for hospitals but we’re using the process of scoring to address these issues and have gotten our quality back up,” Devoe said. “I would expect to see higher scores [on Leapfrog] as the 2020 data drops off and we get closer to today.”

With NMMC being a small rural hospital, they only serve an average of one ICU patient per month, which explains why there is no physician known as an “intensivist” on staff, Devoe said.

NMMC’s last high score on Leapfrog was a B grade for spring 2022. The hospital has a rating of three out of five stars from the Centers for Medicare and Medicaid Services

Northern Light A.R. Gould Hospital in Presque Isle received an overall grade of B in its latest survey report from Leapfrog but has a two out of five star rating from the Centers for Medicare and Medicaid Services.

Houlton Regional Hospital was not listed on Leapfrog’s Hospital Safety Grade. It has a three out of five star rating from the Centers for Medicare and Medicaid Services.