Number of one-star hospitals sinks state rating

Nevada has the highest percentage of one-star acute-care hospitals of any state, the lowest rating given by the Centers for Medicare & Medicaid Services.

The state has a single fivestar hospital, Renown South Meadows Medical Center in Reno, placing Nevada 12th worst for percentage of top-rated facilities, according to a data analysis by the Review-journal.

The rating system is intended to capture the quality of care by measuring death rate, safety of care, readmission, patient experience, and timely and effective care, a Medicare spokesperson said.

Six of the 14 major acutecare hospitals in the Las Vegas metropolitan area were given a single star in the annual ratings published by the federal agency in late July.

“The fact that we have so many one-star hospitals means we have a lot of work to do,” Dr. Marc Kahn, dean of the Kirk Kerkorian School of Medicine at UNLV, said on Thursday.

The highest rating for a Las Vegas metro hospital was three stars, given to four hospitals out of the area’s 14.

The ratings do not “necessarily indicate the public should avoid certain facilities or travel outside of their immediate area to receive care,” the Medicare spokesperson said in an email. Instead, they provide information for consumers to weigh in their decision-making.

Nationally, the one-star category has the fewest number of hospitals with 174. There are 627 with two stars, 793 with three, 766 with four and 385 with five.

The Review-journal’s analysis excluded military hospitals and Washington, D.C., which has just six hospitals, three of which are rated as one-star.

An imperfect system

Las Vegas-area hospitals, as well as national and state hospital associations, emphasized that the star ranking system has its limitations.

“The Star Rating system does not accurately reflect the world-class care delivered by our team members across UMC,” said Scott Kerbs, a representative of county hospital University Medical Center, which received a one-star rating.

“As Nevada’s only Level I Trauma Center, Verified Burn Center and Transplant Center, UMC cares for many of our community’s most critically ill and injured patients, but unfortunately the Star Rating system does not account for patient demographics, the overall complexity of cases treated and UMC’S status as a safety net hospital,” Kerbs wrote in an email.

A representative of the American Hospital Association stressed that the ratings may be affected by factors beyond the control of a hospital.

For example, readmission to a hospital can occur because a patient receives inadequate recovery support after discharge, which could include a lack of transportation to get to appointments or inadequate nutrition, said Akin Demehin, the hospital association’s senior director of policy.

Kahn noted that when discharged patients don’t have a primary care physician, they may resort to using a hospital emergency room for care, which may increase readmission rates. The medical school, he said, is playing a role in expanding the network of primary care physicians in the community.

Hospitals respond

A frequent criticism of hospital rating systems is that a hospital that receives a low grade from one system can receive accolades from another. Las Vegas hospitals echoed this sentiment.

“We are proud of our hardworking team members who have worked tirelessly to provide kind, compassionate, high-quality clinical care in our ERS, nursing units and outpatient centers,” said a representative of the Valley Health System, three of whose hospitals received one star and three two stars. Valley Health System is affiliated with Universal Health Services.

“Thanks to their diligence and expertise, we have received many recent quality-related accomplishments, including awards from 2022-2023 US News and World Report in five different categories, the Spring 2022 Leapfrog patient safety awards and earning accreditations from The Joint Commission and the American Heart Association in the areas of stroke and heart care,” representative Gretchen Papez wrote in an email.

The Valley Health System’s Valley, Spring Valley and Centennial Hills hospitals received one star.

“We recognize the importance of measuring and public reporting of quality performance and safety and we work diligently to continually improve,” said Marissa Mussi, a representative of Sunrise Hospital and Medical Center, which was rated as one-star. She noted that Sunrise had been rated one of America’s 250 Best Hospitals in 2022 by Healthgrades, among other distinctions.

The two other hospitals in the Sunrise Health System, which is affiliated with Hospital Corporation of America, received three stars: Southern Hills and Mountainview.

Hospital representatives said that all information should be considered when evaluating hospitals, noting, too, that some data is out-of-date.

“We trust many of the various grades and ratings that are posted throughout each year,” St. Rose Dominican hospitals representative Gordon Absher said in an email. “However, quality rating initiatives do not always accurately reflect our current performance or quality. Results often lag behind lengthy reporting processes and don’t necessarily reflect more recent improvement data.”

Two St. Rose campuses, San Martin and de Lima, received three stars. The Siena campus received one star.

Hospital representatives encouraged patients to take into account more than just data when evaluating a hospital.

“When making health care decisions, patients should use all available tools at their disposal, such as talking with friends and family and consulting with doctors, nurses and other health care providers,” Marissa Brown, director of workforce and clinical services for the Nevada Hospital Association, said in a statement.

Important metrics

Kahn emphasized that the ratings are a useful tool for patients, hospitals and communities. “Hospitals need to take these ratings seriously,” he said. “Most of the metrics are important, and they’re important for hospitals. So I think what we do is we use these to be better at what we do. … As a new medical school, we see part of our responsibility as to improve the level of care that we provide our community.”

He continued, “We all need to work together to improve those things. That’s really what this is telling us.”