Patients give higher marks to nonprofits

By Marshall Allen

Tuesday, April 8, 2008 | 2 a.m.

Only four in 10 patients treated at Desert Springs Hospital Medical Center said they would definitely recommend the facility to their family and friends.

And the numbers are almost as bad for many other for-profit hospitals in Las Vegas. Only about half of patients treated at Sunrise, Summerlin, Spring Valley and Valley Hospital medical centers said they would recommend those hospitals to others.

In comparison, eight in 10 patients who went to St. Rose Dominican Hospital’s Sienna campus would definitely recommend it to family and friends — 21 percentage points higher than the national average.

The patient recommendation findings come from one of 10 questions on patient satisfaction surveys released recently by the U.S. Centers for Medicare & Medicaid Services, the agency that runs the government’s insurance programs for the disabled, elderly and poor.

The St. Rose Dominican chain, owned by the California-based nonprofit Catholic Healthcare West, generally was rated better by patients than its for-profit counterparts.

The Medicare information, available on the Internet at www.hospitalcompare.hhs.gov, previously centered on about two dozen quality-of-care measures at hospitals across the country. New information, released in late March, includes the numbers of certain procedures performed at hospitals and what Medicare pays for those procedures.

“This is about transparency and accountability,” said Michael Leavitt, secretary of the U.S. Health and Human Services Department, the agency that oversees Medicare. “Without a means of measurement, we continue to reward mediocre and poor performance.”

Hospital officials often complain that the system of measuring performance is crude, and Leavitt agrees. The federal government is in its earliest stages of assessing hospitals, but the process is improving, he said. The overall goal is to “drive quality up and drive costs down,” he said, and releasing information such as patient satisfaction is one of the starting points.

The new patient survey information was gathered randomly from October 2006 to June 2007 from patients in about 2,700 hospitals, Medicare officials said. Hospitals were not required to participate, which explains why some data are missing.

Officials from North Vista Hospital said they chose to withhold the data until next year so they could make improvements before the surveys became public. University Medical Center, the county’s only public hospital, also chose not to release information.

And two other hospitals that did not release the information — the St. Rose Dominican Hospital-San Martin campus and Centennial Hills Hospital Medical Center — opened recently.

In the future hospitals will be penalized financially if they do not gather and submit the information.

The Las Vegas hospital market is unusual because it’s dominated by for-profit facilities, which critics say cut corners to increase their bottom line. Pennsylvania-based Universal Health Services owns Centennial Hills, Desert Springs Hospital, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center and Valley Hospital Medical Center. Tennessee-based Hospital Corporation of America owns MountainView Hospital, Southern Hills Hospital & Medical Center and Sunrise Hospital & Medical Center.

Patients treated at the St. Rose Dominican hospitals — the De Lima campus and the Sienna location — consistently ranked them above local for-profit facilities. In many cases the two nonprofit hospitals were rated better than the state average and in some cases better than the national average.

Donna West, a registered nurse who works at Valley Hospital and is a member of the Service Employees International Union-Nevada, said the nonprofits perform better because they have, by contract, the highest ratio of nurses to patients.

West said she was especially discouraged to hear of the low patient satisfaction at Valley, where she’s worked for 20 years. Valley ranked among the lowest hospitals locally for the percentage of nurses who “always” communicate well, as well as the percentage of patients who said their rooms and bathrooms were “always” clean.

“When you staff at the bare minimum and your bottom line is money, these are the kind of problems that come up and these are the figures you get,” she said.

The St. Rose Dominican hospitals also are unique in Las Vegas because they include nurses in setting staffing levels, West said.

Angie Silla, a registered nurse who works as a patient advocate in Las Vegas, said it’s no surprise that Desert Springs ranks low in patient satisfaction. She said she was in its emergency room Friday night with a patient who was not receiving the necessary care or attention. The doctor had been at the bedside twice in a 12-hour period and the few nurses on duty appeared overworked, she said.

“Nobody was keeping anybody informed of anything, and they’re downright disrespectful and unprofessional to patients and their families,” Silla said.

While Silla said she wouldn’t take her “worst enemy” to Desert Springs, she did not blame the staff for the problems she saw there.

“I blame the system they’re working in,” Silla said. “The patient-to-nurse ratios are just too high.”

Desert Springs officials said they see no link between staffing levels and the patient satisfaction surveys. They said in a statement that some of the data in the surveys are more than a year old, and they take patient perception seriously.

They said they already have made several improvements based on the surveys. For instance, housekeepers now leave a card to tell patients when a room has been cleaned and provide contact information to deal with problems.