Health care transparency touted in Nevada Senate

By David McGrath Schwartz

Tuesday, March 29, 2011 | 2 a.m.

Eighty-seven-year-old Dorothy Schweitzer died in a Sparks nursing home in 2008, the result of severe dehydration, infection and other complications acquired at the facility, a state investigation into her death would find.

On Monday, her daughter, Aubrey Noriega of Las Vegas, testified that if the state had added transparency laws that require nursing homes to report preventable infections and injuries, the potential of public scrutiny could have saved her mother.

“Only those with something to hide would oppose such a bill,” Noriega testified before the Senate Health and Human Services Committee.

Three bills heard in committee Monday would expand health care transparency in Nevada, including requiring nursing homes to join hospitals in reporting preventable harm, and which would mandate that hospitals designate and employ an infection control officer.

The bills are co-sponsored by Sen. Shirley Breeden, D-Henderson, and Sen. Valerie Wiener, D-Las Vegas.

“We must work toward the increase of transparency in health care,” Breeden said, drawing reference to a package of Sun stories Sunday that, among other things, profiled a hospital administrator in Boston who improved patient care after breaking convention with other hospitals and publicly acknowledging instances where patients were injured or harmed.

Hospital executives and other experts say a crucial strategy to improve the level of patient care is publicizing the harm suffered by hospital patients, which prompts self-examination and improvements at hospitals where such transparency is embraced.

Yet, about 40 states, including Nevada, do not require hospitals to report to the public their cases of hospital-acquired injuries or infections.

Breeden said the bills would give consumers more information about hospitals, including allowing them to compare hospitals and ambulatory surgical centers.

The bills “would not link physicians with adverse events at a hospital. But it’s a step, and we hope to get there soon,” Breeden said.

The bills were triggered by a two-year Las Vegas Sun investigation, “Do No Harm: Hospital Care in Las Vegas,” which revealed the extent to which patients sustain avoidable injuries and infections while hospitalized.

The series was based on a review of 2.9 million billing records that hospitals had delivered to state authorities, but which had not been analyzed until obtained by the Sun. The newspaper found 3,689 preventable infections and injuries in Las Vegas hospitals in 2008 and 2009. In 354 cases, patients died in the facilities.

Over the course of the Sun’s investigation, most Las Vegas hospitals refused to discuss patient safety issues. The Nevada Hospital Association has since 2002 lobbied against mandated public reporting of patient harm. But since the Sun’s investigation, and with legislation pending, the association has said it will begin posting patient injury and infection data on its hospital quality website.

Bill Welch, executive director of the association, said the website will be available April 8.

Renny Ashleman, a lobbyist for the Nevada Health Care Association, which represents nursing homes, said the association is reviewing the bills and is neutral toward them.

“In general we’re in favor of disclosure, in reporting and openness,” he said. Nursing homes have to report some information, he said. “Could it be more open, more accessible? Perhaps,” he said. “We’ll take a look at that.”

Welch testified as neutral on Senate Bill 338, which clarifies the law to allow the state to publish information on these events.

“We support it in concept,” he said, but warned that there was overlap with other bills being considered by the Legislature.

He was against a requirement in Senate Bill 339, which requires a medical facility to designate an infection control officer. He said that such a requirement would put a financial burden on hospitals.