Stet NewsMusgrave appeared on the public radio station’s ‘The South Florida Roundup.’
This is a lightly edited transcript of Stet News writer Jane Musgrave’s appearance on the Dec. 13, 2024, edition of WLRN’s “The South Florida Roundup.” Musgrave discussed her coverage of Palm Beach County hospital health grades.
You can listen to the broadcast here.
WLRN: Welcome back to The South Florida Roundup on WLRN. I’m Tim Padgett.
When we talk about hospital problems in South Florida, fairly or not, we’re usually focused on the taxpayer-funded giants, like the Memorial Healthcare System in Broward County, where administrative dysfunction led to the recent ouster of the CEO.
But right now, the big problem looks to be in Palm Beach County, involving private medical centers, especially those owned by Tenet Healthcare based in Dallas.
This week, we learned that a national hospital rating nonprofit called the Leapfrog Group gave five of those Tenet run-facilities, either F or D grades for patient safety.
And mind you, these are five of Palm Beach County’s largest medical centers, the Palm Beach Health Network that includes those Tenet hospitals refutes the Leapfrog findings.
Either way, a Johns Hopkins study has found that D or F hospitals carry nearly twice the risk of patient death as A hospitals do, so this is worth talking about. Let us know your thoughts.
Joining me now to review these hospital grades is Jane Musgrave. She’s a reporter for Stet News in Palm Beach County, who’s been covering this story. Jane, thanks for coming on.
JANE MUSGRAVE: Yeah, thanks for having me. I appreciate it.
WLRN: I want to start by just reminding our listeners what Tenet Healthcare is and what its medical facilities are in Palm Beach County.
MUSGRAVE: Well, it owns five of the biggest hospitals in Palm Beach County. It has Delray Medical, Good Samaritan, Palm Beach Gardens, St. Mary’s, Boca Medical Center, and it also has the Palm Beach Children’s Hospital, which is part of St. Mary’s. But it was not rated as part of this leapfrog survey.
But overall, it represents about 1,900 beds in the county, which is about half of all beds.
WLRN: Well, that is significant. Yes, and as you point out, and we should point out to our listeners, this study, this report we’re talking about, did not include public or taxpayer funded hospitals or children’s hospitals, right?
MUSGRAVE: Exactly. Exactly. So like the VA, which is a giant 400-bed hospital in Riviera Beach, it was not included in the survey.
WLRN: Right. This is focused on privately run hospitals. Can you then remind us what the non-profit Leapfrog Group is and what it does in terms of monitoring private hospitals like Tenet in Palm Beach County?
Is it a respected hospital watchdog?
MUSGRAVE: From what I can gather, yes, it’s very respected. It started in 2000. It was founded when the reports came out about just the skyrocketing numbers of preventable injuries that were harming patients in hospitals.
WLRN: Right.
MUSGRAVE: And beginning in 2012, they started doing these surveys. And they’re a non-profit organization. According to its website, it has some of the top medical schools in the country serve as advisers on its safety boards.
And unlike other organizations that people might be familiar with, like Healthgrades, it focuses totally on patient safety. So, you know, that’s what its focus is.
Grades are based in part on government data
WLRN: Right. And concerning that focus, then, what are the criteria that LeapFrog uses to grade these hospital facilities on that specific issue, patient safety? Your reporting mentions, for example, federal medical reports.
What are the criteria that they bring to bear in this issue?
MUSGRAVE: Well, the majority of their reports are based on, you know, mandatory reporting hospitals do to the Centers for Medicare and Medicaid Services. In addition to that, and there’s 30 performance measures they use. You know, everything from patient falls, objects left in the body after surgery, MRSA infections. It just runs the gamut of various things that would happen in a hospital.
WLRN: And then using those criteria then to come up with these grades that it gives private hospitals around the country. We should remind people, this is not just a Florida thing, this is something that they are looking at nationwide, correct?
MUSGRAVE: Right, it’s like 3,000 hospitals they survey. And of those, the vast majority, the other component of the grading is hospitals are given the opportunity to voluntarily complete surveys. So if their argument happens to be that the Centers for Medicare and Medicaid Services do not accurately represent what’s going on in the hospital, then they can provide their own separate information.
In this case, Tenet declined to participate in the surveys. But what LeapFrog says is, that is just, as they told me, it’s just one piece of the puzzle.
There’s plenty of information available from CMS. So if the hospital elects not to participate, they’re still going to get graded.
WLRN: Right. I want to get to Tenet’s response in that regard in just a second. But first, I just want to remind people of the facilities we’re talking about here and what grades they got.
As you mentioned, we’re talking about five Tenant facilities here in Palm Beach County. And I’ll just mention that the three that got F grades were Good Samaritan, Palm Beach Gardens, and Delray Medical Centers. Jane, take us through the grades the LeapFrog group gave these Tenant medical centers in Palm Beach County, all five of them.
And what exactly LeapFrog found that it said warranted these disturbing rankings.
MUSGRAVE: Well, on their website, they’re all about transparency because what they really want this data to be used for is for consumers, for patients to make informed choices about what hospitals they are going to go to. So on a very elaborate website, they show exactly what they graded each of the hospitals on. They compare them to the worst performing hospital, the average performing hospital, and the best performing hospital.
Are people getting urinary tract infections? Are they getting MRSA?
Are they falling? Things like that.
WLRN: Infections and things of that nature, or in the most extreme cases, you pointed out surgical instruments perhaps being left inside somebody after an operation.
MUSGRAVE: Absolutely, absolutely. Dangerous bed sores, falls causing broken hips, kidney injuries, things like that.
The goal of sharing hospital data
WLRN: All right. Now, as we’ve mentioned, these are five of Palm Beach County’s largest hospitals, correct? And we should mention that the two Tenet hospitals that got D grades were St. Mary’s and West Boca medical centers, correct?
And again, five of Palm Beach County’s largest hospitals, does that make health experts here doubly worried about what the LeapFrog group found when we’re talking about hospitals that are that important to the county?”
MUSGRAVE: I think that is absolutely LeapFrog’s hope. And they claim that since they began these surveys in 2012, they have seen safety improvements. They talk about hand washing, which is critical for patient safety.
That more hospitals have started abiding by more stringent protocols. The urinary tract infections have gone down, MRSA has gone down, medication errors have gone down. So their argument is that by publicly disclosing this, it puts the pressure on hospitals to improve their practices, and it gives consumers the opportunity to make an informed decision.
WLRN: So Jane, I just want to read here a statement we received this week from the Palm Beach Health Care Network that includes the Tenet Hospitals LeapFrog graded, and I quote, “The Palm Beach Health Network’s Fall 2024 LeapFrog Hospital Survey scores aren’t accurate or reflective of our hospitals’ safety environment. Along with more than 20% of other hospitals, we did not submit any data to LeapFrog’s voluntary survey, given it is not a regulatory or credentialing agency. We are disappointed that LeapFrog still assigned a grade to us despite not having completed a survey for an optional program.
“The Palm Beach Health Network’s top priority is providing high-quality patient care. We take our responsibility to provide the safest possible environment for our patients, very seriously, and we are continually implementing improvement initiatives. Our focus on quality and safety is positively reflected in our many quality recognitions that utilize more current and complete data.
So, Jane, I understand that this morning, Tenet Healthcare itself finally responded to you and Stet News. What did they say?
MUSGRAVE: They actually sent me that exact same statement. Actually, they sent it to me yesterday.
So we updated our story to reflect their comments.
Scrutiny of hospitals is relatively new
WLRN: OK. So do Tenet and the Palm Beach Health Network though have a point here? That is, if they didn’t participate in LeapFrog’s data survey, was it unfair of LeapFrog to assign these grades or are the surveys, as you mentioned, LeapFrog argues, just quote, one part of the puzzle?
MUSGRAVE: Well, that is what LeapFrog will tell you. It’s that they are using publicly available data. Now, they have been criticized in the past.
When they first started doing it in 2012, it was very controversial because hospitals were not used to this level of scrutiny. There have been suits filed against them. Naples Hospital sued them in, I believe it was 2019.
They ultimately dropped the lawsuit and another hospital in Chicago sued them for defamation. That suit was dismissed. It appears on mainly procedural grounds.
But you know –
WLRN: Jane, I just want to step in for a second. I’m struck by the fact that you said that these hospitals were not used to this level of scrutiny. I mean, to lay people like you and me, shouldn’t we be a little concerned that before LeapFrog came on the scene, the hospitals were not receiving this level of scrutiny?
MUSGRAVE: But it’s very public. You know, it’s now, it’s online. It’s available to everybody.
WLRN: Yeah.
MUSGRAVE: You know, and I think that level of scrutiny, it was not formally available to people.
WLRN: Right.
You know, and it’s very it’s easily digestible. It’s an F grade or it’s an A grade.
WLRN: Yeah.
MUSGRAVE: You know, it’s not, you know, you don’t have to read a very boring detailed report. I mean, everybody understands what an Agrade means, right?
So I think that’s what kind of made people stand up and take notice.
WLRN: No, that’s a good point. And Jane, one of the interesting notes in your reporting this week was a 2019 analysis by the Johns Hopkins Armstrong Institute for Patient Safety and Quality that found that hospitals that receive these D or F-grades like these carry nearly twice the risk of death for patients as hospitals that receive A-grades. The researchers involved said 50,000 lives could be saved if all hospitals performed at an A-level.
Can you explain a little more how they came to that conclusion and how this also involves the LeapFrog group?”
MUSGRAVE: Well, that is actually the reason that LeapFrog came into existence when the National Institutes of Health did a study. And at that time, I believe it was something, this was like 1998, and it was like 98,000 people died from preventable injuries in hospitals.
Now, according to LeapFrog, just because of the sheer population increase, there are now preventable medical errors, such as accidents, injuries, and infections, kill upward of 200,000 people a year, making it like the third-leading cause of death in the United States.
They also claim that nearly one in four patients will experience preventable injury. You know, so it’s …
WLRN: No, those are really important points, Jane. Thanks for bringing those up. But again, just to be fair, as the Palm Beach Health Network points out, the LeapFrog group is not an official regulatory agency.
It is a non-profit watchdog. Does that or should it tend to weaken the credibility or the importance of these grades LeapFrog handed out to these hospitals?
MUSGRAVE: Well, I guess it depends. Everybody can make their own decision about the weight they give, something like this.
WLRN: Sure.
MUSGRAVE: But I notice if you go on any hospital’s website, they will tout awards they get from various organizations such as Healthgrades or US News and World Report.
WLRN: Yeah.
MUSGRAVE: And they are not regulatory or any kind of certificate-bearing body. You know, they’re just doing the same thing.
WLRN: Really smart point, Jane, yeah.
MUSGRAVE: So I mean, I don’t know how, you know, it could be seen as a little disingenuous.
WLRN: No, I think that’s a good word. No, of course, not all private Palm Beach County hospitals received failing or near failing grades from the leapfrog group. Many got C grades, a couple got Bs.
But we should note, only one got an A grade, and that was Jupiter Medical Center. What do LeapFrog and other public health experts say that suggests, about the general quality of Palm Beach County’s private hospitals, Jane? And if LeapFrog is right, why are Palm Beach County medical centers, or at least the private ones, so relatively subpar here?”
MUSGRAVE: Well, one thing I just want to point out as well is, you know, over the years, Tenet has participated in LeapFrog studies, and over the years, they have gotten, you know, C grades, and St. Mary’s got a B and so did West Boca. So, you know, they have gotten C and B grades, just to let you know. I think LeapFrog’s emphasis is more on transparency.
And what they emphasized to me when I asked a similar question was, you know, that people in Palm Beach County ought to be concerned that they did not voluntarily participate in the survey. And, you know, I guess some health care professionals would say that they’re very labor intensive. You know, they wanted to devote more time to actually taking steps to promote patient safety.
But LeapFrog really just wants the process to be transparent and to give consumers an informed choice.
Broward and Miami Dade ratings
WLRN: And finally, Jane, does LeapFrog also do this kind of grading of private hospitals in Broward and Miami, Miami-Dade County?
MUSGRAVE: Yes, it’s national. Yeah. So if, and their website is incredibly user friendly.
So if you go to hospitalsafetygrade.org …
WLRN: OK. And I take it that Broward and Miami-Dade private hospitals didn’t come out perhaps as badly as the Palm Beach County, or at least the Tenet hospitals did in Palm Beach County?
MUSGRAVE: I see several A grades. I see some Cs. They run the gamut as well.
But no, I do not see Ds or Fs.
People can check it out for themselves.
I mean, it’s very user-friendly. They can see how these hospitals have done in the past. They can see what they were graded on.
WLRN: Well, thanks. Jane Musgrave is a reporter for Stet News in Palm Beach County.
MUSGRAVE: Well, thank you very much for having me. I appreciate it.
