A packed-house crowd of Villagers with plenty of questions about their health care turned out Tuesday night to hear from the CEO of The Villages Regional Hospital.
Billed as an “Update on Improvements at TVRH,” Don Henderson’s presentation came a month after it was revealed that the 307-bed hospital in The Villages was one of 282 in the United States to receive a one-star rating from the Centers for Medicare & Medicaid Services (CMS). The agency ranked more than 3,500 hospitals across the country on a variety of factors, including mortality, safety of care, readmission, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging.
Overall, TVRH ranked below the national average on mortality, readmission, patient experience and timeliness of care. The hospital ranked above average on safety of care and efficient use of medical imaging. And the effectiveness of care ranking was right at the national average.
Henderson spoke before members of the Property Owners’ Association during their monthly meeting, which was held at the Laurel Manor Recreation Center. He currently serves as president and CEO of Central Florida Health, parent company of TVRH and Leesburg Regional Medical Center, which was one of 800 hospitals to receive a two-star rating.
“The star rankings only started coming out about two years ago, and almost from the git-go, we’ve been in a hole trying to dig ourselves out,” Henderson said, adding that there’s been talk of those rankings going away. “The bottom line is if you have a lot of elderly patients, you’re going to score lower than hospitals that don’t have a lot of elderly patients.”
Henderson also pointed out that the mortality rate of older patients is being held against the hospital.
“If you’re 80 percent Medicare, people are going to get terminal illnesses and they’re going to pass away in the hospitals,” he said. “Other hospitals don’t have that percentage of Medicare patients.”
Even though he believes the numbers are skewed against TVRH, Henderson said he and his team are working extremely hard to make improvements. But he also pointed out that when it comes to patient satisfaction, those who don’t give the hospital a score of nine or 10 don’t get included in the rankings.
“Medicare has kind of skewed the game against us a little bit,” he said. “How many events in your life do you rate a nine or 10?”
After Henderson’s presentation, several Villagers were itching to ask questions or make their thoughts known – especially when it came to long wait times at the hospital’s emergency department.
That subject prompted one woman to ask if there was a staffing issue.
“The nurses will tell you there’s a staffing issue,” Henderson said. “But the bottom line is that we’re fully staffed.”
Cindy Grillet, of the Village of Alhambra, took issue with that statement. And she also challenged Henderson on another statement he had made earlier partly blaming long wait times on snowbirds who don’t have doctors here and use the emergency department whenever they get sick.
Grillet pointed out that everyone in the room – including Henderson – was well aware of the demographics in The Villages. She also reminded him that he was the person chosen to serve that demographic. And she expressed frustration with the fact that she recently spent more than 26 hours in the emergency department waiting to get admitted.
“With an entire waiting room and the emergency room hallway full – which is where I spent my first 13 hours – that entire back station was empty and non-staffed and the beds were unfilled,” she said. “So clearly there is a staffing issue, contrary to what you said.”
Grillet wanted to know why an entire area of the emergency room wasn’t in use that day – an issue she said doesn’t bode well for the future.
“We are growing and you can’t serve us now,” she said. “What happens as we continue to grow?”
Michael Pittman, who serves as TVRH’s chief clinical officer and site administrator, invited Grillet to come to his office so he could get her an answer. But he said some beds might not have been in use because some of the nurses may have been needed elsewhere in the hospital.
Another Villager expressed concern about hospital-acquired infections like MRSA, C Diff and sepsis. He cited the recent death of 74-year-old Village of Caroline resident Don Roberts, who is believed to have acquired West Nile Virus from a mosquito bite after playing a round of golf and hanging out the fire pit in the Village of Fenney. Roberts was transferred from TVRH to UF Shands Hospital in Gainesville before he succumbed to West Nile Virus, pneumonia and septic shock on Jan. 16, according to his death certificate.
After explaining that the man was talking about two different things in community-acquired and hospital-acquired diseases, Henderson defended the hospital’s track record on infection issues.
“I would argue that our overall hospital-acquired infection rates are well below one percent,” he said. “And we are working hard and using best practices and reducing that even further.”
Finally, Henderson addressed a question regarding TVRH possibly merging or partnering with another healthcare organization in the future. The hospital already is working with Shands in its stroke program – a hospital that earned just two stars from CMS even though it is “one of the finest in the country,” Henderson said.
“I think there is definitely a possibility,” he said. “We do like Shands a lot and they seem to like us. Unlike some critics, they think we have very high quality and that’s why we’re the only hospital they’re affiliated with in the region. So those discussions continue.”
After the presentation, POA President Cliff Wiener said he was thrilled with the large crowd, though he wasn’t surprised. He said he appreciated Henderson ‘s presentation and will count on him to come back with an update in the future.
“We’re not going to give up,” he said. “The Villages is a first-class community and we deserve a first-class hospital.”