Grades are in for hospital conditions nationwide; How did Western North Carolina fare?

ASHEVILLE - As far as letter grades go, it’s a good fall for Western North Carolina hospitals, none of which scored less than a “B” from national safety assessment organization Leapfrog.

The grades published mid-November are the newest scores since May 2022.

Leapfrog Hospital Safety Grades evaluate hospitals every fall and spring, scoring A, B, C, D or F, using more than 30 measures from the Centers for Medicaid and Medicare Services.

HOSPITAL RATINGS:Mission, AdventHealth get A's from Leapfrog

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The Leapfrog Hospital Safety Grade, published twice a year by national nonprofit Leapfrog Group, reported on several local hospitals including HCA Healthcare-owned Mission Hospital in Asheville and Mission Hospital in McDowell County’s seat, Marion; AdventHealth Hospital in Hendersonville; and UNC Health Care’s Pardee Hospital in Hendersonville.

Other area hospitals that are part of the Mission Health network did not receive grades because they are not eligible.

Here are the grades:

• Mission Hospital in Asheville received an “A.” This is Mission’s third consecutive “A” from Leapfrog since Fall 2021.

• Mission Hospital in McDowell received an “A.” This is McDowell’s second consecutive “A” since spring 2022.

• AdventHealth received an “A.” This is Mission’s eighth consecutive “A" since Spring 2019, which is as far back as Leapfrog’s publicly available grades are listed on its website. However, AdventHealth leaders in a statement noted the “A” was AdventHealth Hendersonville’s 13th consecutive.

• Pardee received a “B.” Pardee scored an “A” in the spring of 2022, a "B" in the fall of 2021 and an “A” in the spring of 2021.

In statements following the grades’ publication, hospital leaders lauded their work and staff.

“I’m incredibly proud to lead this team of capable and caring providers,” Mission Hospital CEO Chad Patrick said. “At Mission Hospital, the safe and compassionate care of our patients is our top priority and we are honored to have the Leapfrog Group independently acknowledge the efforts of this team once again with an A grade.”

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Mission Health is owned by HCA which bought the network in 2019 for $1.5 billion. In spring and fall of that year the Asheville location scored a “C” and “B” grade, respectively. By fall 2020 it had gone up to an “A” grade.

HCA Healthcare, the largest hospital owner in the U.S., is listed as one of many organizations on Leapfrog's Partners Advisory Committee.

Good grades for Mission Health are run parallel with local frustrations that the HCA purchase has lessened the quality of care, bloated prices and created a non-competitive market. HCA as Mission Health currently is facing two antitrust lawsuits brought by local residents, counties and cities in WNC.

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The Mission Health system is the largest provider of health care services in WNC with more than 12,000 employees and hundreds of volunteers, according to a certificate of need application it submitted to the N.C. Department of Health and Human Services’ Division of Health Service Regulation in June. It has hospitals in the area.

The system promoted its recent “A” grades from Leapfrog in its certificate of need application, a bid to build 67 new acute care beds in Buncombe. It is competing with two other hospitals for the CON.

AdventHealth, one of those contenders for the CON, also sang the praises of its Hendersonville facility.

“I am so proud of the entire team for making safety the focus of every aspect of their roles in providing whole-person care – body, mind and spirit,” AdventHealth Hendersonville President and Chief Executive Officer Brandon Nudd said.

"Together this team makes sure people choosing AdventHealth for their health care know they are getting this exceptional level of care. To have The Leapfrog Group recognize this consistent commitment to safe, quality care in their regular surveys of our hospital is a great honor.”

In a brief statement she attributed to Pardee UNC Health Care, spokesperson Amy Holcombe said, "We are disappointed in the recent drop in our Leapfrog score to a B. Pardee is committed to safety and our return to an A rating."

BID FOR BEDS:‘Failed’ to prove a need: Pardee calls foul on Mission, AdventHealth, Novant 67-bed bids

Can you trust the grade?

Hospitals nationwide and Leapfrog itself touts the efficacy of the grading results and methodology.

“An ‘A’ Safety Grade is a sign that hospitals are continuously evaluating their performance, so that they can best protect patients,” Leapfrog Group CEO Leah Binder said in a statement included with many hospitals’ news releases on the fall scores. “Your hospital team should be extremely proud of their dedication and achievement.”

As reported by Patient Engagement Hit, Xtelligent Healthcare Media network, a 2019 report published in the New England Journal of Medicine Catalyst calls rating systems like Leapfrog’s into question.

"Current hospital quality rating systems often offer conflicting results ― a hospital might rate best on one rating system and worst on another," lead author of “Rating the Raters: An Evaluation of Publicly Reported Hospital Quality Rating Systems” Dr. Karl Bilimoria said in a 2019 statement. Bilimoria then was director of the Northwestern Medicine Surgical Outcomes and Quality Improvement Center.

"It's been confusing for patients who are trying to make sense of these ratings," Bilimoria said in the statement. "How are patients supposed to know which rating systems are good or bad? This study gives them information from a group of quality measurement experts to figure out which rating system is the best."

But Leapfrog stands by its system.

After it was sued in Florida by NCH Healthcare System over a “D” grade in 2019, Binder put out her own statement, criticizing the system for spending money on litigation instead of patient care.

“NCH resources would be better spent on initiatives to improve patient safety,” Binder said. “In the United States, over 500 people a day die from preventable medical errors, infections, and injuries, and saving those lives should be the top priority of every hospital. Every hospital should focus on putting the safety of patients first and foremost every minute of every day.”

Andrew Jones is an investigative reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach him at @arjonesreports on Facebook and Twitter, 828-226-6203 or arjones@citizentimes.com. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: What are Leapfrog safety grades for 3 Western North Carolina hospitals