Fall report cards are out, and Charleston's hospitals received mixed results in a nonprofit group's ranking of safety and quality of care.
Bon Secours St. Francis, one of Roper St. Francis' four hospitals in the area, improved to an A grade. Trident Medical Center earned its second consecutive A. Others received Bs and Cs.
While the scores' methods rely on government and self-reported data, the area's public hospital system cautions the grades compare apples and oranges.
The Leapfrog Group releases the scores twice a year to give patients a reference point about which hospitals they should choose. Hospitals with top marks also tend to promote the grade in advertisements. The scores measure more than two dozen factors, including infection rates, bedsores, surgical problems like collapsed lungs, staffing and leadership.
"As we see increasingly sicker patients come to our hospital the 'A' grade is evidence that all of the hard work our physicians and clinicians do every day is paying off," Dr. John McGue, Trident Health's chief of staff, said in a statement.
Its sister hospital, Summerville Medical Center, meanwhile, has received two C marks in 2019 after a few years of consistent Bs.
"We have been working diligently to improve safety by preventing hospital-acquired infections and focusing on quality initiatives, which we expect to see reflected in the next Leapfrog Safety grade release," hospital spokeswoman Kelly Bowen said in a statement. "Positive patient outcomes are our top priority."
In West Ashley, Roper was celebrating its newly earned high score. Gretchen Morin, chief administrative officer at Bon Secours St. Francis, said there has been a focused effort to keep patients from having to return.
That metric — readmissions — is one of several that hospital leaders pay close attention to, Morin said. The entire staff has to coordinate to make improvements.
"You can't rest on your laurels," she said. "It requires diligence on everyone's part."
The Medical University of South Carolina's score dropped to a B in the fall after an A rating in the spring. MUSC's ratings have fluctuated between an A and B for a couple of years.
Heather Woolwine, spokeswoman for MUSC, said the hospital system supports providing patients with transparent information about quality, but pointed to some problems with the scores.
"We spend a lot of time, energy and effort to analyze, understand and improve on quality and safety measures that we consistently track," she said in a statement. "Unfortunately, Leapfrog assigning 'grades' implies that hospitals have been measured on an equal basis; that is not accurate."
MUSC, for instance, often cares for the region's most complex patients, which can drag down scores reported, Woolwine said. She said in the case of certain infections, MUSC was also using the most sensitive test possible, which resulted in a lower score for the system.
No hospitals in South Carolina received an F this fall. The Regional Medical Center in Orangeburg improved its score from an F last year to a D.
One of the four hospitals MUSC acquired at the beginning of this year — the Marion Medical Center in the Pee Dee — also scored a D. The report notes problems with staffing, communication and complications in surgery. The Marion hospital is new to submitting its information to Leapfrog, Woolwine said, which likely hurt its score.
"Hospitals tend to perform better over time as they better understand the survey methods, metrics, and submission requirements," she said.
Another hospital that recently joined the MUSC Health system, Florence Medical Center, has posted consistent A grades in recent years.
South Carolina hospitals overall are 17th-safest in the country, according to Leapfrog. Across the country, a third of hospitals earned an A and a quarter earned a B. Just 1 percent got an F.
Tenet Healthcare's East Cooper Medical Center in Mount Pleasant was not assigned a letter grade.
Washington, D.C.-based Leapfrog was formed by the Business Roundtable in 200 and is made up of large private and public purchasers of health care benefits. Its report cards are based on data collected through a survey it conducts and information published by the Centers for Medicare and Medicaid Services, the federal agency where hospitals send information periodically.
Some out-of-state hospitals have not taken kindly to the rankings, and have even taken Leapfrog to court. Chicago’s Saint Anthony Hospital sued in 2017 over a C rating in a case that was later dismissed. Florida-based NCH Healthcare System filed a lawsuit last month, arguing the scores disparaged a hospital that was assigned a D.