Investigative Report Drives Scrutiny Over HCA's Cardiac Care

An internal investigation conducted by for-profit Hospital Corporation of America identified the performance of unnecessary cardiology procedures at several Florida hospitals from 2002 through 2010, but HCA contends the findings "are not, by any means, definitive," according to a New York Times report.

As part of its investigative report, The New York Times obtained "thousands of pages of confidential memos, email correspondence among executives, transcripts from hearings and reports from outside consultants."

A registered nurse's complaints of unnecessary procedures at Lawnwood Regional Medical Center in Fort Pierce, Fla., in summer 2010 prompted HCA's internal investigation. The probe confirmed the allegations, according to a confidential memo from HCA's ethics officer that was obtained by the newspaper. It found roughly half of the 1,200 cardiac catheterization procedures were performed on patients without significant heart disease. Furthermore, The Times also obtained a 2009 HCA business plan that referred to a Lawnwood physician from the hospital's cardiac cath lab as "our leading EBDITA MD" [sic], according to the report.

Another report mentioned in the investigative article is that from CardioQual, an external company brought on by HCA in 2004 to examine patient medical records from Regional Medical Center Bayonet Point in Hudson, Fla., which found "43 percent of 355 angioplasty cases…were outside reasonable and expected medical practice." Nine physicians were suspended as a result of the CardioQual report, but The Times investigation found "HCA took steps to withhold details of its conclusions to the media and others," according to the report.

Cardiologists claimed the review did not accurately reflect their work and one physician in the report attributed the issue largely to poor medical record documentation. HCA said the reviews are not definitive, and it has taken "action where necessary," according to the report.

HCA released a statement yesterday in anticipation of The Times report, saying "there is a variation across the country, between regions, within regions, and even within the same medical staff or medical group" regarding cardiac procedures. It also says more than 90 percent of HCA hospitals are in the top quartile nationally on CMS Hospital Compare core measures, with more than 80 percent being in the top 10 percent nationwide.

Also yesterday, HCA disclosed that the cardiology practices at some of its Florida facilities were under scrutiny by the Department of Justice.

More Articles on HCA:

HCA's 2Q Profit Swells 71% as Admissions, Surgeries Grow
Dr. Atul Gawande: Should Hospitals Follow the Cheesecake Factory Model?
CFO R. Milton Johnson: Financial Director of the Largest U.S. Hospital Chain


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