Likewise, hospitals in Georgia are particularly upset because the state is greatly overrepresented in the list of EDs with the very longest wait times, a serious error apparently caused by the Georgia Hospital Association, which extracts administrative claims data for most of its 170-member hospitals for accreditation and reporting purposes.
"We made the mistake at our level, at the Georgia Hospital Association," acknowledges Kevin Bloye, GHA's Vice President of public relations. "We inserted zeros in the patient arrival times, and the system that CMS uses read those zeros inserted as 'midnight,' so the patient was recorded as having been in the ED since midnight."
In two of the ED measures—the average time patients spent in the ED before being sent home and the average time patients spent in the ED before they were seen by a healthcare professional—the 10 longest times are all for Georgia hospitals, with patients waiting between 788 and 1115 minutes, or between 13 and 18.5 hours.
At 540-bed John D. Archbold Memorial Hospital in Thomasville, GA patients waited the longest for care in both those two measures, according to the CMS website: 1,115 minutes for the first measure and 1,022 for the second.
Mark Lowe, assistant vice president for marketing and public relations, gave the same explanation: "Zeroes were accidentally put in the field for a patient's arrival time," making it appear that all patients arrived at midnight, even if they had arrived later.
"We sent a formal request to CMS to have this not show up for the first quarter, but they were not able to do that," Lowe says. "They refused to even annotate the data."
A CMS spokeswoman would not comment on the record. She emphasized, however, that all hospitals had received a chance to review their times on a special CMS website and request factual corrections, but not after a certain point. A snow storm in Washington Wednesday closed federal offices, and prevented her agency from responding to other questions in any detail, she said.
Bloye says that many Georgia hospitals have tried to get CMS to change the data, or at least explain the issue so patients and community leaders would not be shocked, or afraid to seek care. GHA officials explained that the reporting criteria is a new one, and that many hospitals are unsure how the data should be sent. There is dissatisfaction with CMS's refusal to fix the mistakes.