Hospitals in the Washington, D.C., area got generally lackluster ratings for quality and safety of health care in the latest reviews by federal and independent groups. Two well-known D.C. hospitals got one star, the lowest ranking, in a federal survey, while a nonprofit rater gave another D.C. hospital a flunking grade of F.

The reviewers, due to the coronavirus, suspended their 2020 ratings, so the new measurements were the first in many months and they showed, to a degree, how institutions held up during the pandemic. The rankings also underscored the urgency of local officials’ announced plans to revamp hospital care, including helping to fund two new facilities.

The stars awarded by the federal Centers for Medicare and Medicaid Services (CMS) reflected criteria revised to deal with criticisms from hospitals themselves and others. The CMS rankings, as described by the industry publication Becker’s Hospital Review, were launched in 2016 and “assigns stars based on 48 measures in the following five categories: mortality, safety of care, readmission, patient experience, and timely and effective care. This differs from CMS’ previous method, which included 65 measures across seven groups.”

Becker’s reported a consistency nationally in hospital ratings, saying, “overall, 50% of hospitals received the same rating, 45% moved up or down by one star, and 5% shifted up or down by two or more stars.” The breakdown works out as follows. One-star: 204 hospitals; Two-stars: 690; Three-stars: 1,018; Four-stars: 988; Five stars: 45.

No institutions in the District of Columbia received five stars.

The government site, from which the public can get ratings on hospitals, nursing homes, and more, can be reached by clicking here.

In Virginia, the top-ranked facilities, as reported by Becker’s, included: Inova Fair Oaks Hospital (Fairfax), Inova Loudoun Hospital (Leesburg), Inova Mount Vernon Hospital (Alexandria ), Lewisgale Hospital Alleghany (Low Moor), Mary Immaculate Hospital (Newport News), Sentara Leigh Hospital (Norfolk), Sentara Williamsburg Regional Medical Center, and Smyth County Community Hospital (Marion).

In Maryland, the five-star hospitals included: Howard County General Hospital (Columbia), Mercy Medical Center (Baltimore), and University of Maryland St. Joseph Medical Center (Towson).

For the curious, Johns Hopkins received a four-star CMS ranking, as did Sibley Memorial, while other notable D.C. hospitals lagged, including Medstar Washington Hospital Center (three stars), GWU Hospital (one star), Howard University Hospital (one star), Medstar Georgetown University (two stars).

Meantime, annual hospital rankings also were issued by the Leapfrog Group. It describes itself as “a nonprofit watchdog organization that serves as a voice for health care consumers and purchasers, using their collective influence to foster positive change in U.S. health care.”

Leapfrog says its letter grades on safety are based on “up to 27 national performance measures to grade hospitals using a methodology developed with guidance from the foremost experts in patient safety.  This most recent data was collected immediately prior to the onset of the Covid-19 pandemic.” Besides undergoing review by national experts whom the group identifies, Leapfrog also “receives guidance from the Johns Hopkins Armstrong Institute for Patient Safety and Quality.”

The group zinged United Medical Center with an F rating, a basement mark given to less than 1% of the 2,700 general-acute hospitals Leapfrog ranks. In the District, Sibley is the only hospital to receive an A, while the others get Cs, including GWU Hospital, MedStar Georgetown, and MedStar Washington Hospital Center. Howard University Hospital received a D.

In Maryland, more than a dozen hospitals received As with a similar number receiving Bs, and about the same number getting Cs. The University of Maryland Prince George’s Hospital Center earned the only D in the state.

Virginia’s Leapfrog grades break down in similar fashion, with Centra Virginia Baptist Hospital receiving the commonwealth’s only D.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent health care. This has become an ordeal due to the skyrocketing cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs.

As patient advocates look to ways to slash at bankrupting health care costs, they have put hospitals squarely in their sights, as these institutions have become a major driver of spending, taking up roughly 1 of every 3 dollars spent in this area (~$1.2 trillion in 2018 alone).

If they are expected to pay hospitals’ astronomic costs, shouldn’t patients also expect over-the-moon excellence in their treatment in these institutions? The reality is that they get hospitalized only when they are seriously ill or injured and then they and their loved ones must make tough, urgent decisions about places they might not have a clue as to how to begin to evaluate.

The hospital ratings, whether by stars or letter grades, are not meant to be the alpha and omega. Patients still, as they can, must consult with their doctors and people they trust and who may be in the know to find their best available and affordable hospital care.

We have a lot of work to do to make hospitals work for us — and not the other way around. Rankings are imperfect but they are at least one way to let big and often intimidating institutions know that people are watching them and holding them accountable.