1/ When three clinicians shared concerns with LRN reporter @BryantFurlow about how Lovelace Women’s — New Mexico’s largest for-profit maternity hospital — cared for its most premature babies, he decided to investigate. This is what he found.
2/ Extremely preterm babies died at Lovelace with striking frequency. How often? Up to twice the rate they did at Presbyterian, a similarly situated maternity facility just a few miles away.
3/ Lovelace also transferred more than 3x as many newborns as did Presbyterian to the University of New Mexico Hospital, the state’s only top-tier NICU, where the state’s sickest newborns are sent for care.
4/ All told, between 2015 and 2019, *nearly half* of the extremely preterm babies born at Lovelace either died at the hospital or were transferred to UNM.
5/ Lovelace and Presbyterian, which had a similar number of births in 2019, are New Mexico’s largest maternity centers. Between 2010 and 2019, they delivered 28% of babies born statewide, and 37% of the state’s extremely preterm babies.
6/ Lovelace objected to our analyses, claiming its neonatal death rate for *all* NICU-admitted newborns — which includes lower-risk full-term babies AND premature babies — is “significantly lower than the national average,” and has declined over time.
7/ But here’s the thing. We’ve been clear our investigation focuses on extremely preterm newborns — not *all* NICU-admitted newborns — because they’re the hospital’s most at-risk babies.

propublica.org/article/the-tw…
8/ Full-term babies, who are generally lower-risk, make up a much larger proportion of the hospital’s NICU population. So to group them with extremely preterm newborns would obscure the death rate for the hospital’s most vulnerable babies.
9/ A spokesperson for Lovelace also said our investigation sought “to undermine [its] quality of care” through a “misinterpretation of data.” But she didn’t respond when asked how the hospital’s data had been misinterpreted.
10/ It was incredibly difficult to obtain and analyze the data, but we didn’t misinterpret it. We even wrote about the methodology behind our investigation so you can judge for yourself 🙃

propublica.org/article/how-we…
11/ But back to the issue.

Experts said the findings were troubling and should be investigated. But it’s unclear who would conduct the investigation.
12/ That’s because the federal government doesn’t set standards for NICUs — regulation of these units falls to individual states — and New Mexico has no NICU-specific legal or regulatory authority.
13/ Put simply, New Mexico requires *virtually no oversight* of its neonatal intensive care facilities or of babies’ hospital outcomes.
14/ But this is not the case in 31 other states, which have some measure of NICU regulation and oversight, showing it can be done!

propublica.org/article/no-one…
15/ California, for example, has both state and NGO oversight of NICU performance. And Texas requires independent on-site verification of NICU levels of care, which includes reviewing patient records and confirming the credentials of staff specialists.
16/ Here’s why this matters.

Because New Mexico doesn’t analyze or publicly disclose NICU data for specific hospitals, parents are left in the dark about where to seek care.
17/ New Mexico is not alone. Nationwide, there’s a “wall of silence that families and the public face with regard to the quality of care in NICUs,” said Dr. David C. Goodman, a professor at The Dartmouth Institute for Health Policy & Clinical Practice at Dartmouth College.
18/ Parents literally have no way to know which birth centers have the best track records for specific newborn risk groups, like extremely preterm babies.
19/ “Hospital transparency could save babies’ lives and save New Mexico families in the future from devastating heartbreak,” said a Lovelace clinician.
20/ Instead, families have to contend with a system that doesn’t collect or share data on neonatal centers, making it incredibly challenging to sort out what’s wrong and figure out how to fix it.

propublica.org/article/i-rece…
21/ You can read the investigation here:

propublica.org/article/the-tw…
22/ And here’s the Spanish translation of our story:

propublica.org/article/los-do…

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More from @propublica

11 Apr
On Friday, @SecDef announced new measures Friday intended to address growing concerns about extremists in the DOD & armed forces.

@propublica has been covering this issue for years. (THREAD)

2/ Working with @frontlinepbs in 2018, we identified at least a half-dozen members of the white supremacist group Atomwaffen Division who were either currently in the military or had previously served. propublica.org/article/atomwa…
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10 Apr
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7 Apr
1/ On Monday, a man who’s 60+ with underlying conditions went to a @GiantFood pharmacy in Virginia for his vaccine appointment. He is undocumented and brought a consular ID.

He was told that corporate policy is not to vaccinate people without social security numbers...
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And no one is supposed to be charged anything for receiving the vaccine.

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Catch up on the week that was @ProPublica (THREAD)
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propublica.org/article/coal-a…
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Happy Tax Season!
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Read 18 tweets

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