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Federal officials say they will cut Medicare funding to Murrieta hospital June 1

April 15, 2010 |  5:17 pm
Days after state officials announced Southwest Healthcare System in Murrieta had received California's first $100,000 fine for putting patients at risk of death or serious injury, federal regulators announced they are cutting the hospital’s Medicare funding June 1.

The action comes after a surprise federal inspection in January found deficiencies at the hospital in nine areas required for Medicare participation.

“Many previously identified systemic problems persist,” regulators wrote in a letter Thursday to Southwest Chief Executive Dennis Knox, stating the January inspection demonstrated “the inability of the hospital’s governing body to identify and take appropriate measures to eliminate clear threats to patient health and safety.”

Among the problems cited:

* Medical staff failed to ensure six physician assistants in the emergency room were competent to screen patients.

* Nurses failed to follow doctors’ orders and administer antibiotics and blood pressure medications, failed to check on a patient with low blood pressure and failed to follow policies to prevent patients from falling.

* Pharmacy staff failed to decontaminate the area used to prepare chemotherapy medications, potentially exposing other patients to the drugs.

* Hospital staff removed and failed to replace an alarm system on the newborn nursery designed to prevent newborn abductions, and posted security guards out of sight of the nursery.

* Hospital staff admitted they and doctors failed to wear head coverings and face masks to prevent infections in the cardiac catheterization unit.

A Southwest spokeswoman said hospital officials are in talks with regulators to avoid losing their funding, and plan to “work collaboratively on an arrangement that will negate the termination.”

“We expect to have a resolution very shortly which will enable Southwest to continue to provide care and treatment for our Medicare patients,” spokeswoman Teresa Fleege said.

The hospital is entitled to appeal within two months and have a hearing before an administrative law judge of the U.S. Department of Health and Human Services. If funding is cut, they may apply for reinstatement, but would have to show all outstanding problems cited in Thursday’s letter had been fixed and pass unannounced inspections held over the course of at least three months.

Regulators said Thursday that Southwest already has had years to fix its problems.

“We have gone to great lengths to work with the provider,” said Rufus Arther, director of hospital operations for the Medicare region that includes California.

Federal regulators first responded to a complaint at the hospital in June 2007. By July 2009, regulators were prepared to cut Southwest’s Medicare funding, but instead gave hospital officials six months to fix the problems, according to Arther.

Southwest has never lost Medicare funding before, he said. Arther said only a few hospitals each year are cut off in the region that includes California, Arizona, Nevada, Hawaii and Pacific Territories,

The last Los Angeles-area hospital to lose Medicare funding was Martin Luther King Hospital, he said. County leaders closed King in 2007 after federal regulators cut $200 million in annual federal payments due to ongoing lapses in care. Two years before, UC Irvine Medical Center closed its liver transplant program after federal regulators withdrew Medicare funding.

Earlier this week, California Department of Public Health

officials announced they were fining Southwest $100,000 after investigators determined that doctors at its Rancho Springs Medical Center performed caesareans on three women in October using electrical cauterizing instruments in a delivery room with dangerously low humidity, which could have sparked a fire.

The fine was one of three against the hospital totaling $225,000, bringing Southwest’s total to six, the most in the state. Hospital officials have pending appeals in three earlier cases and also plan to appeal the latest three.

The hospital’s three previous fines were each for $25,000 and pertained to staffing issues and food safety.

-- Molly Hennessy-Fiske

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