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Southwest Healthcare in Riverside County to keep Medicare funding

Southwest Healthcare officials announced Monday that the Riverside County hospital system had reached an agreement with federal regulators that will allow them to keep their Medicare funding past June 1.

The agreement comes a month after state officials announced a $100,000 fine, the state's first, after multiple determinations that the hospital system’s two facilities had put patients at risk of death or serious injury. The day after that fine was made public, federal officials said they planned to cut off Medicare funding June 1.

Under the agreement, Southwest officials must hire a team of independent experts to evaluate the hospital system and report to federal regulators within two months, according to Steven Chickering, an associate regional administrator for the Centers for Medicare and Medicaid Services.

If federal regulators accept the experts’ proposed improvements, they will share the report with hospital officials, who will have about a year to make improvements before a final federal survey to ensure the hospital is in compliance, Chickering said.

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.

Marc Miller, president of Southwest’s parent company, King of Prussia, Pa.-based United Health Services Inc., said in a statement that hospital officials agreed to hire a team of independent experts to analyze their compliance with federal regulations and propose improvements during the next year. After a year, federal regulators will survey the hospital to ensure it is in compliance, the statement said.

Universal Health Services has already sent a “quality response” team to the hospital and improvements they proposed are already being made, according to the statement.

It is unclear whether the agreement will help Southwest preserve its state license, which covers both facilities.

Last week, the California Department of Public Health sent Southwest a letter stating that its license was being revoked. This week, state officials were in talks with Southwest officials to avoid revocation, according to Ralph Montano, a department spokesman.

Southwest spokeswoman Teresa Fleege said officials hope to have an agreement finalized soon.

The state and federal actions came after a surprise inspection in January found deficiencies at the hospital in nine areas required for Medicare participation. Among the problems cited in a letter to hospital officials last month:

* Medical staff failed to ensure that 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 in 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.

Only a handful of hospitals in the region face such cuts each year. The last Los Angeles-area hospital to lose Medicare funding was Martin Luther King Jr.-Harbor Hospital, which was closed in 2007 after losing $200 million in annual federal payments because of ongoing lapses in care.

-- Molly Hennessy-Fiske
 
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