Sutter Health may accommodate electives as California hospital faces CMS contract loss

Stanislaus Surgical Hospital has typically seen more than 400 elective surgeries per month. But the facility is likely to close April 30, when its Medicare contract with CMS is set to terminate. At least one other hospital in Modesto, Calif., has indicated it plans to take on cases originally scheduled at SSH, according to a report from The Modesto Bee. 

On April 11, CMS provided a written notice to hospital leadership saying it will terminate its Medicare Provider Agreement with Stanislaus Surgical Hospital April 30 — a decision the agency said is based on the hospital's non-compliance with nine conditions of participation. The hospital is appealing the CMS decision, though it's unclear how long the process could take or how long a closure might last. 

"We have connected with physicians from Stanislaus Surgical Hospital to evaluate how we can help accommodate procedures from the facility after April 30 so these patients may continue to access care they need," a spokesperson for Sacramento-based Sutter Health, which owns Modesto-based Memorial Medical Center, told the Bee

On April 22, Rep. John Duarte sent a letter to CMS asking the agency to give the hospital a 45-day extension. According to the Bee, the letter did not dispute findings from hospital surveyors — which cited issues surrounding the hospital's handling of patient emergencies after surgeries, infection prevention and control, and sterilization processes and governance — but argued CMS didn't give Stanislaus Surgical Hospital a fair opportunity to fully address deficiencies. 

"If this decision is not overturned, 1,800 patients per month, the majority of whom are Medicare or MediCal beneficiaries, will lose access to necessary care in an underserved community that cannot support this patient load," Patrick Haley, a spokesperson for the hospital, previously told Becker's. "Many of the cited issues have been identified to be false or misleading, and SSH is asking that CMS engage in a reasonable discussion regarding these allegations, and move forward toward a mutually agreeable resolution."

The hospital is planning to lay off nearly 200 employees, effective April 30. It aims to retain up to 20 workers throughout the appeals process. 

In a statement to Becker's, CMS said facilities "are given every opportunity" to resolve immediate jeopardy situations and come back into compliance with federal requirements as a Medicare and Medicaid provider. 

"Involuntary termination of a Medicare provider agreement is generally the last resort after all other attempts to remedy noncompliance deficiencies at a facility have been exhausted," the agency said. 

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