CMS terminates Kentucky hospital's Medicare contract

CMS ended its provider agreement with Southeastern Kentucky Medical Center in Pineville on May 24.

A survey of Southeastern Kentucky Medical Center on Jan. 30 by the Kentucky State Survey Agency found the hospital was not in compliance with Medicare rules and revealed several deficiencies related to patient care. Inspectors identified an immediate jeopardy to patient health and safety due to the hospital's failure to maintain cardiology services, equipment to monitor patient medical conditions, medications for patient emergencies and staffing to provide required care to patients, according to a survey report provided to Becker's Hospital Review.

In a March 29 letter, CMS notified Southeastern Kentucky Medical Center officials that the hospital's Medicare contract would be terminated if it did not make changes to comply with Medicare rules. The hospital failed to make the necessary changes and CMS terminated its provider agreement May 24, according to a letter the agency sent to Southeastern Kentucky Medical Center's CEO, a copy of which was provided to Becker's.

The Medicare program will not reimburse Southeastern Kentucky Medical Center for services provided to patients whose plan of treatment was established on or after May 24, according to the involuntary termination notice. Termination of the hospital's participation in the Medicare program also resulted in the termination of its Medicaid agreement.

Southeastern Kentucky Medical Center, formerly called Pineville Community Hospital, was owned and operated by the Pineville Community Hospital Association until two years ago. In 2017, the hospital association entered into an agreement with Fort Lauderdale, Fla.-based Americore Health. PCHA still owns the hospital real estate, but it entered a long-term lease deal and sold non-real estate assets to Americore.

Earlier this month, the Middlesboro Daily News reported that Southeastern Kentucky Medical Center was roughly $400,000 behind on payroll and needed an influx of cash to overcome financial troubles and keep its doors open. During an emergency meeting May 9, the Pineville City Council voted unanimously to allow Mayor Scott Madon to gather information about acquiring the licenses to operate the hospital from Americore Health.

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