Houston hospital's Medicare funding in jeopardy

Baylor St. Luke's Medical Center in Houston, part of Englewood, Colo.-based Catholic Health Initiatives, learned June 22 it could lose federal funding for its heart transplant program, according to a Houston Chronicle and ProPublica report.

Medicare notified the hospital it plans to terminate funding to the program Aug. 17, according to the report. Federal officials said not enough has been done to address potential quality issues in the wake of recent patient deaths.

The hospital suspended its heart transplant program for 14 days beginning June 1 after ProPublica and the Houston Chronicle reported the program's high volume of transplants in recent years led to deaths and unusual complications. The program resumed June 15 after an investigation into recent deaths, which hospital officials said "did not identify systemic issues related to the quality of the program." The hospital took multiple actions after the review, including expanding the role of Gabriel Loor, MD, the co-chief of adult cardiac surgery, as well as refining patient selection criteria and forming a transplant committee to continue to review the program and recommend necessary changes.

However, Medicare officials wrote in a letter June 22 that evidence submitted by the hospital of mitigating factors that may have prevented the program's full compliance with federal rules "does not support an approval of mitigating factors." Overall, CMS said not enough has been done to ensure patient safety, according to the report.

St. Luke's said via a statement to the Houston Chronicle and ProPublica that it looks forward to talking with federal officials about their worries. The hospital said it also believes it is eligible to enter into a systems improvement agreement with CMS, among other corrective actions, "which would provide a long-term path forward for our program."

"Our unwavering focus is always to ensure our patients receive the best possible medical care, and in ways that reflect our core values of reverence, integrity, compassion and excellence," the hospital said.

A systems improvement agreement was not mentioned in the CMS letter. According to the report, CMS rules allow St. Luke's to appeal the termination, although the termination process would continue.

Read the full report here.

Ayla Ellison and Megan Knowles contributed to this report.

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