Texas hospital's Medicare contract in jeopardy over threats to patient safety

CMS is giving United Memorial Medical Center in Houston one more chance to correct patient safety issues before terminating the hospital's Medicare contract. 

The agency conducted four surveys of United Memorial Medical Center between Jan. 8 and Sept. 10, and each time surveyors cited immediate jeopardy to patients and substandard quality of care. 

"Despite several opportunities to address their non-compliance, UMMC has failed to ensure the health, safety, and well-being of its patients," CMS told Becker's Hospital Review Dec. 13. 

In late November, CMS notified UMMC leaders that the facility's Medicare contract would be terminated Dec. 11. The day before the deadline, CMS extended the termination date to Jan. 11, pending a follow-up inspection. 

The decision to extend the termination date was based on several factors, including the recent increase in COVID-19 cases, the hospital's reported implementation of plans of correction, and changes to the facility's governing board and management officials, CMS said in a Dec. 10 letter to the hospital's CEO. 

The hospital fixed some issues and submitted a plan to correct other deficiencies. CMS said it will conduct a final unannounced Medicare certification survey before Jan. 11. 

During the most recent follow-up inspection in September, surveyors identified deficiencies that "pose an immediate jeopardy to patient health and safety and placed all patients in the facility at risk for likelihood of harm, serious injury, and possible death," reads the Sept. 10 survey report CMS shared with Becker's Hospital Review

Surveyors said patients in the hospital's COVID-19 unit who required ventilation assistance were put in rooms behind closed fire doors, and nurses were unable to hear critical alarms from equipment in the rooms behind the fire doors. This practice "could cause serious injury, harm, impairment, or death" to the patients requiring ventilation assistance who are placed in these rooms, according to the survey report. 

The survey report noted other deficiencies, including that two patients requiring ventilation assistance were placed in a long hallway with room doors closed. The hallway included a room where a patient was disconnected from a ventilator for about 30 minutes in August. "A 'high priority disconnect' alarm sounded without staff intervention. The patient died," reads the survey report. 

In addition to submitting a plan to correct patient safety issues, the hospital is creating a new board comprising seven members who are former CEOs and physicians, UMMC leaders said at a press conference Dec. 11, according to the Houston Chronicle. The names of the new board members have not been released. 

Involuntary termination of a provider agreement is rare and is generally a last resort after all attempts to remedy deficiencies have been exhausted. 

"In this instance, CMS has found that UMMC — despite proposed corrective actions — is out of compliance with CMS' basic health and safety requirements," CMS told Becker's Hospital Review Dec. 13.

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