CMS notifies HCA Mission Hospital of EMTALA violation

CMS has sent a letter to HCA Healthcare's Mission Hospital in Asheville, N.C., to notify leadership that the hospital was found in violation of the Emergency Medical Treatment and Labor Act and must take action or risk losing federal funding, according to a letter obtained by the Citizen Times.

In a March 14 letter addressed to Chad Patrick, CEO of Mission Hospital and Asheville Surgery Center, CMS gave the hospital until March 24 to submit a plan of correction to address deficiencies and avoid losing Medicare funding. 

"Unless Memorial Mission Hospital and Asheville Surgery Center has achieved substantial compliance within 90 days (June 5, 2024) of the date of this notice, the Medicare provider agreement between Memorial Mission Hospital and Asheville Surgery Center and [HHS] may be terminated," CMS said in its preliminary determination letter. 

The notice marks the second time in recent months the hospital has faced the possible loss of federal funding related to a series of site visits last year. In November, the North Carolina Department of Health and Human Services concluded a survey at Memorial Mission Hospital and Asheville Surgery Center on behalf of CMS based on a reported allegation of noncompliance with EMTALA, CMS said in its letter. 

EMTALA, enacted in 1986, requires that Medicare hospitals provide all patients appropriate emergency care regardless of state laws or mandates that apply to specific procedures. CMS said Mission failed to comply with EMTALA standards on medical screening exams. 

Hospital officials acknowledged receipt of the March 14 letter from CMS and addressed the agency's finding.

"One finding from the initial survey was based on a medical screening examination in the emergency department," Nancy Lindell, a spokesperson for the hospital, said in a statement sent to Becker's March 15. "This subsequent 90-day standard notice was an expected part of this process and means that specific elements of our approved plan of correction will also be examined and re-surveyed in tandem with the revisit to ensure that this EMTALA finding has been addressed."

The March 14 letter from CMS comes after Mission received a notice of immediate jeopardy from CMS Feb. 1 stemming from serious deficiencies it was cited for in January that centered around policies related to emergency department care. CMS in February found Mission in compliance with its plan of correction to address the issues. While CMS determined the hospital was no longer in immediate jeopardy last month, some nurses contend that steps to correct immediate jeopardy at Mission have "backslid." 

The previous immediate jeopardy status also stemmed from the North Carolina Department of Health and Human Services inspections at the hospital late last year on behalf of CMS and, once the immediate jeopardy status was lifted, CMS notified the hospital it has until June 5 to come back into full compliance and avoid losing federal funding. 

"As we continue to state, we take these matters very seriously and have made significant process changes to improve our patient care experience," Ms. Lindell said. "Ongoing measurement of various indicators, including EMS offload times and patient satisfaction, validates what we are hearing from our patients, providers and EMS partners — that our care teams are excellent and significant improvement in emergency care has been recognized."

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