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September 18, 2014

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HEALTH CARE:

Inspection to determine if MountainView loses Medicare payments

Second inspection to determine if changes made; Medicare payments in balance

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Steve Marcus

MountainView Hospital

MountainView Hospital

A recent inspection at MountainView Hospital will determine whether the facility loses its Medicare payments, a staggering financial blow.

In October, the Centers for Medicare & Medicaid Services, the federal government’s insurance for patients older than 65, found that MountainView was not meeting the conditions for the program. Specifically, the hospital’s governing board had failed to ensure the safety of patients and protect their rights, the government said.

The findings followed the May suicide of a MountainView patient. The 59-year-old man went to the hospital recently divorced, depressed, with a suicide attempt and thoughts of killing himself. He had not been taking his medications and suffered from apocalyptic delusions and Vietnam flashbacks.

A state investigation revealed missteps in his treatment — his transfer to a mental hospital was needlessly delayed for hours, video surveillance failed to protect him and he was given his street clothes. He used his belt to hang himself in a bathroom.

MountainView’s safety problems limit its capacity to provide adequate care to patients, Medicare officials wrote to the hospital.

The hospital submitted to Medicare a plan of correction that included changes made since the patient’s suicide:

• A Mental Health Task Force was formed, which met with a consultant who reviewed the facility’s procedures and provided education.

• Nurses, sitters, greeters and technicians were educated on safety procedures and the need to notify administrative nurses of any changes in patient behavior.

• Techs monitoring the cameras in patient rooms are required to take breaks every two to four hours.

MountainView made Medicare’s concerns its “highest priority,” Will Wagnon, the hospital’s CEO, wrote to the agency.

In recent weeks, Medicare inspectors revisited MountainView to see if the problems had been corrected.

MountainView officials declined to be interviewed for this story, but sent a statement saying they extended their sympathies to the family of the patient who committed suicide, and that they take compliance with the Medicare inspection process seriously.

However, a source familiar with the investigation told the Sun there were unspecified problems found by inspectors. The findings of the inspection will be publicly reported in the coming weeks.

It’s extremely rare for hospitals to lose their Medicare payments.

State records show that more than half of the hospital’s billed charges came from Medicare in the first three quarters of 2010.

It’s the second time since 2008 that MountainView’s participation in Medicare has been at risk. The problems then related to multiple infection control violations, including blood on a lab floor, a physician assistant contaminating equipment with bloody gloves and no system in place to track whether patients had picked up an infection after undergoing an outpatient endoscopy or cardiac catheterization procedure.

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