ProMedica Flower Hospital’s access to Medicare and Medicaid reimbursement is in jeopardy because of an event in the facility’s psychiatric unit, which hospital and federal officials declined to describe on Thursday.
The Centers for Medicare and Medicaid Services said Flower was “out of compliance” for patient rights. The order means patients who have Medicare or Medicaid coverage can’t use Flower after May 9 unless the hospital is able to correct the problem to the satisfaction of federal officials.
Flower was notified its agreement with the secretary of the Health and Human Services Department, as a hospital in the Medicare program, would be terminated.
Alan Sattler, president of Flower, said the hospital was given five days to send Medicare and Medicaid Services and the Ohio Department of Health an action plan by Monday, which must detail the changes it will make.
“We own this. It’s our responsibility,” Mr. Sattler said. “We want to respect our patients’ privacy rights. ... This came about as a result of events exclusively that transpired on our psychiatric unit and we are actively working with CMS.”
He said the event did not result in a loss of life, but that it prompted an investigation by the state health department.
Mr. Sattler said he was confident the action plan would allow Flower to have continued access to Medicare and Medicaid.
“We understand that if we provide them an action plan that is compliant with the request they made of us, which we fully expect we will do, that that process would stop,” he said. “If not, we are hopeful that they will engage us and we will continue to work diligently to provide an action plan to address all of their concerns.”
Mr. Sattler said he was also unable to reveal the date of the event because of patient privacy.
ProMedica spokesman Tedra White also declined to elaborate on the event that prompted the recent investigation.
Elizabeth Schinderle, a spokesman for Medicare and Medicaid Services, said Flower was cited with “an immediate jeopardy” related to patient rights.
“When an immediate jeopardy is cited, the facility is placed on a 23-day track to remove the situation that is the immediate threat or face termination from the Medicare program,” Ms. Schinderle said.
“This may be done while the survey team is on site or within the 23 days. In either case, a survey team must make on-site verification that the steps taken by the hospital truly remove the immediacy of the threat.”
After the “immediate jeopardy” is removed, the hospital stays in a 90-day watch period when it is expected to develop and implement changes to correct whatever problems occurred, Ms. Schinderle said.
“During the termination track, the hospital is expected to develop and implement system changes that will correct the cited problems in a manner that makes it unlikely to reoccur,” she said. “The hospital develops and submits its plan of correction that documents how it has accomplished these system fixes.”
Ms. Schinderle said Medicare and Medicaid Services would not release to the public the incident or violation report regarding what happened at Flower until the hospital responds with that “plan of correction.”
A new multimillion dollar psychiatric wing at Flower opened in March. The hospital in Sylvania began construction last year of the wing for psychiatric services. Located on the third floor, the 12,000-foot area brings the space for the department to nearly 30,000 square feet. The department has 74 beds, which includes 10 psychiatric intensive care unit beds on the second floor.
The department treats patients suffering from mental illness, including dementia, schizophrenia, depression, and bipolar disorder.
Ohio Health Department records show Flower was surveyed on Feb. 28 and before that on Aug. 29, 2013. Both “substantial allegation” surveys found Flower was in compliance with acute care requirements. The record did not specify the allegations that prompted those two surveys.
In 2012, ProMedica released to The Blade reports for some of its local hospitals from the Joint Commission, a national nonprofit independent organization that accredits and certifies more than 19,000 health-care organizations and programs in the United States.
The reports — which were from 2012 for ProMedica Toledo Hospital; 2011 for ProMedica Bay Park Hospital, and 2009 for Flower — said the hospitals’ performances were “similar to the target range [or] value.” The ProMedica hospitals did not get an overall “above the target range,” or the “achieved the best possible results” designation from the Joint Commission. The most recent Joint Commission reports could not be immediately obtained.
Hospital officials also would not comment about an alleged rape of a patient by another patient that took place in a bathroom at Flower earlier this month, or if it prompted the recent health department investigation.
The incident occurred at the hospital at 10:15 a.m. April 1, and was reported to a hospital employee at 11:07 p.m. April 2, said William Rhodus, Sylvania police chief.