A rural Missouri hospital cited for nearly 100 serious deficiencies in a 1991 survey was threatened last month with loss of accreditation-after whittling the deficiency list down to one infraction.
Hedrick Medical Center, a 64-bed facility in Chillicothe, a town of about 9,000 in northern Missouri, has until May 17 to appeal the so-called "adverse decision." It was one of two such decisions handed down on April 21 by the Joint Commission on Accreditation of Healthcare Organization.
The other was slapped on 31-bed Kingsburg (Calif.) Hospital District. Hospital representatives did not respond to several calls asking for comment.
Hedrick's saga began in September 1991, two months after Richard L. Conklin joined the hospital as its administrator. Mr. Conklin said surveyors found 95 "Type I" violations, the most serious type.
"We had a mess," he said.
The JCAHO imposed conditional accreditation on Sept. 13, 1991, said spokeswoman Cathy Barry-Ipema. The category is probationary, requiring action to correct problems by a set date.
"We got busy," Mr. Conklin said, "and on the follow-up survey we had 16 Type I's." That was in October 1992, and on Nov. 11, 1992, the hospital was upgraded to "accredited with Type I's," said Ms. Barry-Ipema. That level is higher than the conditional rating, but it still requires resolution of the problems by a certain date.
Another follow-up survey in September 1993 uncovered one Type I deficiency related to delinquent medical records, Mr. Conklin said. Seven months later, the hospital learned its accreditation was in jeopardy.
"We're surprised they would do this at this time, when we corrected all but one deficiency," he said, contending the hospital now could pass inspection. The adverse decision comes five months before the hospital's next scheduled survey in the JCAHO's three-year cycle.
"It's an awful black mark for one problem," Mr. Conklin said.
Ms. Barry-Ipema said the hospital's leaders "were given ample time to improve," and the remaining deficiency was a substantial one related to patient care. "This was a serious problem and*.*.*.*did not go away. In fact, it became more of a problem."
Mr. Conklin said the hospital's board would decide this week whether to appeal or reapply for accreditation. The facility would lose its accreditation if it doesn't appeal, but an appeal would delay another site visit, he said. Taking the accreditation loss and reapplying would speed up getting a survey team out to the hospital, he said.
Besides the two accreditation denials, eight acute-care facilities were given conditional accreditation in decisions made between Feb. 12 and April 21.
They are 50-bed Fallbrook (Calif.) Hospital District; 221-bed Los Medanos Community Hospital, Pittsburg, Calif.; 123-bed Palmdale (Calif.) Hospital Medical Center; 331-bed St. Elizabeth Hospital, Elizabeth, N.J.; 106-bed Plains Regional Medical Center, Clovis, N.M., and 46-bed Plains Regional Medical Center, Portales, N.M.; 157-bed Bella Vista Hospital, Mayagues, Puerto Rico; and 56-bed Hospital Oncologico, Ponce, Puerto Rico.
The commission also imposed adverse decisions on one mental healthcare facility and two home healthcare agencies, and it conditionally accredited one home healthcare agency.