Coral Springs (Fla.) Medical Center has been cited by HCFA for long waits in its emergency room, a problem state officials say is on the rise in Florida.
HCFA officials in Atlanta said 164-bed Coral Springs has until June 26 to respond with a corrective plan or face losing Medicare funds.
"We have determined the deficiencies are so serious they constitute an immediate threat to the health and safety of any individual who comes to the emergency department and requests examination or treatment," HCFA said in a letter to the hospital.
An official for four-hospital North Broward Hospital District, which owns Coral Springs, said he could not comment on the issue until lawyers finished drafting the response to HCFA.
Bill Bell, general counsel for the Florida Hospital Association, said several hospitals in the state have received similar HCFA letters threatening loss of Medicare certification over various issues, including emergency room waits.
"Most complaints are later found to be unsubstantiated," Bell said. "There is no law specifying a maximum waiting time. We are trying to work with HCFA to come up with a better process to deal with complaints."
Under federal law, HCFA is required to investigate all complaints. If potential violations are found, hospitals generally have 30 days to submit a corrective plan before detailed reports are made public. However, in the case of Coral Springs, HCFA released the letter threatening Medicare termination before the hospital could draft the response.
The problem at Coral Springs began on Feb. 12 when 2-year-old Alexandria Silverman was brought to the Coral Springs emergency room. Vomiting and suffering from diarrhea, she waited one hour before a nurse examined her and another 30 minutes before a doctor admitted her.
Three days later, on Feb. 15, the girl died. The Broward County medical examiner ruled the girl died after her blood pressure dropped and that the hospital wasn't at fault.
HCFA officials said Coral Springs violated its own policy to screen patients within 15 minutes.
But Coral Springs isn't the only hospital in Florida with long waits in its emergency room. In 1994, the state Agency for Health Care Administration received a total of 66 emergency department-related complaints from hospitals and patients. Through the first six months of 1995, the state has received 59, a 176% increase from the same period last year.
While the complaints include long waits, Bell said he believed most of the complaints were filed by hospitals over what they consider inappropriate transfers by other hospitals.