Two Kaiser Foundation hospitals in Oakland and Richmond, Calif., gave inadequate care and endangered patient lives, according to a validation survey ordered by HCFA.
The survey, done by regulators at the California Department of Health Services and released publicly last week, found Kaiser Oakland Medical Center and Kaiser Richmond Medical Center did not meet minimum Medicare participation standards.
Kaiser executives weren't available to comment on the report.
Administratively and by license, the hospitals are one facility with two campuses. Kaiser intends to close the Oakland campus.
The survey explicitly corroborates many of the recent allegations by the California Nurses Association, which is engaged in a long-running dispute with Kaiser over staffing levels and contract terms.
"We have sounded this alarm for two years," said Rose Ann DeMoro, CNA executive director. "This was completely predictable. The report speaks for itself."
Indeed, the CNA picketed the new Richmond hospital two years ago to alert the public to what the nurses considered inadequate staffing levels in the emergency room.
The HCFA report said, "The lack of availability of (critical-care transport) RN staffing has caused inappropriately long delays of patients receiving treatment." Some of those ER patients died due to the delays, it said.
Because Kaiser doesn't staff the intensive-care unit at the Richmond hospital, critical patients who arrive there are supposed to be transferred to critical-care beds at the Oakland site. But the Oakland hospital's director of quality assurance said even if beds are available, they can't be used because of personnel shortages.
"If there are no staff, then there are no beds," she told the surveyors.
The Joint Commission on Accreditation of Healthcare Organizations said it is aware of the incidents.
"We have contacted the hospital. We will be making a special visit soon," a spokeswoman said.
The 104-page HCFA report lists numerous violations of patient-care standards and regulations:
Quality-control reporting was haphazard. When problems were reported, they were often not acted on.
Crash carts were not secured and were not being checked regularly by nurses, as required.
The hospital doesn't evaluate performance of its outsourced services.
Documentation was missing in many areas.
Medicines were not properly secured, and drugs were out of date. A refrigerator with a door latch that had been broken for weeks or months had a temperature of 56 degrees, while the antigens inside needed to be stored below 46 degrees.
The chief pharmacist said he can no longer inspect medication refrigerators because "I lost two-thirds of my pharmacy staff last year, and frankly these inspections are not a priority."