HCFA has threatened to kick a suburban Phoenix hospital out of the Medicare and Medicaid programs on Aug. 3 if it doesn't correct its allegedly lax emergency care-the third time in less than two years the agency has moved against an Arizona hospital.
An April 7 inspection of 278-bed Mesa (Ariz.) Lutheran Hospital by the Arizona Department of Health Services on HCFA's behalf uncovered seven breaches of emergency medicine protocol, according to a May 6 letter HCFA sent to the hospital.
They included failure to stabilize patients with emergency medical conditions; lack of a list of on-call physicians to stabilize patients; no central log of emergency room patients; failures and delays in providing appropriate medical screening; and the inappropriate transfer of a patient to another facility.
State investigators also determined that Mesa Lutheran, owned by not-for-profit Lutheran Health Systems of Fargo, N.D., failed to keep proper documentation of physician orders for medications and treatment.
Lutheran is merging with Phoenix-based Samaritan Health System, which operates four hospitals in Arizona. A Lutheran spokesman said the deal, which is expected to be completed in late summer, would not be affected by HCFA's actions.
A hospital spokeswoman said a plan of correction was submitted to HCFA on May 26, but she declined further comment.
HCFA officials doubted the agency would decertify Mesa Lutheran.
"Our goal is to get them compliant," said HCFA spokeswoman Linda Barnhart.
Arizona DHS spokesman Brad Christensen said Mesa Lutheran came under scrutiny only after its emergency room physicians allegedly misdiagnosed 13-year-old Gricelda Zamora Gonzalez's appendicitis as gastritis March 16. She was treated with antacids and referred to a local doctor, who allegedly turned her away after being unable to verify her family's insurance benefits. Gonzalez returned to Mesa Lutheran on March 18 with a burst appendix, and died later that day.
State investigators determined that during Gonzalez's first visit to Mesa Lutheran, an on-call surgeon with experience performing appendectomies on adolescents did not respond to a request by the emergency room physician to examine her.
HCFA has decertified or tried to decertify two other Arizona hospitals since 1997, both owned by Phoenix-based not-for-profit Baptist Hospitals and Health Systems. It decertified 182-bed Western Arizona Regional Medical Center in Bullhead City in November 1997. It moved to decertify 104-bed Arrowhead Community Hospital and Medical Center in Glendale in December 1998 but reached a legal settlement with Baptist after the hospital sued to block the action.