A Rockville, Md., hospital stands to lose its accreditation and consequently its Medicare certification after state investigators reported finding evidence of low staffing levels that threatened patient safety.
The Joint Commission on Accreditation of Healthcare Organizations has temporarily denied the accreditation of 253-bed Shady Grove Adventist Hospital pending a hearing later this month.
In 1998, at Shady Grove's most recent triennial accreditation survey, the JCAHO accredited the facility with commendation, the highest level possible for a hospital.
The state investigation was triggered when some physicians and nurses on the Shady Grove staff complained to the Maryland health department that staffing cuts had caused overworked nurses to make medication errors and miss signs of deteriorating health.
Hospital spokesman Robert Jepson said Shady Grove cut some staff this year. "The hospital is facing lots of pressure, in the forms of higher drug costs, (state-regulated) rate-setting, and HMOs," he said. "We felt that we needed to remove some cost."
JCAHO officials conducted a surprise survey of the hospital Oct. 22 but haven't publicly released their findings. The Maryland health department's report recommended that HCFA disqualify the hospital from Medicare participation because it did not properly administer drugs to patients, kept deficient medical records and did not provide adequate nursing supervision.
To date, HCFA has not become directly involved in the investigation, Jepson said.
Shady Grove is cooperating with state and JCAHO investigations, he said.
The JCAHO stepped in after the Maryland health department began an investigation Oct. 17 of more than 100 complaints. The JCAHO heard about the state's probe the same way it has discovered others, namely from local news reports, according to a commission spokeswoman.
The allegations and subsequent investigations caused such a stir that the board of Adventist HealthCare, the regional not-for-profit corporation that oversees the hospital, accepted the resignation of Adventist's chief executive officer.
Cory Chambers, a 30-year veteran of Adventist Healthcare, exited the top post Nov. 3 at a special board meeting. Chambers had served as CEO of both Shady Grove and 300-bed Washington Adventist Hospital in Takoma Park, Md.
To foster better supervision, Adventist HealthCare will implement a new management structure, with each hospital having its own president and chief operating officer.
Shady Grove has already responded to the allegations by hiring nursing consultants and forming a task force of doctors, nurses and administrators to oversee patient-care policies, Jepson said.