Controversy over hospital ownership reared its head in other ways last week. In a situation that must feel like deja vu for Sens. Max Baucus and Chuck Grassley, a recent inquiry into patient death in Texas has led the CMS to send an imminent termination letter to a physician-owned hospital.
In a probe that mirrors an investigation into an Oregon hospital this time last year, Grassley (R-Iowa) and Baucus (D-Mont.)together with Rep. Pete Stark (D-Calif.)have again raised questions about the safety of physician-owned hospitals. But for Grassley, Baucus and Stark, the debate about physician ownership continues. The hospital targeted last year eventually was sold to Vibra Healthcare, a private, for-profit specialty healthcare provider. The most recent case involves 14-bed West Texas Hospital in Abilene, a for-profit facility led by more than 35 physicians, according to the hospitals Web site. On Jan. 23, a spinal-surgery patient suffered respiratory arrest at West Texas and later died after being taken to nearby 181-bed Abilene Regional Medical Center. The incident prompted the prominent Capitol Hill legislators to demand
After a review, the CMS sent an imminent termination letter to the hospital on Feb. 22. West Texas, which the Texas Department of State Health Services said is licensed as a general hospital, must file a letter of correction and has 23 days to fix the conditions the CMS found to be of serious and immediate threat to patient health and safety. If the hospital is not compliant, its Medicare agreement will terminate on
March 17, the CMS said in its response to Baucus, Grassley and Stark.
We fully anticipate that CMS will accept our plan of correction and upon (a) revisit will certify us as in full compliance, West Texas said in a written statement. Ron Rives, the hospitals chief executive officer, declined requests to be interviewed because of visits with state surveyors.
For its part, the CMS offered a comprehensive response in its letter to the three congressional leaders, and cited four Medicare conditions of participation in which West Texas was not compliant: governing body, patient rights, nursing services and emergency services. Please be assured that it is never acceptable for a Medicare-participating hospital to rely upon 911 as its response ... in lieu of having its own capability to provide emergency treatment, the letter said.
Emily Palmer, a spokeswoman for the Texas Department of State Health Services, said that there are no minimum standards for Texas emergency departments. But our rules say that the hospital must have policies in place to deal with emergencies and a staffing plan to deal with the level of patient care as needed, Palmer said. As a licensed general hospital, the facility must have services and beds in use for 24 hours for two or more individuals and must be able to provide treatment for either surgery or obstetrical care, she added.
Molly Gutierrez, executive director of Physician Hospitals of America, a trade group that represents physician-owned hospitals, said the CMS comments were nothing but fair, appropriate and unbiased. And although West Texas is not a specialty hospital, the incident could bolster the argument of those who oppose physician ownership. I dont view it as a setback because I dont think one hospitalwhether they were right or wrongreflects an industry, Gutierrez said. I do think it gives our opponents on Capitol Hill another opportunity to pick on us.