Parkland submits action plan

Seeking to prevent a Sept. 2 decertification from Medicare for health and safety violations, Parkland Health & Hospital System in Dallas has submitted a 344-page plan to address the “immediate and serious” threats to patient health identified by inspectors.

The 672-bed public hospital was notified Aug. 9 that it no longer complied (PDF) with the requirements for Medicare certification, and was given an Aug. 20 deadline to submit a comprehensive plan of action. Violations included the lack of medical screening examinations to triage emergency-room patients, not providing enough nurses to staff the ER, and insufficient recordkeeping on patients.

The hospital met the filing deadline for its action plan (PDF), and then posted the entire document on its website, along with public letters from President and CEO Dr. Ron Anderson.

“In healthcare we have to be prepared for this kind of scrutiny from others and we should ask it of ourselves,” one letter from Anderson says. “We expected deficiencies and we are grateful for assistance in identifying them.”

The descriptions of the corrections in many cases are longer than the CMS' complaints themselves, and they touch on numerous aspects of the hospital. The changes include not just the clarifications of policies and greater staff training, but also regular meetings of senior staff and the hiring of at least 10 new nurses in the emergency department.

CMS officials intend to dispatch a follow-up round of inspectors to the hospital before the Sept. 2 deadline to determine whether the corrections are being implemented and whether they're adequate to address the problems.