In a rare decision, the CMS will terminate Medicare and Medicaid funding at St. Joseph Medical Center in Houston after an investigation of the hospital found it was noncompliant with federal regulations.
Medicare and Medicaid programs will be cut on Dec. 3. A spokeswoman for Iasis Healthcare, St. Joseph's parent company, declined to provide the number of patients receiving federal insurance coverage at the hospital. The Houston Chronicle claims the programs cover 63% of St. Joseph's patients, many of whom visit the hospital for psychiatric reasons.
An Oct. 15 inspection report of the facility found St. Joseph Medical Center was in violation of four protocols for Medicare participation: governing body, patient rights, nursing services and infection control.
The report was conducted after a patient this year was tased, shot and handcuffed by two hospital security staff members who were also police officers.
The first inspection report by the state found the hospital failed to properly train security guards to deal with aggressive and disoriented patients. The report also claimed the hospital failed to properly train nursing staff to identify psychological changes in patients, according to the inspection report.
After that report, the hospital made changes, such as removing police officers from the core security staff.
In a follow-up inspection, the state found St. Joseph Medical Center continued to violate protocols for Medicare participation. It was after that report that the CMS decided to terminate funding.
In a statement, David Wright, the CMS deputy regional administrator in Dallas, said, “This action is necessary to ensure that patients have access to care and treatment in a safe environment, as is expected in all Medicare-certified facilities.”
St. Joseph CEO Mark Bernard told employees in a statement that was eventually made public that the hospital is meeting with CMS officials to discuss the termination. He said “we are hopeful of finding a solution where our hospital remains in these governmental programs and able to continue to provide care to our Medicare and Medicaid beneficiaries.”
St. Joseph Medical Center is a 374-bed hospital in downtown Houston with an emergency department and trauma center. The hospital employs 1,500, according to its website and serves a great number of homeless people in the area.
A three-month Modern Healthcare 2014 analysis of hundreds of pages of federal inspection reports revealed Cleveland Clinic spent 19 months on “termination track” with Medicare between 2010 and 2013 as a result of more than a dozen inspections and follow-up visits triggered by patient complaints. Only in very rarest of circumstances has the CMS followed through on the threat.
