Health & Welfare | Daily Report

Medicare officials do not take the decision they face in coming weeks lightly. They are weighing whether to offer two troubled hospitals additional chances to improve or to give up and “decertify” them. That's Medicare-speak for cutting off their funding, a move that's devastating to a hospital.

The facilities in question are Inland Valley Medical Center, in Wildomar, and Rancho Springs Medical Center, in Murrieta. Both are roughly halfway between San Diego and Riverside in the Inland Empire.

The hospitals have faced close scrutiny from state public health authorities in recent years, receiving $25,000 state fines in each of the following cases:

• In August 2007, the Murrieta hospital was cited for failing to have physicians on call to meet the needs of nine emergency room patients. One patient, who showed up at the emergency room in April of that year, had a sudden loss of vision but waited eight hours before the facility sent him elsewhere for care; a stroke patient waited 11 hours, records show.
• One hospital stored raw fish and sausage above ready-to-eat food in freezers crusted with ice after defrosting and refreezing, creating the potential for food-borne illness among fragile patients in October 2007.
• In June 2008, the Murrieta hospital received its third $25,000 fine from the state after it failed to have two nurses attend to intensive-care patients.

Jack Cheevers, spokesman for the Medicare regional office in San Francisco, said three surveys of the hospitals were recently completed. Officials are currently reviewing the surveys to determine the hospitals' standing and will reach a decision in several weeks.

Cheevers said Medicare already asked the Murrieta hospital to hire quality monitors who are tasked with providing monthly reports to federal officials. “They’ve been under close scrutiny recently,” he said.

The status of Rancho Springs Medical Center comes with some added drama for residents who depend on them in the Inland Empire, which saw rapid growth last decade. Last week the Riverside Press Enterprise detailed the added twist:

An expansion designed to shorten long waits at a Murrieta hospital's emergency room remains shuttered as hospital leaders work with state inspectors to fix health and safety issues.

On Jan. 19, Murrieta Fire Chief Paul Christman told the City Council the $53 million addition to Rancho Springs Medical Center could be open in seven to 10 days.

On Friday afternoon, the two-story building, which includes 18 emergency room bays, a neonatal intensive care unit and labor and delivery rooms, remained closed.

… Work on the expansion finished more than a year ago. But the California Department of Public Health has not let it open, saying Southwest needs to correct violations of state regulations.

Southwest Healthcare officials did not respond yesterday to questions from California Watch. The most recent quarterly report filed with the U.S. Securities and Exchange Commission by Southwest's Pennsylvania-based parent company, Universal Health Services, summarizes the company's perspective:

During the third quarter of 2009, Southwest Healthcare System (“SWHCS”), which operates Rancho Springs Medical Center and Inland Valley Regional Medical Center in Riverside County, California, entered into an agreement with the Center for Medicare and Medicaid Services (“CMS”). The agreement required SWHCS to engage an independent quality monitor to assist SWHCS in meeting all CMS’ conditions of participation. Further, the agreement provides that between the approximate dates of November 15, 2009 and January 15, 2010, CMS will conduct a full Medicare certification survey. While we believe that SWHCS has complied with all obligations under the agreement, there can be no assurance as to the outcome of such a survey or that the outcome would not have a material adverse effect on us.