Health & Welfare | Daily Report

Federal Medicare officials told two Riverside County hospitals yesterday that they would no longer pay for seniors' care after June, signaling the end of a three-year process of trying to get the hospitals to follow basic care standards.

Photo by U.S. Army

The hospitals, Rancho Springs Medical Center and Inland Valley Regional Medical Center, were also hit Tuesday with three fines from state public health officials who independently noted serious problems at the facilities.

Alleged lapses at the hospitals in recent years include a failure to have enough doctors on call to meet emergency room patients’ needs, food storage messes and failing to identify infants at risk for a dangerous enzyme.

Rancho Springs Medical Center received the state’s first $100,000 fine to a hospital after a doctor used electrical cauterizing tools on patients in a room with dangerously low humidity, causing a fire hazard.

Medicare officials based their decision to terminate the hospitals on the findings of January inspections. Officials noted that pharmacists failed to ensure safe use of dangerous medications and physician assistants were not equipped to properly screen patients, among other shortcomings. (You can read the full letter – it's posted below.)

Rufus Arther, who oversees hospitals for Medicare’s California office, said officials have been finding problems in the hospitals since June 2007 and giving them repeated chances to meet federal standards.

“We have to balance looking at needs of the community with safety and protection of the (Medicare) beneficiaries that receive care,” Arther said in an interview.

Southwest spokeswoman Teresa Fleege released a statement Thursday saying that the system was in talks with Medicare about “an arrangement that will negate” termination. “We expect to have a resolution very shortly which will enable Southwest to continue to provide care and treatment for our Medicare patients,” the statement says.

Arther said Southwest was not offered a final chance to shape up before June. But it can appeal the termination or prepare to reapply for Medicare coverage.

Medicare has terminated 31 hospitals from the program since 2000, according to information released to California Watch when we inquired earlier this year. 

The last California hospital to lose Medicare funding was Kindred Hospital in Modesto in 2008. Before that, Martin Luther King Hospital in Los Angeles was cut off in 2007.

The news comes as no surprise to corporate owners of the Southwest Healthcare facilities, Universal Health Services, based in Pennsylvania.

The company, which operates 25 hospitals and 102 mental health facilities, notified shareholders in a February annual report that Medicare had been examining the facilities the month before.

“While we believe that (Southwest) has complied with all obligations under the agreement, there can be no assurance as to the outcome of the survey or that the outcome would not have a material adverse effect on us,” the report says.

The company also noted in its annual report that one of its psychiatric facilities in Missouri had already been terminated from Medicare, but was fighting the action in court.

Despite the problems with meeting funders' standards, the company CEO was rewarded with a $3.4 million bonus in March, records show.

Foia Southwest Healthcare System 4-15-10 Ltr[1]