Drug Topics - May 12, 2008 - (Page HSE12)

12 HSE DRUG TOPICS MAY 12, 2008 www.drugtopics.com > > > Professional Practice N.C. hospital loses CMS certification over drug and other errors Fred Gebhart aywood Regional Medical Center (HRMC) in Clyde, N.C., has lost eligibility for Medicare & Medicaid reimbursement due a series of medication and other errors leading to patient deaths. The 170-bed hospital in Clyde serves a large section of western North Carolina. “The next major medical center is a good 50 miles away,” said Fred Eckel, executive director of the North Carolina Association of Pharmacists. “Losing CMS certification creates a real problem for patients.” Just five hospitals nationwide lost CMS certification last year, according to the agency. One has regained A hospital must have performed certification, two closed, and two egregiously to lose remain without certification. CMS reimburseCMS revoked HRMC’s certifiment, says Jay Campbell. cation, which involves meeting all required conditions of participation, in February after investigators from the state Department of Health & Human Services’ Division of Facility Services (DFS) found medication administration errors in over half of the patient records examined. Inspectors also found lapses in pharmacy oversight of medication administration and identification of drug errors. DFS notified the hospital that the agency would recommend the facility not be recertified for Medicaid. HRMC hired outside consultants, the Compass Group, to salvage the hospital and restore CMS certification. The hospital board of directors has also discussed selling the county institution. “We have a pretty good relationship with North Carolina Medicaid,” said Jay Campbell, executive director of the state board of pharmacy. “If problems they find had to do with pharmacy, we would be notified, which we were. One of our investigators is still in the middle of her investigation at Haywood. But you have to have serious problems in more than one department to get Medicaid acting this strongly.” Hospital’s problems An earlier inspection of HRMC in January had found that it was out of compliance with four conditions of participation in the Medicaid program. H Problem areas included the governing body (board of directors), quality assessment and performance improvement, nursing services, and pharmaceutical services. The second February inspection found that HRMC was still out of compliance in all four areas. Inspectors found additional deficiencies in patient rights, infection control, and respiratory care services. CMS followed DFS recommendation and decertified the hospital. Medicare and Medicaid accounted for more than half of HRMC’s patient volume and nearly 70% of hospital revenue. Within days, Blue Cross Blue Shield, UnitedHealthcare, and at least one other private payer suspended HRMC from their network or allowed the facility to withdraw. By late March, HMRC’s daily census was down to 11 patients. The decision to pull CMS funding followed physician complaints in late 2007 about multiple medication administration errors. The complaint included a patient death associated with an early and unordered termination of a Xigris (drotrecogin alfa, Lilly) infusion. A physician was escorted out of the hospital by security staff in early December and fired. She has sued the hospital for wrongful termination and conspiracy to cover up patient care deficiencies. Haywood has also lost at least six top executives. Compass Group consultants have moved into top positions. Hospital spokeswoman Robin Tindall-Taylor did not respond to questions about the HRMC pharmacy director’s involvement in these incidents. Corrective action The new leadership team has created a 12-point plan to address surveyor concerns and improve patient care. How well that new plan is working remains to be seen. Joint Commission staged a surprise survey in March. The survey report had not been released by deadline. In early April, the hospital notified CMS that it was ready for reinspection. If HRMC passes the unannounced inspection, it will enter a period of “reasonable assurance” that lasts up to four months. If it passes a second unannounced inspection during that period, CMS certification could be restored. Once federal funding returns, private payers usually follow. http://www.drugtopics.com

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Drug Topics - May 12, 2008 Contents Latebreakers Letters R.Ph.s Say More Needs to be Done to Prevent Pediatric Drug Errors There's a New School of Thought on Use of Beta-Blockers for Hypertension Cover Story Guest Spot Letters Clinical Practice Special Report Professional Practice Broad Label for New Leukemia Therapy Looks Promising Treating Asthma During Pregnancy Safer than Not, Says New Guide In the Pipeline Clinical Q&A APhA Leader's Plan to Leave Office Takes Center Stage at its Conference Policies Passed at a Glance Giving a Talk to the Community? Check Out These Materials This Foundation has Funds to Spare JP at Large Cover Story: Employers and R.Ph.S: A Win-Win Combo FDA's Ilisa Bernstein Discusses Pharmacy Affairs Legal Q&A Manufacturers Unleash a Rash of Poison Ivy Treatments Are OTC Cold Remedies Safe for Kids? Probiotics are All the Rage: How You Can Capitalize on It CMS' Prices for Round One of DMEPOS Competitive Bidding Raising Concerns CVS Caremark's Mentoring Program Recruits and Retains R.Ph.s Antibiotic Resistance Among Community Pathogens Technology Update New Products Advertisers Index Classified Viewpoint

Drug Topics - May 12, 2008

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