ALAMEDA COUNTY: Medical Center Could Lose Federal Funds

      The Alameda County Medical Center stands to lose $160 million in annual Medi-Cal and Medicare reimbursements because of its poor performance on a HCFA validation survey last month, the Oakland Tribune reports. The center operates three hospitals and five county clinics. State Department of Health Services officials who performed the survey for HCFA informed center officials that they must make improvements in six areas of operation: governing body; medical staff; quality assurance; nursing; medical records; and dietary. The center will receive a written report within the next two weeks and then will have either 23 or 90 days to make improvements. Center officials said they believe the recent survey was sparked by a Joint Commission on the Accreditation of Healthcare Organizations review in May in which the center scored 72 points out of 100 -- a low mark that only 2% of the nation's hospitals receive. Center officials have initiated "corrective actions," including a formal review process for outside contractors providing care; improved documentation standards; protocols for providing emergency psychiatric care; a reorganized and consolidated quality management program to respond to allegations of poor medical care; a pain committee to develop a process for managing patients' pain; and additional dietitians. Center CEO Mike Wall said that if the corrections are not made soon and the center loses the funding, it would be "tantamount to closure." He added: "This organization is on top of the situation. It is a serious situation. There are a number of deficiencies of regulatory standards that this organization must address and will address." Some Alameda County supervisors also expressed concern about the situation. Supervisor Keith Carson said that "we have to fight and ensure that the [center] stays up and operational," particularly for poor people who depend on Oakland's Highland Hospital for care (Horowitz, 7/13). Some officials were impressed with the center's immediate response to the survey. Janice Caldwell, associate regional administrator for HCFA's state operations, said, "The hospital is certainly showing an aggressive approach by jumping on these problems before they have even seen the written report" (Gonzales, San Jose Mercury News, 7/14). She added, "A lot of the time the initial survey is problematic, but then the facility has time to correct it and invariably they do. There may be a larger number that are put on notice like this; what's rare is for them to go all the way to the end of the cycle and still be out of compliance." She noted, "We're nowhere close to that with this place" (Anderson, Contra Costa Times, 7/14).