CMS May Stop Medicare, Medicaid Reimbursements To Alameda County Medical Center

CMS has notified the Alameda County Medical Center that unless the public hospital system "demonstrates marked improvements" in four regulatory areas, it will halt reimbursements for Medicare and Medicaid services on Nov. 10, which would cause the loss of millions of dollars in payments resulting in the closure of ACMC, the Oakland Tribune reports. The decision follows an unannounced Aug. 12 inspection of all county health facilities, including Highland Hospital in Oakland, Fairmont Hospital in San Leandro, three outpatient clinics and John George Psychiatric Pavilion in San Leandro, the facility that prompted an initial inspection in February.

In a February report, CMS cited nursing, governance, quality assurance and patients' rights as areas in which ACMC required improvements, and deficiencies in those areas resulted in 309 corrective actions.

In May, CMS informed the medical center that it must provide evidence of corrective action -- not just a plan of action -- to maintain its Medicare reimbursement status. Although the facility was unable to supply such proof at the time, it was able to retain its reimbursement status because CMS failed to give the facility proper notice.

During the follow-up inspection in August, a team from the Department of Health Services found deficiencies in medical records, pharmacy, physical environment and food and dietary areas. According to the Tribune, the problems identified in the August inspection were centered at Highland Hospital.

The report also found that the "situation at John George was much improved," the Tribune reports. John George now has more deputies on duty to respond to assaults; regular alarm drills; improved recordkeeping; close patient observation; active, therapeutic treatment; and personal alarms for staff to use in the event of an assault.

Assaults have decreased at the facility, but some problems persist. For example, the facility continues to employ 15 temporary nurses and has not hired a permanent director of psychiatric nursing. CMS requested that the medical center submit a plan of correction -- which hospital officials provided last week -- before establishing a termination date.

Claude Watts, interim COO at the center, said, "We feel confident they will approve the plan of correction. I don't feel the medical center is in danger" (Vesely, Oakland Tribune, 9/26).