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CMS notice applies to Medicare and Medicaid patients at Greenville Memorial Hospital

By Jim Fair, Editor
Published on Tuesday, March 28, 2017

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The Centers for Medicare and Medicaid Services on Tuesday posted a public notice stating Medicare will not pay for any hospital services for patients admitted to Greenville Memorial Hospital starting April 16 unless the hospital makes needed changes.
 

The Centers for Medicare and Medicaid Services on Tuesday posted a public notice stating Medicare will not pay for any hospital services for patients admitted to Greenville Memorial Hospital starting April 16 unless the hospital makes needed changes.

 

Update
March 29, 11:14 p.m.

The CMS notice applies to both Medicare and Medicaid patients, according to a Greenville Memorial Hospital update on Wednesday.

The Centers for Medicare and Medicaid Services  notice applies to both Medicare and Medicaid patients.

The notice is specific to Greenville Memorial Hospital. It does not affect any of the other hospitals that are part of Greenville Health System, nor does it affect any of our primary care physician practices or outpatient services outside of Greenville Memorial.

Based on Greenville Memorial Hospital’s FY 16 volume, roughly 21,000 Medicare and Medicaid inpatients could potentially be affected. This represents about 59% of Memorial's inpatients. The net revenue at risk from Medicare and Medicaid patients (both inpatient and outpatient net revenue for patients at Greenville Memorial) could potentially be approximately $495 million.

But, as Dr. Sasser stressed yesterday, we do not anticipate any interruption of Medicare services, and we are committed to making improvements over and beyond what CMS requires, according to the GHS clarification.

 March 28

The Centers for Medicare and Medicaid Services on Tuesday posted a public notice in an upstate newspaper that said Medicare will not pay for any hospital services for patients admitted to Greenville Memorial Hospital starting April 16 unless the hospital makes needed changes.

The audit of the emergency department followed the death of Donald Keith Smith, 48, who died at GHS on March 6 after an altercation with an officer at Greenville Memorial, according to a coroner’s report.

The coroner ruled Smith’s death a homicide caused by traumatic asphyxiation, according to news reports. The State Law Enforcement Division is investigating Smith’s death.

GMH officials told WYFF-TV that the deficiencies will be corrected before the deadline, and they don't anticipate any interruption of Medicare services.

The Centers for Medicare and Medicaid Services posted a public notice in the Greenville News:

“Notice is hereby given that effective April 15, 2017, the agreement between GHS Greenville Memorial Hospital, 701 Grove Road, Greenville, S.C. 29605 and the Secretary of Health and Human Service, as a provider of Hospital Services and Health Insurance for the Aged and Disabled Program (Medicare) is to be terminated. GHS Greenville Memorial Hospital does not meet the following conditions of participation. 42 CFR 482.12 Governing Body, 42 CFR 482.13 Patients’ Rights and 42 CFR 482.23 Nursing Services.

“The Centers for Medicare and Medicaid Services has determined that GHS Greenville Memorial Hospital is not in compliance with the conditions of coverage. The Medicare program will not make payment for hospital services to patients who are admitted after April 16, 2017.”

• 42 CFR 482.12 Governing Body states: “There must be an effective governing body that is legally responsible for the conduct of the hospital. If a hospital does not have an organized governing body, the persons legally responsible for the conduct of the hospital must carry out the functions specified in this part that pertain to the governing body.”

• 42 CFR 482.13 Patients' Rights states: “A hospital must protect and promote each patient's rights.”

• 42 CFR 482.23 Nursing Services states: “The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or supervised by a registered nurse.”

The site survey took place on March 13 by the Centers for Medicare and Medicaid Services.

“The survey came after GMH notified CMS that the hospital had identified potential areas for improvement in the emergency department.

“Nearly all action plan items have already been initiated, and we feel confident that CMS will find our plan and its implementation satisfactory.

“We do not anticipate any interruption of Medicare services, and we are committed to making improvements over and beyond what CMS requires,” Sasser’s statement continued.

Sasser, according to WYFF, did not give a specific number of deficiencies that were cited, but he said that GHS has until the first week of April to submit an action plan to correct the problems.

April Washington, spokesperson for GHS, told media the hospital failed to ensure nursing and security staff followed policies for aggression management and restraint connected to the death of Smith.

According to Washington, security officers at GHS failed to perform a safe takedown hold and the patient was not given a clinical assessment for an injection was administered.

She said the victim was placed face down on a bed and there was "no clinical assessment of the patient during the incident to ensure patient safety."

"The patient died while in a four-point restraint," Washington said.

 

 

 

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