Following a series of inspections, UCI Medical Center has guaranteed its adherence to safety and hygiene protocols to ensure its partnership with the Medicare and Medicaid programs.
Based on inspections by the California Department of Public Health (CDPH) the Centers for Medicare and Medicaid Services (CMS) determined that the UC Irvine Medical Center was not in compliance with the Conditions of Participation for a provider of hospital services in the Medicare program.
The two inspections occurred from Oct. 27 to Oct. 30 and another was held on Nov. 6. In a letter dated Dec. 19, CMS initiated a process of review in which the UCI Medical Center would have to submit a Plan of Correction listing the actions taken to address the problems cited by the report or risk termination of the hospital’s Medicare provider agreement on or by March 19, 2009.
The UCI Medical Center submitted its Plan of Correction on Jan. 16 under the condition that the solutions in the Plan of Correction would be implemented by the date of submission. Jack Cheevers, media spokesman of the San Francisco office of CMS, stated that an inspection would follow to determine the adherence of the Medical Center to its Plan of Correction. This inspection will occur at an undisclosed day during a timeline that will be specified by CMS to the UCI Medical Center.
“If the inspection finds additional problems, the process will repeat itself,” Cheevers said.
The Dec. 19 letter stated that “in the event [that] termination [of services] does occur, there will be no payment for inpatient services rendered to Medicare beneficiaries admitted on or after the effective date.”
The Medical Center issued an Executive Summary on Jan. 15 on its Web site along with a message from Vice Chancellor David N. Bailey. Bailey assured his constituency that correcting the issues identified in the CMS survey will be his “highest priority.”
“The efforts of CMS and other regulatory agencies are important quality assurance experiences for UC Irvine; they will enable us to move into our new hospital with a clean slate and help us ensure that we meet or exceed the highest standards for patient care,” Bailey said.
“[The CMS survey] is like going over the hospital with a fine-tooth comb,” UCI Medical Center Media Relations Manager John Murray said. “[After fixing the problems], it basically amounts to a clean bill of health.”
The October and November surveys were follow-up inspections to a complaint validation survey in May 2008 involving the Medical Center’s Department of Anesthesiology. Although no problems were found in the Department of Anesthesiology, six of the 23 Conditions of Participation for the CMS program were deficient: Governing Body, Patient Rights, Quality Assurance and Performance Improvement, Food and Dietetic Services, Physical Environment and Infection Control. The Executive Summary noted that CMS did not find that patients were in immediate jeopardy and “remains fully accredited by The Joint Commission, with additional disease-specific certification for stroke and heart failure.”
“None of these problems were so deeply rooted that we couldn’t fix them easily,” Murray said.
The survey will not affect the University Hospital, Murray said.
“The hospital is moving ahead as planned,” said Murray on Jan. 30. “We’re dedicating the hospital today and will be moving patients into the [University Hospital] in a month.”