Miami Valley could lose Medicare funding

Miami Valley Hospital is in jeopardy of losing Medicare funding after an investigation found nursing staff failed to respond to a patient’s heart monitor alarm and deployed malfunctioning equipment that delayed the patient’s treatment during cardiac arrest.

The unnamed patient, who was emaciated and whose medical history included a stroke and myocardial infarction, ultimately died after after being admitted to the hospital’s oncology/medical surgical unit.

His death was ruled natural by a coroner.

But a report from the Centers for Medicare & Medicaid Services (CMS) said the hospital “failed to evaluate nursing care related to the circumstances surrounding the death” and that deficient practices “had the potential to affect all patients receiving care in the hospital.”

CMS officials said the Dayton-based hospital’s Medicare contract and reimbursement for patients will be terminated on Oct. 3 unless the hospital submits a “plan of correction” to return to compliance.

“We have submitted the plan, but until CMS accepts that plan we are unable to give you any detail about it,” a Miami Valley spokeswoman said. “We have submitted explanations and details that are relevant to the issues.”

Miami Valley President and CEO Mark Shaker said the hospital has already taken steps to address the issues that triggered the termination notice.

“Because of the work that we’ve done in addressing the concerns that they (CMS) had, we do not believe there will be any interruption in service,” said Shaker. “We’ve not had a notice like this before.”

He said the CMS action was a first for Miami Valley

If the hospital’s contract were to be terminated, Medicare would stop paying for inpatient treatment and services for patients admitted on or after Oct. 3. Payments for patients admitted before that date may continue for up to 30 days, according to a public notice from CMS.

CMS frequently notifies hospitals when they are not in compliance with Medicare guidelines. Department officials said termination of Medicare contracts is rare because most hospitals are successful in executing their correction plans.

Shaker said he welcomed CMS’ vigilance.

“It’s a way we can improve our operation,” he said. “It’s another set of eyes looking at our program, and that’s how health care organizations across the country continue to improve.”

Miami Valley has established a consumer hotline for consumers with questions at (937) 208-2666.

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