CMS "Immediate Jeopardy" 3rd time in two years

[xaelia]

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I mean, yea, HCA is going on, but what's actually going on here?! Sheesh.

Mission Hospital again placed in immediate jeopardy, CEO tells employees • Asheville Watchdog

For the third time in less than two years, Mission Hospital faces sanctions that could result in it losing crucial federal funding, CEO Greg Lowe told employees in a letter Thursday night. The letter, obtained Friday by Asheville Watchdog, said the Centers for Medicare and Medicaid Services had...

avlwatchdog.org

 

[JacobMcCandles]

Sounds like a hospital that shouldn't be in business.

 

[AlmostAnMD]

Well maybe it could be in business but not with profit-sucking ownership

Related point
Someone once told me you can judge the priorities of a hospital/system (Owners vs staff) by the quality of the chairs

Like, the literal chairs you sit on

If beat up, massive profit diversion/cash poor

If chairs are routinely replaced = sweet gig

Sounds dumb but 100% accurate when thinking about every shop I've worked in

 

[deleted1223140]

Well maybe it could be in business but not with profit-sucking ownership

Related point
Someone once told me you can judge the priorities of a hospital/system (Owners vs staff) by the quality of the chairs

Like, the literal chairs you sit on

If beat up, massive profit diversion/cash poor

If chairs are routinely replaced = sweet gig

Sounds dumb but 100% accurate when thinking about every shop I've worked in

I've had the same experience. I didn't even realize how much of a game changer large, padded office chairs are compared to tiny plastic chairs when used for 9+ hours.

 

[southerndoc]

EMTALA complaints are getting more common. Patients and families can file them online now. Most EMTALA complaints end with corrective action, and nearly all correction plans are accepted.

 

[deleted1223140]

EMTALA complaints are getting more common. Patients and families can file them online now. Most EMTALA complaints end with corrective action, and nearly all correction plans are accepted.

What are some corrective actions/plans you are seeing?

 

[southerndoc]

What are some corrective actions/plans you are seeing?

Their previous citations involved a woman who died from suspect drug overdose (CMS alleged they should've prevented her from having drugs in her room; drugs were stuffed in stuffed animals). They also had 30 deaths for various reasons (not monitoring pulse oximetry when transporting from ED to floor, patient disconnected from remote telemetry monitoring for an hour, etc.).

 

[xaelia]

They also had 30 deaths for various reasons

When's the last time an immediate jeopardy actually went forward and killed funding?

 

[southerndoc]

When's the last time an immediate jeopardy actually went forward and killed funding?

It's pretty rare. <1% of EMTALA violations end with loss of funding, and most can fix things within a week or two after losing.

 

[bky3c]

Well maybe it could be in business but not with profit-sucking ownership

Related point
Someone once told me you can judge the priorities of a hospital/system (Owners vs staff) by the quality of the chairs

Like, the literal chairs you sit on

If beat up, massive profit diversion/cash poor

If chairs are routinely replaced = sweet gig

Sounds dumb but 100% accurate when thinking about every shop I've worked in

Not to derail the thread too much, but this is absolutely true. And if you can't even FIND a chair (only a stool, trash can, etc.)... extra bad sign. I once worked with a doc who bought a chair, kept it at work with his name on it, and unceremoniously kicked out whatever poor soul was sitting in it when he arrived for his shift. Reminds me of the intensivist who told me, as a med student, that you can tell the general quality of someone's health by their toenails. Chairs are the toenails of an ED.

 

[WhatJobDoIPick]

Not to derail the thread too much, but this is absolutely true. And if you can't even FIND a chair (only a stool, trash can, etc.)... extra bad sign. I once worked with a doc who bought a chair, kept it at work with his name on it, and unceremoniously kicked out whatever poor soul was sitting in it when he arrived for his shift. Reminds me of the intensivist who told me, as a med student, that you can tell the general quality of someone's health by their toenails. Chairs are the toenails of an ED.

This is based.

I frequently cannot find chairs, dragons, computers. I work in some shytholes.

 

[NYEMMED]

This is HCA, and a fed up local community.

Let’s be honest Mission was never a top hospital, but it is a bottom hospital under HCA.

The politicians are to blame too, they could have given the sale to non-profits in the state, but instead sold to HCA.

 

[HemorrhagicShock]

Their previous citations involved a woman who died from suspect drug overdose (CMS alleged they should've prevented her from having drugs in her room; drugs were stuffed in stuffed animals). They also had 30 deaths for various reasons (not monitoring pulse oximetry when transporting from ED to floor, patient disconnected from remote telemetry monitoring for an hour, etc.).

If one theoretically had a handful of old locums hospitals who did not follow best practices when it came to professional interactions among the physicians working under their hood, how could a physician use this information to really stick it to them.

You know.. asking for a colleague...

 

[ShockIndex]

This is HCA, and a fed up local community.

Let’s be honest Mission was never a top hospital, but it is a bottom hospital under HCA.

The politicians are to blame too, they could have given the sale to non-profits in the state, but instead sold to HCA.

You’re on the right track. Everyone familiar with the region knows this is the State of NC and Asheville region having a severe case of buyer’s remorse. The deal that landed Mission in HCA’s lap was the back-door, smoke filled rooms stuff out of movies. Since that time, the State of NC has been at war with HCA, and it is abundantly clear that the NC AG wants HCA to sell the system (comprised of Mission in Asheville plus a few critical access hospitals). This immediate jeopardy is yet another pawn at play since suspending CMS funding would collapse the system that serves roughly 400,000 people. They won’t do that even if Mission mounts crucified bodies around its entrance. The AG would try to file criminal indictments against hospital officers as another pressure play before collapsing the system.

Unfortunately, it’s not like the alternatives to HCA are much better. Advocate Health (formerly Atrium Health formally Carolinas Health System) is the dog**** system in Charlotte with its hands deep in the pants of NC government that would be the likely buyer. That would consolidate even more of NC’s healthcare under a behemoth and perpetuate an already severe anti-trust environment.

Welcome to the slow collapse of rural healthcare that has been happening since 2009.

 

[VA Hopeful Dr]

You’re on the right track. Everyone familiar with the region knows this is the State of NC and Asheville region having a severe case of buyer’s remorse. The deal that landed Mission in HCA’s lap was the back-door, smoke filled rooms stuff out of movies. Since that time, the State of NC has been at war with HCA, and it is abundantly clear that the NC AG wants HCA to sell the system (comprised of Mission in Asheville plus a few critical access hospitals). This immediate jeopardy is yet another pawn at play since suspending CMS funding would collapse the system that serves roughly 400,000 people. They won’t do that even if Mission mounts crucified bodies around its entrance. The AG would try to file criminal indictments against hospital officers as another pressure play before collapsing the system.

Unfortunately, it’s not like the alternatives to HCA are much better. Advocate Health (formerly Atrium Health formally Carolinas Health System) is the dog**** system in Charlotte with its hands deep in the pants of NC government that would be the likely buyer. That would consolidate even more of NC’s healthcare under a behemoth and perpetuate an already severe anti-trust environment.

Welcome to the slow collapse of rural healthcare that has been happening since 2009.

UNC is making big inroads into western NC, I could see them trying to snatch it up.

 

[NYEMMED]

You’re on the right track. Everyone familiar with the region knows this is the State of NC and Asheville region having a severe case of buyer’s remorse. The deal that landed Mission in HCA’s lap was the back-door, smoke filled rooms stuff out of movies. Since that time, the State of NC has been at war with HCA, and it is abundantly clear that the NC AG wants HCA to sell the system (comprised of Mission in Asheville plus a few critical access hospitals). This immediate jeopardy is yet another pawn at play since suspending CMS funding would collapse the system that serves roughly 400,000 people. They won’t do that even if Mission mounts crucified bodies around its entrance. The AG would try to file criminal indictments against hospital officers as another pressure play before collapsing the system.

Unfortunately, it’s not like the alternatives to HCA are much better. Advocate Health (formerly Atrium Health formally Carolinas Health System) is the dog**** system in Charlotte with its hands deep in the pants of NC government that would be the likely buyer. That would consolidate even more of NC’s healthcare under a behemoth and perpetuate an already severe anti-trust environment.

Welcome to the slow collapse of rural healthcare that has been happening since 2009.

I agree, it’s likely Advocate Atrium would try. They are basically just a for profit under the disguise of a non for profit using shell companies.

But there are other potentials, Novant Health, and Advent health both have some nearby presence. UNC and Duke might also be interested

 

[ShockIndex]

I agree, it’s likely Advocate Atrium would try. They are basically just a for profit under the disguise of a non for profit using shell companies.

But there are other potentials, Novant Health, and Advent health both have some nearby presence. UNC and Duke might also be interested

I would favor any of those alternatives over Advocate/Atrium. Perhaps the one that makes the most sense would be another Novant-UNC cooperative similar to what is happening in Wilmington / New Hanover. That would provide needed medical education infrastructure and support future healthcare manpower across the Blue Ridge much like what is happening near Wilmington.

Having said that, my familiarity is with the Charlotte market. So, people familiar with Wilmington may feel differently if that relatively new partnership has been to the detriment of the region. What we absolutely do not need is further expansion of Advocate / Atrium which uses its regional status a a hospital authority to float between behaving like a quasi-government entity, private non-profit, and for profit system as it sees fit.

 

[Powdermonkey]

I would favor any of those alternatives over Advocate/Atrium. Perhaps the one that makes the most sense would be another Novant-UNC cooperative similar to what is happening in Wilmington / New Hanover. That would provide needed medical education infrastructure and support future healthcare manpower across the Blue Ridge much like what is happening near Wilmington.

Having said that, my familiarity is with the Charlotte market. So, people familiar with Wilmington may feel differently if that relatively new partnership has been to the detriment of the region. What we absolutely do not need is further expansion of Advocate / Atrium which uses its regional status a a hospital authority to float between behaving like a quasi-government entity, private non-profit, and for profit system as it sees fit.

The wife and I worked outside of Charlotte about a decade ago. I would concur with your thoughts/feelings of the Carolinas/Atrium system. Even back then they were acting too big to fail and were bullying things around. It's frustrating that we can't seem to find a way to let hospitals run independently so that they can serve their own community's needs as they need to rather than obeying and falling in line with the mothership.

 

[RustedFox]

It's frustrating that we can't seem to find a way to let hospitals run independently so that they can serve their own community's needs as they need to rather than obeying and falling in line with the mothership.

Quoted for truth.

 

[Apollyon]

Mission is directly north of Greenville, SC. 20 years ago, when I worked in G-Vegas, we didn't have a neurointerventionalist, but Mission did, so we infrequently sent pts up there. Too bad it's gone downhill.

 

[alpinism]

Yeah not surprising for anyone who has been following the situation at the hospital.

The disappointing thing is that despite everything there are still TeamHealth EM docs there who like to constantly post on the EM DOCS JOBS site recommending the hospital to any new grads who are searching for jobs in the Carolinas. They like to claim that everything is much better now and the current leadership cares deeply about the emergency department. Ironically when questioned about the numerous recent news stories that all claim otherwise with examples of patients who died because of the unsafe conditions they stop answering questions and then delete the job post.