A severe sanction of “immediate jeopardy” was slapped on the Commonwealth Health Center by the Centers for Medicare & Medicaid Services which now threatens its funding support from the federal agency.
The CNMI's lone public hospital was sanctioned on the first day of the Medicare team's five-day inspection of the facility.
Commonwealth Healthcare Corp. board chair Joaquin Torres disclosed to Saipan Tribune that the serious sanction was imposed Tuesday by the visiting Medicare representatives who are expected to complete the survey visit this Friday.
Once an “immediate jeopardy” status is given to a facility, the healthcare provider has 23 days to get into compliance before funding is cut. Immediate jeopardy indicates that the provider's noncompliance with one or more requirements of participation in the Medicare and Medicaid program has or is “likely to cause serious injury, harm, impairment, or death.”
Torres revealed that the sanction was placed following an inspection of the key units of the hospital where surveyors uncovered non-functioning defibrillators and the lack of backup machine at the facility. Defibrillators are electronic devices that treat life-threatening heartbeat irregularities.
The chairman disclosed that the team, upon completion of the visit on Friday, will conduct an exit conference with the corporation officials where observations will be relayed to the providers, including additional citations or deficiencies if any. He said “findings” are normal in every survey done in hospitals.
Torres acknowledged the seriousness of the status, but is confident that the problem will be immediately rectified before the 23-day deadline and the hospital will get back in good standing.
If CHC does not meet CMS standards, the Medicare program will halt payments to the hospital for inpatient treatment occurring on or after that date. Each year, the public hospital receives from $8 million to $10 million in funding from Medicare.
Saipan Tribune learned that immediate jeopardy is among the statuses issued by Medicare in their survey visits. Immediate jeopardy results from immediate threats to life and safety and this finding requires immediate response to avoid serious threats to the regulatory or accreditation status of the organization. Other sanctions include Medicare termination, preliminary denial of accreditation, and conditional accreditation, among others.
Medicare is keeping its surveys unannounced and their timing unpredictable. This gives the agency doing the surveying greater ability to obtain valid information.
It was in January 2010 when Medicare placed CHC in jeopardy status after it issued 112-page statement of deficiencies majority covers the nursing services. A corrective action plan was then submitted followed by a re-survey visit to validate the report. On the same year, Medicare lifted the jeopardy status at the facility after implementing action plans.
According to Torres, the serious deficiency uncovered this week by Medicare-on the lack of defibrillators-was a result of the corporation's budget constraint that affected not only the important supplies in the hospital but the replacement and maintenance of medical equipment.
He said yesterday, CEO Juan N. Babauta met with the Marianas Public Land Trust on the $7-million line of credit for the hospital. Torres said, the corporation will make sure the non-functioning defibrillators will be replaced immediately. It was early this year when the corporation, due to budget challenges, cut the contract of the vendor that maintains the hospital equipment, mostly are dilapidated.
As of 6pm last night, Torres said hospital administrator Karen Buettner is working on corrective measures at the hospital.
The Medicare team arrived on island last Monday from Guam and started to meet with officials and staff of the health corporation. Yesterday, inspections continued at the hospital units, according to staff and employees.
Among the visiting group members are Edgardo Japitano and Renie Soria, according to hospital staffers. The team also briefly met with CEO Babauta. This week's inspection serves as a follow-up visit from Medicare to validate the hospital's progress reports earlier submitted by CHC.