Parkland Memorial Hospital learned Wednesday it had passed a make-or-break government survey and would not lose its crucial Medicare and Medicaid funding.
The announcement came two years after the Dallas County hospital began correcting patient-safety problems that ultimately cost tens of millions of taxpayer dollars.
“Parkland is where it needs to be,” said David Wright, deputy regional director for the U.S. Centers for Medicare and Medicaid Services, which implemented a rare monitoring program at the hospital.
“They’ve put themselves in a position to provide sustainable care.”
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At a hastily called news conference, Parkland officials announced that the public hospital was found in “substantial compliance” with federal regulations.
The decision rescinds a funding-termination order pending since Aug. 9, 2011.
“I see people with tears out there because you all have worked so hard on this,” Dallas County Judge Clay Jenkins said to a hospital auditorium filled with Parkland executives, board members and other staffers.
Series of failures
Parkland’s problems came to light after a series of stories in The Dallas Morning News raised questions about basic patient safety. One story focused on the February 2011 death of psychiatric patient George Cornell, which sparked a series of failed inspections.
Government regulators warned two years ago that the failures posed “an immediate and serious threat to patient health and safety.” They ordered the hospital to hire safety monitors and devise a plan of action to remedy patient dangers.
Since then, Parkland overhauled many of its patient-safety practices, revamped the emergency department and hired more nurses to improve patient care. The changes cost more than $75 million.
Parkland will continue to operate under a corporate-integrity agreement enforced by the U.S. Department of Health and Human Services. For the next five years, outside consultants hired by Parkland will monitor its billing operations and patient-quality efforts.
The hospital also will have enhanced safety oversight from state health regulators for another year as part of a settlement agreement to resolve penalties for past care failures.
Amid smiles and hearty applause, Parkland board chairwoman Debbie Branson thanked county officials, hospital administrators, board members, doctors, nurses and hospital staffers for working to improve the hospital.
“We have rebuilt public health care in Dallas from the ground up, and we’ve done it in a way that is sustainable,” she said. “This is an exciting day … and I’m so very, very proud of everyone here.”
Among those present at the news conference was Dr. Daniel K. Podolsky, president of UT Southwestern Medical Center, whose faculty oversees Parkland resident doctors.
“We congratulate Parkland for achieving this important milestone, which we know has required sustained commitment by the leadership and all who work there,” Podolsky said in a statement.
“We are proud of all of our physicians, both faculty and residents, for their role and for their dedication to the needs of patients.”
The successful survey capped a tension-filled summer as surveyors from the Texas Department of State Health Services made three visits between June 15 and July 19.
The lengthy process allowed the surveyors to observe the hospital’s operations over time to assure that patient-safety efforts were not simply temporary measures.
Interim Parkland chief executive officer Bob Smith said Wednesday that the surveyors identified new problems at the hospital. He said Parkland would submit a correction plan to CMS within the next two weeks.
This happens “anytime a hospital is surveyed,” Smith said. “It’s a normal process.”
Among Parkland’s new troubles was the unsanitary condition of the kitchen that serves patients and staff, according to hospital documents.
Nearly $2 million is being spent to upgrade food services and satisfy government standards.
Close call
After the half-hour celebration, Jenkins acknowledged how close Parkland had come to defaulting on its health care mission. The hospital was founded in 1894 to provide charity care for the local indigent population.
“If Parkland hadn’t passed the inspection and CMS cut off the funding, we would have run out of money in 100 days,” he said.
“We would have been faced with downsizing the hospital or turning it over to a third party to operate. Luckily, that’s not happened.”
CMS rarely terminates a hospital’s Medicare and Medicaid funding. Only two Texas hospitals have lost such certification since 2005, according to the agency. One was in Houston and another in San Benito. Both were small hospitals with fewer than 100 beds. Parkland has more than 700.
The positive outcome means Parkland will no longer operate under a rare systems improvement agreement, which went into effect Sept. 27, 2011.
It required the hospital to retain independent consultative experts to conduct a hospitalwide analysis of its operations compared to national industry standards.
The consultant, the Alvarez & Marsal Healthcare Industry Group, developed a corrective action plan to bring Parkland into compliance with Medicare’s quality-of-care requirements.
The firm was paid about $14 million for overseeing 499 improvements required throughout the hospital.
In its final review last spring, the consultant gave Parkland a mostly positive report card.
“The quality and patient-safety functions at Parkland have been completely overhauled and redesigned under new leadership,” the consultants said.
Date: 07 August 2013