CMS: Mission still not compliant with federal regulations, at risk of losing funding

ASHEVILLE – Mission Hospital remains out of compliance with six federal regulations, threatening the hospital’s Medicare and Medicaid reimbursements, according to a Friday letter to Mission Chief Executive Officer Chad Patrick.

The federal government will terminate Mission’s Medicare and Medicaid contract by June 5 if the hospital does not become substantially compliant with the regulations. This is the latest step in the hospital’s monthslong entanglement with regulators. State officials notified the hospital that conditions at the facility posed immediate jeopardy to patients’ health and safety Dec. 1. The Centers for Medicare and Medicaid Services notified the hospital about the designation Feb. 1. This means conditions at the hospital put patients in danger of serious injury, harm, or death, according to the CMS definition.

Immediate Jeopardy Findings

A report detailing the deficiencies that rose to the level of immediate jeopardy found four patient deaths and violations of Medicare regulations concerning the hospital’s governing body, patient rights, quality improvement, nursing standards and emergency services. That report included the hospital’s plan to correct deficiencies, which a coalition of local doctors, former Mission employees, and advocates criticized, saying it did not address the fundamental issue: staffing.

State and federal regulators surveyed the hospital Feb. 20-23. Investigators found that the hospital removed immediate jeopardy conditions, but the hospital was still out of compliance with federal regulations concerning the hospital’s governing body, patient’s rights, quality assessment and performance improvement, nursing, laboratory, and emergency services.

Plan of Correction

To avoid losing Medicare and Medicaid payments, Mission must submit a “Plan of Correction” by March 13, which describes in detail the measures taken to resolve issues at the hospital.

“Mission’s status is the same now as it was on February 23 when the immediate jeopardy was removed. This new letter is just part of the ongoing process and restates what was in the initial findings. The 90-day extension is simply to ensure ongoing sustainability with the already-accepted plan of correction. This is not abnormal. We remain in close communication with the agency, and we will resubmit the approved plan of correction,” Mission Health spokesperson Nancy Lindell told the Citizen Times in a March 9 statement.

Next Steps

If the federal government accepts the plan, the North Carolina Department of Health and Human Services will visit the hospital again to determine if the facility is compliant with regulation. Should the hospital not achieve compliance, CMS will notify Mission 15 days before terminating its contract, giving information on how the hospital will appeal.

Conclusion

Mission Hospital’s compliance with federal regulations remains a critical issue as the deadline for substantial compliance approaches. The hospital’s Medicare and Medicaid contract is at risk, and the next steps will determine the future of funding for this vital healthcare institution.