Two Detroit Medical Center hospitals are in danger of losing federal payments after they failed health and safety inspections last month.

State inspectors found multiple infection control violations at Detroit’s Harper and Receiving Hospitals, the Centers for Medicare and Medicaid Services informed both hospitals in letters earlier this month.

In both cases, CMMS warned the hospitals that “the deficiencies cited are significant and limit your hospital’s capacity to render adequate care and to ensure the health and safety of your patients.” Because of that, “your hospital is no longer deemed to meet the Medicare Conditions of Participation and is now under the survey jurisdiction of the (Michigan Department of Licensing and Regulatory Affairs)."

The finding means that LARA inspectors will conduct more thorough, follow-up reviews at both hospitals to ensure compliance. If the agency finds new or ongoing problems, the hospitals could lose Medicare and Medicaid patient funds.

A LARA spokesman confirmed that investigators are back on site at Receiving Hospital this week.

At Harper Hospital, the citations included:

A catheter bag touching the floor in the Intensive Care Unit.

A kitchen preparation area with “multiple large spills,” among other unsanitary conditions.

Small black bugs and gnats flying around Intensive Care Unit patient rooms, along with dirty or deteriorating conditions across the ICU.

Improperly covering sterile equipment in an operating room.

Failure to follow protocol when it comes to information-sharing about hospital-acquired infections, “resulting in the potential for missed opportunities for corrective action and quality improvement.”

At Receiving Hospital, the following violations were noted:

Non-violent patients put in restraints for longer than authorized.

The hospital “failed to maintain an ongoing infection control program designed to prevent, control and investigate infections and communicable diseases for 12 of 12 months reviewed, resulting in the potential for transmission of infectious agents for all patients.”

The hospital did not properly document or report hospital-acquired infections other than those mandated by the U.S. Centers for Disease Control.

Multiple instances of violating policies on wearing surgical gloves and proper hand hygiene, including one surgeon who put surgical tape on a patient’s incision without wearing gloves or washing their hands.

At least two instances where non-sterile surgical equipment was provided to doctors, though it appears those instruments were not actually used on patients. However, the report notes that staff failed to properly document or follow up on how non-sterile equipment packets could have made it to the hospital from the joint sterilization center used by all hospitals on DMC’s Detroit campus.

The DMC has responded to the reported violations with corrective action plans it says have already been implemented. In a statement, the hospital system says it “expected and welcomes” the LARA inspectors. “The DMC remains committed to providing residents of Detroit with safe, accessible, quality care,” it stated.

This is the second time in as many years that DMC hospitals have been cited for infection control violations, specifically ongoing problems with dirty surgical instruments documented by a Detroit News investigation. The DMC claimed to have fixed the problems, and did not lose its Medicare-eligible status.

The latest round of inspections came after three cardiologists and a DMC Heart Hospital executive were forced to step down for what the hospital system called breaches of its standard of conduct. The exact allegations were never specified. The dismissed doctors claimed that was a retaliatory move and attempt to “silence” them after they brought up concerns about patient safety and quality of care.