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WEBVTT STAKE.COREY?COREY: MICHAEL AND CAROL WE'RE TALKING MILLIONS OFDOLLARS IN LOST REVENUE ANDTHOUSANDS OF MEDICARE PATIENTSAFFECTED IF CHANGES AREN'T MADE.A HOSPITAL SPOKESPERSON SAYSLAST YEAR GREENVILLE MEMORIALSAW ROUGHLY $305 MILLION IREVENUE FROM MEDICARE PATIENTSRIGHT NOW THE CENTERS FORMEDICARE AND MEDICAID SERVICES,OR CMS COVERS THE COST FOR THOSEPATIENTS AT GREENVILLE MEMORIALHOSPITAL.A STATE AGENCY AUDITED THEEMERGENCY DEPARTMENT AFTER APATIENT DIED AND SAYS IT ISN'TMEETING STANDARDS.>> IT WAS BASED ON THE DEATH OFA PATIENT WHO WAS EXHIBITINGAGGRESSIVE BEHAVIORS DUE TO THEFACILITY'S FAILURE TO PERFORM ASAFE TAKE DOWN. . WE'VEDISCOVERED THAT THE PATIENT WASDONALD SMITH.OFFICIALS SAY HE DIED ON MARCH 6AFTER FIGHTING WITH A HIREDSECURITY TEAM.BUT THE AUDIT CLAIMS THATSECURITY AND NURSES DIDN'TFOLLOW PROPER GUIDELINES TORESTRAIN SMITH WHILE STRUGGLINGWITH HIM.>> IN THAT, THE PATIENT'S UPPERBODY WAS POSITIONED FACE DOWN ONTHE BED AND THERE WAS NOCLINICAL ASSESSMENT OF THERESTRAINED PATIENT THROUGHOUTTHE INCIDENT TO ENSURE THEPATIENT'S SAFETY. . CMS SAYS ACOMPLAINT WAS FILED AFTER SMITHDIED BUT WASN'T ABLE TO TELL USWHO NOTIFIED THE GOVERNMENT.THE HOSPITAL SAYS IT ALSOCONTACTED THE AGENCY>> WE SELF REPORT.WE LET CMS KNOW THAT WE WANT YOUTO COME IN AND WE WANT YOU TOKNOW WHAT WE'RE THINKING ABOUT.THAT'S THE WAY THIS PROCESSUNFOLDED. . RIGHT NOW THE>> RIGHT NOW THE HOSPITAL IS INVIOLATION IN THREE CATEGORIES.GOVERNING BODY PATIENT RIGHTS AND NURSING SERVICES.>> WHERE WAS THE LEADERSHIP TOMAKE SURE THAT THEY WEREFOLLOWING THE LAWS OF CMS?>> WE'RE GOING TO FIX IT.WE ABSOLUTELY ARE COMMITTED TOFIXING IT. . THE HOSPITAL HASUNTIL APRIL 16 TO FIX THEISSUES.SO WHAT HAPPENS TO MEDICAREPATIENTS IF THEY DON'T MEET THEDEADLINE?>> IT'S IMPORTANT TO KNOW THATMOST HOSPITALS DO TAKE THENECESSARY STEPS TO CORRECTDEFICIENCIES PRIOR TOTERMINATION. . HOSPITALOFFICIALS SAY A SITUATION LIKETHIS HASN'T HAPPENED IN AT LEASTTHE LAST 11 YEARRIGHT NOW SOUTH CAROLINA'SLARGEST HEALTH CARE PROVIDER ISPROMISING THAT MEDICARE COVERAGEWILL NOT BE INTERRUPTEMICHAEL: HOSPITAL OFFICIALS SAYROUGHLY 13,000 MEDICARE PATIENTSIN THE HOSPITAL COULD BEAFFECTED.A GOVERNMENT OFFICIAL WANTS TOSTRESS THAT THOSE PATIENTS ARENOT IN ANY IMMEDIATE JEOPORDY OFHAVING TO BE TRANSFERRED

Advertisement Greenville Memorial will lose Medicare, Medicaid payments unless changes are made, officials say GHS says it’s making changes and expects no interruption of Medicare, Medicaid services Share Shares Copy Link Copy

WYFF News 4 has learned that an audit of Greenville Memorial Hospital’s emergency department has led to the pending withdrawal of both Medicare and Medicaid payments.The audit of the emergency room followed complaints about the death of a patient, WYFF News 4 learned Tuesday.The Centers for Medicare and Medicaid Services posted a public notice Tuesday.It said the agency will not pay for any hospital services for Medicare patients admitted to the emergency department of Greenville Memorial starting April 16 unless the hospital makes needed changes.On Wednesday, Sandy Dees, with GHS, said that the notice will also affect Medicaid.Dees said this could potentially affect about 21,000 Medicare and Medicaid inpatients, based on the volume from 2016. This represents about 59% of Memorial's inpatients, Dees said. Dees added that the net revenue at risk from Medicare and Medicaid could potentially reach around $495 million. This includes both inpatient and outpatient net revenue at Greenville Memorial."The CMS notice applies to both Medicare and Medicaid patients -- but is specific to Greenville Memorial Hospital. It does not affect any of the other hospitals that are part of Greenville Health System (e.g., Greer, Hillcrest, Laurens, North Greenville, Patewood, Oconee or Baptist Easley), nor does it affect any of our primary care physician practices or outpatient services outside of Greenville Memorial."April Washington with CMS said Wednesday, “Our first priority is to protect the health and safety of the hospital's patients. At this time, the patients served by the hospital are not in any immediate jeopardy of being moved or transferred to another facility. The hospital has an opportunity to take steps to correct deficiencies prior to termination, which takes effect April 16, as stated in their 23-day notice. In addition, the hospital has the right to appeal the decision within a 60-day period. “It is important to note that most hospitals take the necessary steps to correct deficiencies prior to termination. “The 23-day termination applies to the Medicare participating provider that can impact Medicare and Medicaid beneficiaries. The Immediate Jeopardy determination is applicable to Medicare certification requirements. However, if the hospital does not come into compliance, the state of South Carolina licensure requirements stipulate the provider must be Medicare certified to receive Medicaid funds.” Hospital officials said Tuesday that the deficiencies will be corrected before the deadline, and they don't anticipate any interruption of Medicare or Medicaid services.WYFF News 4’s Myra Ruiz interviewed CMS spokesperson April Washington, who confirmed that the audit of the emergency department followed a complaint about the death of a man earlier in March at Greenville Memorial. Donald Keith Smith, 48, died at Greenville Memorial on March 6 after an altercation with security personnel. The coroner ruled his death a homicide caused by traumatic asphyxiation. Washington told WYFF News 4's Corey Davis that , "in this case the hospital failed to ensure that nursing personnel and their contracted security staff followed the hospital policy and procedure they call aggression management."Washington said that while guards tried to restrain Smith, "the patient's upper body was positioned face down on the bed and there was no clinical assessment of the restrained patient throughout the incident to ensure the patient's safety."Smith’s death is being investigated by the State Law Enforcement Division.Washington stressed that medicare patients are not in any immediate jeopardy of having to be transferred to another facility. She said, "It's important to note that most hospitals do take the necessary steps to correct deficiencies prior to termination."A public notice in the Greenville News says: “Notice is hereby given that effective April 15, 2017, the agreement between GHS Greenville Memorial Hospital, 701 Grove Road, Greenville, S.C. 29605 and the Secretary of Health and Human Service, as a provider of Hospital Services and Health Insurance for the Aged and Disabled Program (Medicare) is to be terminated. GHS Greenville Memorial Hospital does not meet the following conditions of participation. 42 CFR 482.12 Governing Body, 42 CFR 482.13 Patients’ Rights and 42 CFR 482.23 Nursing Services.“The Centers for Medicare and Medicaid Services has determined that GHS Greenville Memorial Hospital is not in compliance with the conditions of coverage. The Medicare program will not make payment for hospital services to patients who are admitted after April 16, 2017.”According to 42 CFR 482.12 Governing Body: "There must be an effective governing body that is legally responsible for the conduct of the hospital. If a hospital does not have an organized governing body, the persons legally responsible for the conduct of the hospital must carry out the functions specified in this part that pertain to the governing body."According to 42 CFR 482.13 Patients' Rights: "A hospital must protect and promote each patient's rights.According to 42 CFR 482.23 Nursing Services: "The hospital must have an organized nursing service that provides 24-hour nursing services. The nursing services must be furnished or supervised by a registered nurse.Scott M. Sasser, MD, GHS' chair of emergency medicine, said a site survey, by the Centers for Medicare and Medicaid Services, took place on March 13, but that he could provide little information about the findings because many of the deficiencies were discovered through the audit of individual patient charts.GHS officials said Tuesday that it is the first time in at least a decade that the hospital has been found non-compliant.Greenville Memorial Hospital released a statement in response to the notice saying: “Greenville Memorial Hospital is making changes to improve processes in its emergency department following a site survey by the Centers for Medicare and Medicaid Services, which found that GMH was not in compliance with some CMS requirements. “The survey came after GMH notified CMS that the hospital had identified potential areas for improvement in the emergency department. “’Nearly all action plan items have already been initiated, and we feel confident that CMS will find our plan and its implementation satisfactory,’” Sasser said. “’We do not anticipate any interruption of Medicare services, and we are committed to making improvements over and beyond what CMS requires. We’re proud of our public mission and the care we provide our community. GHS is absolutely committed to continuing to deliver high-quality care to every patient.’” “The broad areas of concern cited by CMS under its conditions of participation include nursing services, patient rights and the governing body. The GMH action plan for the emergency department includes strengthening clinical documentation processes around patient care, increasing staffing and providing more intensive training.” “’We take these issues very seriously and respect CMS’ judgment,’” Sasser and. ‘Whether we have internal processes for improvement or have an opportunity presented to us by regulatory agencies, we welcome any opportunity to be better.’”Sasser did not give a specific number of deficiencies that were cited, but he said that GHS has until the first week of April to submit an action plan to correct the problems. Sasser said, “We are going to fix it,” Sasser said. “We are committed to fixing it.” “We will take the feedback, and we will do better,” he said.To see a full interview with Sasser, click here.