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October 19. 2012 5:28PM
Exeter Hospital scrambles to avoid loss of Medicare funding
EXETER - Officials at Exeter Hospital insist that steps are being taken to address deficiencies found during a recent inspection to avoid losing its federal Medicare funding by the end of the year.
The hospital called a press conference Friday to respond to a report that outlined several deficiencies found by inspectors in September in the wake of a hepatitis C outbreak linked to former hospital radiology technician David Kwiatkowski.
In the report dated Oct. 11, the Centers for Medicare & Medicaid Services - the agency that ensures hospitals comply with standards to receive Medicare funding - found that the hospital wasn’t compliant in several areas, including infection control, and that it failed to ensure that all areas were identified and investigated related to the hepatitis C infections.
If it doesn’t correct the problems quickly, the hospital’s Medicare provider agreement will be terminated on Dec. 28, meaning the federal program will no longer pay for services provided to patients admitted on or after that date.
Mark Whitney, the hospital’s vice president of strategy and community affairs, said the hospital takes the deficiencies raised in the report “very seriously” and is working on a formal action plan to address them to keep its Medicare funding.
“We are confident we will be able to work with (Centers for Medicare & Medicaid Services) to find satisfactory resolutions to all of their concerns,” he said.
Dubbed a “serial infector” by federal prosecutors, Kwiatkowski is accused of infecting 32 former hospital patients by stealing syringes filled with the painkiller fentanyl, injecting himself, and then returning them to be used on unsuspecting patients.
Inspections began after a complaint lodged in response to the hepatitis C cases announced in late May. The complaint prompted a spot survey of the hospital’s procedures in June and a more thorough inspection in July, which found that the hospital was not in compliance with certain standards known as Medicare conditions of participation related to infection control.
The hospital has been working to fix the deficiencies, which have been described in inspection reports as being of “such a serious nature as to substantially limit the hospital’s capacity to provide adequate care.”
Despite the accusation, Whitney said he is confident in the quality of care the hospital provides.
“We are in a new world following the uncovering of the full scope of David Kwiatkowski’s alleged criminal acts in multiple states.
Hospitals and regulators both need to embrace the need for increased review of even commonly used practices,” Whitney said. “As a result of our identifying Mr. Kwiatkowski’s alleged criminal activities, we are thankfully the final chapter in a national tragedy that has affected hospitals and, sadly, many of their patients across the nation.”
The October report was issued after a follow up inspection of the hospital in September.
In the report, inspectors said the hospital failed to follow the Centers for Medicare & Medicaid Services administrative investigative process to identify the source of the hepatitis C infections. During a follow up inspection on Sept. 17 and Sept. 18, inspectors reviewed the hospital’s analysis of the hepatitis C outbreak but found that it did not “contain the necessary scope to address all causal factors,” the report said.
The report continued, “Although the analysis looked at infection control and medication security, it did so with a very narrow focus.
Based on these findings, a much wider scope for both was necessary to establish a true root cause, providing the ability to analyze and evaluate the quality of their existing programs pertaining to infection control and medication security. This would allow the hospital to identify other potential areas for performance improvement.”
Under normal circumstances, Whitney said the hospital would have followed the Centers for Medicare & Medicaid Services’ process for investigating the cause of an “event.” However, Whitney said it didn’t follow all of the agency’s steps because state public health officials quickly launched an epidemiological investigation in addition to state and federal criminal investigations, which took precedent.
During a tour of the cardiac catheterization procedure room on Sept. 17, a team of inspectors also found numerous medications in an unlocked refrigerator.
Whitney said the refrigerator was located in a secure unit and didn’t contain controlled substances. Still, regulations state that refrigerators should be locked and the hospital is now making sure they are secured and in compliance, Whitney said.
Inspectors also expressed concern that Pyxis machines containing drugs allow employees to change their own biometrics (fingerprint) without creating a reported audit trail.
Whitney said the biometrics issue is a problem with all Pyxis machines and that the hospital is working with the manufacturer to address the concern.
Inspectors noted that ceiling tiles in the hospital’s family center operating room suite had not been replaced when they showed up for the September visit, but Whitney said they have now been replaced.
The report as well found housekeeping staff were not compliant with infection control practices. During their visit, inspectors documented an incident where a housekeeper’s protective gown wasn’t properly secured and that the housekeeper didn’t follow protocol for glove replacement.
Whitney said the hospital consistently scores at or above average in reportable infection control measures, but in light of the report, it has enhanced training of housekeeping and clinical staff regarding infection control practices.
jschreiber@newstote.com
The hospital called a press conference Friday to respond to a report that outlined several deficiencies found by inspectors in September in the wake of a hepatitis C outbreak linked to former hospital radiology technician David Kwiatkowski.
In the report dated Oct. 11, the Centers for Medicare & Medicaid Services - the agency that ensures hospitals comply with standards to receive Medicare funding - found that the hospital wasn’t compliant in several areas, including infection control, and that it failed to ensure that all areas were identified and investigated related to the hepatitis C infections.
If it doesn’t correct the problems quickly, the hospital’s Medicare provider agreement will be terminated on Dec. 28, meaning the federal program will no longer pay for services provided to patients admitted on or after that date.
Mark Whitney, the hospital’s vice president of strategy and community affairs, said the hospital takes the deficiencies raised in the report “very seriously” and is working on a formal action plan to address them to keep its Medicare funding.
“We are confident we will be able to work with (Centers for Medicare & Medicaid Services) to find satisfactory resolutions to all of their concerns,” he said.
Dubbed a “serial infector” by federal prosecutors, Kwiatkowski is accused of infecting 32 former hospital patients by stealing syringes filled with the painkiller fentanyl, injecting himself, and then returning them to be used on unsuspecting patients.
Inspections began after a complaint lodged in response to the hepatitis C cases announced in late May. The complaint prompted a spot survey of the hospital’s procedures in June and a more thorough inspection in July, which found that the hospital was not in compliance with certain standards known as Medicare conditions of participation related to infection control.
The hospital has been working to fix the deficiencies, which have been described in inspection reports as being of “such a serious nature as to substantially limit the hospital’s capacity to provide adequate care.”
Despite the accusation, Whitney said he is confident in the quality of care the hospital provides.
“We are in a new world following the uncovering of the full scope of David Kwiatkowski’s alleged criminal acts in multiple states.
Hospitals and regulators both need to embrace the need for increased review of even commonly used practices,” Whitney said. “As a result of our identifying Mr. Kwiatkowski’s alleged criminal activities, we are thankfully the final chapter in a national tragedy that has affected hospitals and, sadly, many of their patients across the nation.”
The October report was issued after a follow up inspection of the hospital in September.
In the report, inspectors said the hospital failed to follow the Centers for Medicare & Medicaid Services administrative investigative process to identify the source of the hepatitis C infections. During a follow up inspection on Sept. 17 and Sept. 18, inspectors reviewed the hospital’s analysis of the hepatitis C outbreak but found that it did not “contain the necessary scope to address all causal factors,” the report said.
The report continued, “Although the analysis looked at infection control and medication security, it did so with a very narrow focus.
Based on these findings, a much wider scope for both was necessary to establish a true root cause, providing the ability to analyze and evaluate the quality of their existing programs pertaining to infection control and medication security. This would allow the hospital to identify other potential areas for performance improvement.”
Under normal circumstances, Whitney said the hospital would have followed the Centers for Medicare & Medicaid Services’ process for investigating the cause of an “event.” However, Whitney said it didn’t follow all of the agency’s steps because state public health officials quickly launched an epidemiological investigation in addition to state and federal criminal investigations, which took precedent.
During a tour of the cardiac catheterization procedure room on Sept. 17, a team of inspectors also found numerous medications in an unlocked refrigerator.
Whitney said the refrigerator was located in a secure unit and didn’t contain controlled substances. Still, regulations state that refrigerators should be locked and the hospital is now making sure they are secured and in compliance, Whitney said.
Inspectors also expressed concern that Pyxis machines containing drugs allow employees to change their own biometrics (fingerprint) without creating a reported audit trail.
Whitney said the biometrics issue is a problem with all Pyxis machines and that the hospital is working with the manufacturer to address the concern.
Inspectors noted that ceiling tiles in the hospital’s family center operating room suite had not been replaced when they showed up for the September visit, but Whitney said they have now been replaced.
The report as well found housekeeping staff were not compliant with infection control practices. During their visit, inspectors documented an incident where a housekeeper’s protective gown wasn’t properly secured and that the housekeeper didn’t follow protocol for glove replacement.
Whitney said the hospital consistently scores at or above average in reportable infection control measures, but in light of the report, it has enhanced training of housekeeping and clinical staff regarding infection control practices.
jschreiber@newstote.com
