Feds Threaten to Cut Off Medicare Payments to St. Joseph Hospital

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(Updated as of 5 p.m., 5/6)

Federal authorities have warned St. Joseph Hospital in Orange, one of Orange County’s largest and best-known hospitals that it will have its Medicare payments cut off in July unless it corrects a number of patient “deficiencies.”

The warning came in an April 24 letter to St. Joseph President and CEO Steven C. Moreau and the hospital was given until “close of business” May 7 to describe how it will fix the issues.

A statement issued by the hospital Wednesday said it already had sent federal officials its plan for correcting the problems. The next step will be for federal officials to determine if the hospital’s plan corrects the problem.

The four-page letter from the federal Centers for Medicare & Medicaid Services didn’t lay out specific deficiencies, but indicated details were included in a 93-page attachment sent to Moreau but not made publicly available.

But in its public statement, St. Joseph said “a patient’s rights deficiency was found in the hospital’s use of mittens as restraints.”

It didn’t provide specifics, but “mitts” or “mittens” can be used with patients who are grabbing at medicines or equipment. They also can be used on patients who are emerging from anesthesia and may be trying to pull at tubes or bandages. The mitts keep patients from closing their hands. If too tight, they can harm the patient.

“The hospital will no longer use mittens as restraints unless ordered specifically by a physician,” the hospital statement said. “The use of mittens in the hospital setting is designed to ensure a higher level of patient safety, as it is common for patients who are agitated or in altered states to attempt to remove vital medication tubes or monitors.”

In 2010, the most recent year it lists statistics on its website, St. Joseph ranked first in Orange County and second statewide in emergency room visits, with 101,945. It also was first in the county and second in the state in numbers of surgical procedures with 28,027, and second in the county for number of deliveries with 5,149 live births.

The hospital had, as of 2010, 525 beds, 3,800 employees and 971 doctors on staff.

The CMS letter said a California Department of Public Health “complaint survey” was completed on Feb. 26. The survey determined the hospital was out of compliance with provisions of the “patient rights” federal regulations.

Those findings placed St. Joseph’s under state “survey jurisdiction until you demonstrate full compliance,” the letter said. “This means that the hospital is now subject to all applicable participation and enforcement requirements and may be subject to termination of its Medicare provider agreement.”

The letter continued: “We have further determined that the deficiencies identified by the February 26, 2015 survey substantially limit St. Joseph Hospital’s capacity to render adequate care to patients or are of such character as to adversely affect patient health and safety.”

It said the hospital’s agreement to treat Medicare patients would end July 23 unless it submitted by Thursday “credible documentation evidencing correction of the cited deficiencies and that St. Joseph Hospital is otherwise in compliance with all” federal regulations.

If no documentation was turned in by Thursday or materials submitted are “unacceptable,” St. Joseph’s Medicare contract could be cancelled even before July 23, the letter said. The hospital has the legal option to appeal.

You can contact Tracy Wood at twood@voiceofoc.org