Medicare Terminates Contract with Southeastern Kentucky Medical Center For Patient Safety Violations

By WILL WRIGHT, for Lexington Herald Leader.

The federal government cut off Medicare and Medicaid payments to a Kentucky hospital last week following a scathing inspection that found the hospital failed several of its patients.

The Centers for Medicare and Medicaid Services terminated its provider agreement with the Southeastern Kentucky Medical Center in Pineville after a January report from the Kentucky State Survey Agency found numerous problems.

The report said the hospital failed to protect six patients from neglect, and did not have a number of medications that it was required to keep on site, including antibiotics, intravenous fluids, and a variety of medications used during cardiac arrest and other emergencies.

The termination means the government will no longer reimburse the hospital for care that is normally covered by Medicare or Medicaid for patients who begin treatment plans after Friday, May 24. For patients whose treatment plans began before Friday, CMS will continue to cover treatment through June 24, or 30 days after CMS announced its termination.

The hospital also failed to have an adequate operating budget, the review found. Interviews with hospital officials revealed it had “no plan to ensure the facility could continue to operate,” according to the report.

April Washington, a CMS spokeswoman, said CMS and the Kentucky State Survey Agency will “continue to work together to ensure the safety of all patients in this facility.”

“CMS does not shutter the doors of hospitals,” Washington said. “That is a solely a business decision made by the facility’s owners.”

Officials with Southeastern Kentucky Medical Center referred the Herald-Leader to an attorney, who has not responded to requests for comment.

The report lists a number of instances in which hospital staff either failed to provide care, or otherwise jeopardized the health of patients.

In one instance, a social services consultation was requested for a patient who did not have running water or access to transportation, but the hospital never arranged the consultation. Instead, the patient was discharged.

Last year, one patient who was experiencing abdominal pain signed a consent form for an EGD, a procedure to examine the lining of the stomach and part of the small intestine using a small camera on a tube that is inserted through the mouth. Instead, hospital staff attempted to perform a colonoscopy on the patient, without the patient’s consent, and performed a sigmoidoscopy — an examination of the lower colon and inner part of the rectum — without the patient’s consent.

The report also showed that multiple patients who required emergency services were transferred to other hospitals because Southeastern Kentucky Medical Center could not provide adequate care.

Last July, an ambulance was transporting one patient who was experiencing symptoms of an acute stroke to the medical center. When paramedics called to alert the emergency room, a nurse told them to take the patient elsewhere because the emergency department would “kill this guy,” according to the report. The ambulance service called a helicopter and flew the patient to another facility.

The report also details the hospital’s precarious financial situation, including that it had an outstanding debt of about $500,000 with its pharmacy distributor, and owed about $600,000 to its electronic medical records vendor.

All vendors supplying the hospital were refusing to provide services without payment, the report said.

In 2017, the hospital’s then-owner, the Pineville Community Hospital Association, sold all of its non-real estate assets to Florida-based Americore Health.

The PCHA, which still owns the hospital’s real estate, declared Chapter 7 bankruptcy last year.

In a statement, Pineville Mayor Scott Madon said the hospital remains open, and that the city is “doing all it can to provide support for the efforts of the Bankruptcy Trustee to protect and preserve the assets of the Pineville Community Hospital Association.”

Madon said the city approved a $100,000 loan secured by a lien on the hospital’s real estate, which it will use to fund the bankruptcy proceeding.

“As the people of Pineville know, the hospital is an important community asset,” Madon said.

Madon also thanked community members who have helped hospital employees who have not been paid. One doctor has purchased gift cards worth thousands of dollars to a local grocery store, and the owner of the store has agreed to match the dollar amount of those gift cards.

“At this point in time, I think we need to support our local hospital and let the professionals on both sides work out the details,” Madon said. “We hope and pray that this is resolved soon.”

The nearest hospitals to Pineville are about 15 miles away. According to CMS, Barbourville AHR is 14 miles from Pineville, Middlesboro ARH is 15 miles away, and Harlan ARH and Baptist Health Corbin are both 35 miles away.

May 30, 2019