Wilson hospital again facing federal threat to end Medicare contract
Wilson County’s only hospital is in regulatory trouble again after officials say the facility violated a federal law designed to ensure care for people seeking emergency treatment.
Regulators from the Centers for Medicare and Medicaid Services say they found several problems during inspections at Wilson Medical Center earlier this year that put the health and safety of its emergency room patients in “immediate jeopardy.”
It’s a serious and relatively rare designation — one the hospital already earned in June after regulators discovered issues with the quality and oversight of treatment there.
The facility is now at risk of losing its Medicare contract by Nov. 19 if it doesn’t provide a new corrective action plan and submit to another unannounced inspection by state health officials, who have been in and out of the hospital since earlier this year.
Hospital officials say federal regulators did not take into account fixes staff implemented earlier in the year and expect to resolve the issues quickly.
“When CMS first flagged these cases for us several months ago, we took proactive action, instituting a plan to address regulators’ concerns and updating staff training,” Wilson Medical Center spokesperson Jessie Nunery said in a statement last week.
“Given the corrective actions in place today, we are confident that we have resolved the identified issues and can successfully complete the review process with CMS over the next several weeks.”
Nunery added in a statement this week that the hospital leadership was “disappointed” with the decision and had no concerns about their ability to meet the Nov. 19 deadline.
The hospital’s most recent issues, first reported by The Wilson Times on Oct. 29, involve violations of the Emergency Medical Treatment and Labor Act, a federal law that requires hospitals to care for patients who show up to emergency rooms regardless of their ability to pay.
Problems at Wilson hospital ER
Inspection reports obtained by The News & Observer this week show the violations center on the treatment of three patients who arrived in the emergency department in April, June and July.
Regulators already cited the hospital earlier this year for issues related to one of those cases — a 41-year-old man who locked himself in the ER lobby bathroom and threatened to overdose on medication officials say should have been confiscated when he arrived. But the new report faults the hospital for failing to ensure the man received the psychiatric care he needed.
“The patient was still suicidal. There was no documentation in the medical record to indicate that the facility ED staff attempted to transfer the patient to an inpatient psychiatry facility for psychiatric care and treatment,” the report said.
Instead, the report says that after the patient cursed at and assaulted medical staff, they discharged him to the local jail on suicide precautions, which “posed an immediate and serious threat to the patient’s safety, and inappropriately delayed treatment for his identified emergency medical condition.”
The new report also notes two other patients whom the hospital either failed to document or properly screen before they left the facility’s care.
In one case, EMS workers transported an 87-year-old man to Wilson Medical Center’s emergency room after he was redirected there from a nearby hospice facility without space to treat him. After some initial confusion over why he was transported there, his hospice caretakers told EMS workers to send him back home. Federal regulators faulted the hospital for failing to provide medical screening for the patient, who returned to the emergency room 19 hours later after a fall.
Federal regulations require hospitals to document and track patients who show up to the emergency room for treatment. And even if those patients choose to leave, hospitals must take steps to properly screen them and explain the risks of walking out.
But inspectors say the hospital failed to meet those requirements for a 2-year-old girl experiencing an allergic reaction after she was attacked by fire ants in her yard.
Although the patient was initially seen by a triage nurse who did not find signs of a “systemic reaction,” she and her parents waited for more than two hours before leaving without a medical screening exam.
The hospital’s failure to provide her parents with the risks and benefits of leaving, the report said, “posed an immediate and serious threat” to her health and safety.
In its statement last week, Nunery said the hospital took “proactive action” when CMS officials alerted them to the cases several months ago, addressing their concerns and updating staff training.
“We have made significant changes in our operations over the past several months as part of the regulatory reviews in which we have participated. These changes have ensured that our hospital – including our Emergency Department – is a safe place for care,” Nunery said.
But the three cases outlined in the reports from CMS may not be the only ones posing regulatory issues for the hospital.
Nunery noted in a statement to the N&O Friday that “there are a few outstanding cases identified this summer that are still under review.
“We will work with CMS to address any concerns they have related to these as well,” he said.