A pair of Nashville hospitals have been granted a nine-month extension to gain Medicare recertification following a medication error at one hospital that injured four people, paralyzing one, on Aug. 14.
The Centers for Medicare and Medicaid Services (CMS), part of the Department of Health and Human Services, notified Ascension St. Thomas Midtown that three findings of “immediate jeopardy” had been lifted after the hospital provided additional corrective action plans on Sept. 10.
Ascension St. Thomas West had also been under threat of termination from the program because the two hospitals operate as one entity.
The agency notified St. Thomas CEO Dr. Shubhada Jagasia of the reprieve in an Aug. 16 letter obtained by The Epoch Times.
The agency appears to have taken into account the potential impact of termination on Tennessee Medicare beneficiaries in granting the extension.
“CMS understands the impact that the termination of Ascension St. Thomas Hospital system Medicare Provider Agreement would have on the community, the best interests of the Medicare program and its program beneficiaries,” wrote Linda D. Smith, director of survey enforcement and clinical standards for the Atlanta division.
Even so, the hospital remains out of compliance with federal regulations regarding governance, assessment and performance improvement, pharmaceutical services, and surgical services, the letter stated.
The agency extended the timeline for full compliance with federal regulations until June 16, 2027.
The hospital pledged to continue working on quality improvement.
“We have engaged and continue to work with an independent quality consultant to guide and verify the full scope of our corrective actions and process enhancements,” an Aug. 16 statement on the hospital website reads.
“At all times, our hospitals will remain open, operational, eligible for Medicare, and fully committed to serving the Middle Tennessee community,” The statement added.
Four patients received spinal injections of potassium phosphate—normally used to treat low levels of blood phosphorus—instead of the spinal anesthetic mepivacaine, when undergoing joint replacements.
All four patients experienced neurological systems, trouble breathing, and poor circulation. The most severely affected patient was paralyzed below the midsection.
The facility self-reported the error the day it happened, according to a hospital statement.
“Our hearts remain with those impacted by this event, and we are committed to learning from this and upholding the standards of patient safety, quality, and compassionate care,” the hospital statement said.
After an initial site visit, which concluded on Aug. 21, the agency found that the hospital posed “immediate jeopardy to patients’ health and safety.”
CMS later notified the hospital that its status as a “deemed” hospital was revoked as of Aug. 26.
A deemed hospital is one that the agency approves for the Medicare program based on its accreditation by a national agency. Such hospitals do not require state surveys, like the one performed at Ascension St. Thomas, for recertification. However, the status can be revoked.
Because Ascension St. Thomas Hospital is under an immediate jeopardy warning, removal of the deemed status triggered a 23-calendar-day process for termination of participation in Medicare.
Although the timeline for full compliance has been extended, automatic renewal of the hospital’s participation in Medicare was not restored, the agency said.
The hospital must pass an inspection by the Tennessee Health Facilities Commission by June 16.
The hospital must submit a hospital-wide analysis of the root cause of the error, a detailed, correction action plan, a hospital-wide quality assessment and performance improvement program, recommended hospital-wide changes, and assessment procedures by Sept. 25.
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