It’s been all of nine months since Meridian Behavioral Health Systems took over operation of Southeast Louisiana Hospital (SELH) in Mandeville in what we like to call the Jindal Swindle and already the facility has been notified that it has been found to have deficiencies serious enough to threaten its eligibility to continue participation in Medicare.
Meridian, a Florida-based company chosen to run SELH after Gov. Bobby Jindal chose to close the hospital, has been running the 58-bed facility under the name of Northlake Behavioral Health System.
Jindal announced last year that he was closing the hospital, effective Oct. 1, a move that left mental patients in all of southeast Louisiana, including the New Orleans, Houma and Thibodaux metropolitan areas, with no access to any state mental treatment facility. The move threw more than 300 SELH employees out of work.
Formed as a company less than a year before taking over the Mandeville hospital, Meridian had never handled a facility the size of SELH and in fact, listed no facilities it had ever run on its application.
And it didn’t take long for that inexperience to surface.
Northlake Behavioral Health System CEO Richard Kramer was notified by the Center for Medicare & Medicaid Services (CMS) on June 3 that Northlake no longer qualified for participation in Medicare.
“After a careful review of the May 23, 2013, survey report, we have determined that Northlake Behavioral Health System no longer meets the requirements for participation in the Medicare program,” wrote Greg Soccio, manager of the CMS Non-Long Term Care Certification and Enforcement Branch.
“Although the deficiencies do not constitute an immediate threat to the health and safety of patients, the deficiencies have been determined to be of such a serious nature as to substantially limit your hospital’s capacity to render adequate care and prevent it from being in compliance with all the conditions of participation for hospitals,” Soccio’s letter said. “Consequently, we plan to terminate participation in the Medicare program if compliance is not achieved within the given timeframes specified.”
Soccio, in his letter, gave Sept. 1, exactly 11 months after Meridian took over the facility, as the date of its termination in Medicare. “CMS will monitor your progress in correcting the deficiencies cited,” he said. “You must submit by June 14 a plan of correction with acceptable time schedule.” His letter, while imposing a July 3 deadline for completion of corrective action, listed criteria Northlake must meet for recertification:
• The plan must address correcting the specific deficiency cited;
• The plan must address improving the processes that led to the deficiency cited;
• The plan must include procedures for implementing the acceptable plans of correction for each deficiency cited;
• A completion date for the implementation of the plans of correction for each deficiency cited;
• All plans of correction must take a QAPI (Quality Assurance/Performance Improvement) approach and address improvements in its systems in order to prevent the likelihood of the deficient practice reoccurring;
• The plan must include the monitoring and tracking procedures to ensure that the plan of correction is effective and that specific deficiency cited remains corrected and/or in compliance with the regulatory requirements;
• The plan must include the title of the person responsible for implementing the acceptable plan for correction.
Subsequent to Soccio’s letter, Kramer submitted a 43-page plan of correction to CMS on June 14, the deadline given by CMS.
As serious as the letter may have been to Northlake and as welcome as it may have been to those opposed to the privatization, it did leave one gigantic loophole for Jindal:
“The Louisiana Department of Health and Hospitals (DHH) will conduct a focus Medicare survey of your facility to assess your hospital’s compliance with the conditions of participation that were found out of compliance and assess your corrective actions,” Soccio’s letter said.
“Compliance must be achieved at the time of this revisit if further action is to be avoided. If you remain out of compliance at the time of your revisit, you can expect to receive another letter advising you of the continuation of the termination process and your appeal rights.
“You will again be asked to submit an acceptable plan of correction to our office and we may conduct one final revisit before the termination date,” it said.
That July 3 deadline was more than a week ago and a CMS spokesperson in Dallas said on Wednesday that no new paperwork had been received on Northlake by his office.
But allowing DHH to make the determination of compliance? This is the same agency that, under former Secretary Bruce Greenstein, was allowed to manipulate specifications to allow Greenstein’s former employer, CNSI, to bid on and win a $280 million contract that is now the subject of a federal investigation.
Greenstein may be gone but his successor, like Greenstein, was appointed by Jindal and does anyone really doubt that the governor maintains an iron grip over DHH? And Jindal doesn’t like to admit he ever made a mistake.
Anyone care to take any bets on the outcome of that DHH focus Medicare survey of Northlake?