April 29, 2011

UCMC retains Medicare services

After an investigation into an accidental death at the University of Chicago Medical Center (UCMC) placed its Medicare coverage in jeopardy, the hospital will continue to receive payments from the federally funded program.

The Chicago branch of the Centers for Medicare and Medicaid Services (CMMS) notified the UCMC in March that it was out of compliance with the centers’ conditions of participation, and a public notice issued April 13 cited “deficiencies... so serious they constitute an immediate threat to patient health and safety.”

The CMMS chose to investigate possible safety violations at the hospital after the March 16 death there of Chicago Sun-Times chairman James Tyree. Although the public notice did not detail the exact nature of the violations, Medicare payments for inpatient services were to cease on April 28.

Tyree died from an air embolism at the UCMC on March 16, two days after a physician’s assistant improperly removed a dialysis catheter. Tyree, 52 years old at the time, was being treated for pneumonia.

The hospital has since announced that coverage will continue after it submitted a plan laying out how it would comply with Medicare’s standards, the Chicago Tribune reported in an April 14 article, “Federal Government Acts After James Tyree’s Death.”

The investigation was conducted by the Illinois Department of Public Health and the Joint Commission, a hospital accrediting agency. It resulted in a “finding of immediate jeopardy due to the hospital’s failure to ensure that facility staff were adequately trained and showed competency in conducting such procedures,” the Tribune reported.

Some health care industry groups, including the U.S. Department of Health and Human Services, categorize the faulty catheter removal that triggered Tyree’s embolism as a “never event,” referring to its rarity and how easily it can be prevented.

But an April 14 UCMC statement asserted that the hospital is committed to preventing similar “unfortunate rare” accidents from occurring. The statement reads, “The investigations confirmed that all related personnel have appropriate training, experience, competency, and credentialing. Documentation, which was at the center of the investigation, has been improved and centralized.”

The Cook County Medical Examiner deemed the improper removal of Tyree’s catheter to be the primary cause of death, but also identified pneumonia and metastatic cancer as secondary causes. Tyree was diagnosed with stomach cancer last fall.

The near-loss of Medicare funding was not the hospital’s first source of controversy this year. Last week, UCMC nurses voiced their concern that staffing practices were inhibiting the quality of care, voting in favor of calling a strike once their current contract expires in June.

Funding from Medicaid, a federally-subsidized health insurance program for the poor, was not at risk.