LEWISTON — Central Maine Medical Center officials announced Thursday the hospital has fixed its problems, is now in compliance with Centers for Medicare & Medicaid Services and will not lose federal funding later this month.
“We’re excited,” said John Alexander, chief quality officer at Central Maine Healthcare, CMMC’s parent. “It’s certainly something that when you put in a lot of work and a lot of effort across the board, throughout the organization, it’s nice to feel that effort has been recognized — which it has been.”
CMS told the hospital earlier this year it would stop paying for its Medicare and Medicaid patients unless the hospital fixed issues uncovered by investigators. Such a move would have affected not only Medicare and Medicaid patients who use the hospital but also MaineCare recipients who use CMMC doctors or any of the nearly 50 clinics and medical practices affiliated with CMMC.
The hospital had until June 30 to address its issues or lose tens of millions of dollars a year, a large chunk of its annual revenue.
CMMC recently submitted its plan of correction to CMS.
In the 10-page plan, CMMC said it was hiring The Greeley Co., a Massachusetts-based consulting firm, to help correct its problems. The hospital also said it would clarify and enhance emergency department processes, including promptly evaluating anyone with cardiac chest pain, adding a triage nurse from 10 a.m. to 10 p.m. and deploying nurses or doctors to the emergency department’s waiting room during busy times.
The hospital also said it would change the way medical orders are issued for patients with spine problems, require training reviews for medical staff and require emergency nurses to show they understand spinal precautions, particularly the danger of raising the head of a spinal patient’s bed.
“I think it was really important for us to really stay focused on the patients through the entire process, and ensure that with every single patient encounter that we’re focused on high quality and safety for each and every patient,” Alexander said.
According to a letter sent Thursday to CMMC officials, investigators visited the hospital June 6 and 7 and found CMMC had corrected its issues and was in compliance with CMS.
“I think as an organization, we’ve learned from the process,” Alexander said. “And I think we’ll continue to be better, subsequently, as a result of it.”
A January investigation by CMS found a number of problems at CMMC, including the failure of hospital leaders to ensure that a life-changing medical error was thoroughly reviewed, the failure of hospital leaders to prevent that error from happening in the first place, the failure of the hospital to identify and address documentation disparities in that patient’s medical record and multiple failures by the hospital to stick to its own policy on patient grievances.
Much of the January report centered on a patient who had fallen and was brought to CMMC’s emergency department by ambulance on the morning of Oct. 4, 2018. At CMMC, according to the report, the patient complained of neck pain, back pain and numbness to the right half of his abdomen and down his right leg. A CT scan showed a skull fracture and a small fracture with fragments to one of the bones in his neck.
A trauma surgeon had the patient move his head and neck “in every possible way” to determine range of motion, “contrary to the standard of care for a patient with a known cervical fracture,” according to the report. Later, a nurse raised the head of the patient’s bed, forcing him to sit up at a 45-degree angle, while a family member protested that a doctor had ordered the patient to remain flat.
The patient was left paralyzed.
Additional investigations in March and April found more or continuing problems at CMMC, including failure to ensure medical records were accurate and failure to document whether patients had an advance directive to guide their treatment.
The March investigation also found CMMC, which includes a nationally accredited heart center, failed to care for a patient who arrived in the emergency department at 5:13 p.m. on Jan. 22 with chest pain, dizziness, shortness of breath and blood pressure so high it met the American Heart Association’s criteria for a “hypertensive crisis.”
The patient received an EKG within seven minutes, and that test came back normal. However, according to the report, nothing else happened for almost two hours. The patient never saw a medical provider and left.
“I would say there’s no question that not only do we feel like we’re in a better place, we are in a better place,” Alexander said. “We’re going to continue to strive toward the highest-possible quality and safety for the care of our community.”
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