- The Washington Times - Tuesday, March 29, 2005

The U.S. Centers for Medicare and Medicaid Services has said it plans to take action against St. Elizabeths Hospital in Southeast, unless “serious” problems uncovered in a recent review of medical records are corrected.

Federal health-enforcement regulators cited deficiencies in the way that medical staff devised treatment plans for patients and maintained medical records, according to a Jan. 24 letter from the agency to the city-run mental institution.

The letter was included among hundreds of legal documents, correspondence and e-mails in a legal filing Friday by University Legal Services Inc., a federally designated protection agency that advocates for people with disabilities in the District.

The group earlier last week filed a lawsuit against St. Elizabeths and the District over conditions at the hospital, saying staffing and management failures have led to the deaths of several patients and overcrowded and unsanitary conditions for others.

D.C. Department of Mental Health officials declined to comment yesterday and referred questions last week about the lawsuit to the D.C. Office of the Attorney General. Officials for that agency say they’re reviewing the complaint by University Legal Services.

The letter from the Centers for Medicare and Medicaid Services contrasts with the D.C. government’s account of the federal survey. The D.C. Department of Mental Health, which oversees the hospital, announced in a Dec. 17 press release that the federal survey team advised that “no conditions would be placed on the hospital’s operations.”

However, five weeks later, federal regulators warned the hospital in a sternly worded letter that St. Elizabeths was in danger of being terminated from the Medicare program.

“If continued noncompliance with the conditions of participation is found, we will give you notice of termination and advise you of your appeal rights,” wrote Dale Van Wieren of the enforcement branch of the Centers for Medicare and Medicaid Services.

“These deficiencies have been determined to be of such a serious nature as to substantially limit the hospital’s capacity to provide adequate care,” he wrote.

Sharon Graham, a spokeswoman for the Centers for Medicare and Medicaid Services, yesterday said federal inspectors plan to visit the hospital again soon “because we still have some outstanding questions.”

“I wouldn’t say this is all completely behind them,” she said.

Last week, University Legal Services sought an injunction to force the hospital to immediately hire more staff and “ensure safe and sanitary conditions,” including setting up pest- and insect-control programs.

Mary Nell Clark, an attorney for the group, yesterday said a hearing on the request has not been scheduled.

Meanwhile, staffing shortages continue to surface as a concern. Edward J. Smith, staff attorney for the D.C. Nurses Association, yesterday said hospital officials indicated in a labor meeting early in 2004 that 35 more nurses should be hired to fully staff St. Elizabeths.

“They are making strides, and it’s not easy to hire at St. Elizabeths,” Mr. Smith said. “But we think the department can do more. The bottom line is that there needs to be more nurses there.”

The District has plans to replace St. Elizabeths by 2007, according to the city’s proposed 2006 budget.

Earlier this month, city officials moved ahead on the first of eight contracts to build a new hospital. Forney Enterprises Inc. won a $2.3 million contract for the construction of early road and utilities work.

In a letter to University Legal Services in October, Martha B. Knisley, director of the Department of Mental Health, said St. Elizabeths is trying to relocate some of its 470 patients into community settings once they no longer require inpatient psychiatric care.

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