- Associated Press - Tuesday, August 18, 2015

DALLAS (AP) - When Parkland Memorial Hospital moves across Harry Hines Boulevard, it will bring along about 600 patients, 11,000 employees and countless pieces of medical equipment.

What hospital leaders don’t want to transport is the controversy that has dogged Dallas County’s public hospital for the past four years.

That will be impossible.

The Dallas Morning News (https://bit.ly/1MAPE3M ) reports while Parkland satisfied many of the issues that threatened its federal funding, it remains under continued scrutiny by the federal government. The Dallas County public hospital is two years into a five-year corporate integrity agreement that has focused on billing problems and patient-safety concerns.

The agreement with the U.S. Department of Health and Human Services requires hospital employees to follow government rules, starting with a code of conduct and ethics that had to be signed by each worker. An annual refresher course also is required.

“Parkland is making progress completing the requirements” of the agreement, said Paul Leslie, the hospital’s general counsel. “None of us are trying to suggest that everything’s perfect. There’s always room for improvement.”

It’s not clear if the move to the new hospital could complicate any aspect of the agreement. Hospital staff will have to learn new work procedures in a more modern facility.

“The staff is going to have to adjust to new work flows, but around a better and safer environment,” said Dr. Fred Cerise, Parkland’s chief executive officer. “It’s going to put us in a better position.”

Corporate integrity agreements, which typically require tighter government scrutiny of billing processes, are fairly common. But Parkland was also forced to accept a quality-of-care integrity agreement requiring that patient-safety measures be implemented.

In 2013, only nine other U.S. health care facilities - including nursing homes and dental services - had been forced into such agreements since 2010, according to the HHS inspector general.

Parkland’s agreement grew out of a lawsuit filed by a former physician resident, who trained at the hospital in physical medicine and rehabilitation. He alleged that he was required to perform consultations on patients who did not need physical rehab. The hospital would bill the government for the unnecessary procedures, he said.

The U.S. attorney’s office in Dallas substantiated those claims in 2012, and Parkland agreed to repay $1.4 million to the Centers for Medicare and Medicaid Services. The hospital admitted no wrongdoing.

But Parkland had to hire two independent consultants to oversee billing and quality issues through 2018. As of the end of fiscal 2014, the hospital had spent $7.2 million for such the oversight and related costs.

Cerise, a longtime Louisiana hospital official and state health executive, noted that this was his first experience handling such an agreement with the federal government.

Cerise and Leslie declined to describe any problems that had been uncovered at Parkland so far. They agreed, however, that all issues are being addressed but are not considered “systemic.”

Unlike the previous improvements completed in 2013 for CMS, Parkland is keeping the latest correction effort hidden from public view. This time, monthly progress reports are discussed behind closed doors. Annual reports that describe Parkland’s shortcomings likewise are missing key details.

Parkland’s first annual report, covering May 2013 through May 2014, was sent to HHS last September. The Dallas Morning News asked for a copy under the federal Freedom of Information Act.

When HHS responded seven months later, the 1,331-page report was missing all but 272 pages. Most of the information on those pages was obscured by gray blocks.

For example, eight pages were devoted to a summary of reportable billing issues, including instances of “substantial overpayment.” All were blank as were eight pages listing reportable patient quality issues.

The information was withheld because it constituted “trade secrets and commercial or financial information obtained from a person that is privileged or confidential,” said the letter from HHS’ inspector general’s office. Secondly, releasing the information “would constitute a clearly unwarranted invasion of personal privacy,” it added.

Leslie said Parkland was not trying to cover up anything the public needed to know. The hospital was simply required to provide the information to the government and it was doing so.

“I hear your concern that there’s a lot blank (pages) there,” he said. “It looks like there’s a lot of stuff.”

___

Information from: The Dallas Morning News, https://www.dallasnews.com


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