Luis officials mum as future hangs in balance

ST. CROIX – The U.S. Centers for Medicare and Medicaid Services is scheduled to wrap up its weeklong inspection of Luis Hospital today, with an exit conference to discuss the survey before inspectors leave.

The hospital’s certification is on the line – the inspection is supposed to determine whether or not the hospital will get to keep it.

Without certification, Luis Hospital would not be reimbursed for treating Medicare and Medicaid patients, who comprise a significant portion of the hospital’s book of business.

Officials have said that insurance companies likely would follow suit if the hospital is decertified.

On Thursday night, Luis Hospital board chairman Troy deChabert-Schuster said the survey is progressing well, although he declined to speculate on the outcome.

Acting Chief Executive Officer Ken Okolo and other executives have met with the inspectors this week, he said.

Okolo declined a Daily News request for an interview on Thursday.

“They’ve been conducting a very thorough survey of the entire hospital,” deChabert-Schuster said Thursday. “The feedback that I have received has been positive thus far. However, we await the exit conference tomorrow, and we remain extremely optimistic that we will have a positive outcome.”

CMS has had Luis Hospital under the regulatory microscope for years.

The hospital has been under threat of decertification at least since 2011. Since that time, it has come up with plans of correction and first one and then another Systems Improvement Agreement – all aimed at bringing conditions at the hospital up to the basic standard of care that CMS requires to participate in its programs.

DeChabert-Schuster said that today, the hospital will have a more clear picture about how the survey went.

Officials are hopeful, he said.

“The governing board of directors are very happy that the survey is taking place now – and we hope to be able to present a wonderful Christmas gift of good news to the people of St. Croix,” he said.

CMS notified Luis Hospital that it would be decertified in October 2014 because of the hospital’s repeated inability to meet basic standards of care – coupled with the findings of a summer 2014 CMS inspection.

That survey uncovered myriad deficiencies, with the report outlining a number of incidents in which the hospital’s failure to meet standards caused actual harm to patients.

Luis Hospital officials traveled stateside to plead with CMS for one more chance, and ultimately, the federal agency granted the reprieve, giving the hospital six weeks to come up with a Systems Improvement Agreement and nine months after the agreement was signed to make improvements and fix the problems.

The decertification was held in abeyance during that time.

Although an inspection was supposed to occur toward the end of the nine months, it did not happen, and CMS in September extended the Systems Improvement Agreement until the end of the year.

Now, with the final inspection going on, the hospital must prove that it has fixed longstanding problems and can sustain lasting change.

Information from CMS suggests that involuntary decertification of hospitals by the agency is a relatively rare occurrence.

CMS Region II spokeswoman Reina Becnel provided information in response to a Daily News inquiry showing that five hospitals across the country have been decertified by CMS so far this year, and four were decertified in 2014.

Attempts by The Daily News to find out from CMS the status of those hospitals and whether they had attempted to get recertified had mixed results.

At least two of the facilities had closed, according to media reports.

At least one remained opened but decertified.

At least one was certified anew this year, according to CMS.

Some remained decertified, but CMS did not have information immediately available about whether they had closed.

George Pink, a lead investigator with the University of North Carolina’s Cecil G. Sheps Center for Health Services Research, said that “very few” of the 100 or so rural hospitals that have closed across the nation since 2010 have closed because of quality or safety violations. More often that not, the problem that leads to closures in rural hospitals is lack of money, he said.

In fact, Pink said, quality and safety issues come in a distant third to longstanding financial performance problems and mergers and acquisitions as reasons for rural hospital closures.

As for CMS certification, a Systems Improvement Agreement can be an alternative to termination, allowing a facility that is under threat of decertification to continue to operate while working to correct the deficiencies over a fixed period of time, before a final CMS inspection determines whether the hospital meets the agency’s Conditions of Participation.

It wasn’t clear on Thursday how many hospitals may be operating under Systems Improvement Agreements with CMS.

The Daily News asked Becnel on Wednesday for information about CMS certifications, including how many hospitals CMS certifies nationwide and how many are operating under Systems Improvement Agreements.

She said Thursday that she was still trying to gather the information. (VI Daily News)

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