The University Medical Center released a plan of correction yesterday to improve patient safety and address other patient-care concerns.
The plan was prompted by events last spring, when a patient care assistant, Rudolph T. Johnson Jr., was arrested for allegedly raping two patients.
Following the two alleged assaults and reports that psychiatric restraints were being used improperly, the Centers for Medicare and Medicaid Services (CMS) put the hospital on immediate jeopardy status.
On July 12, reviewers from the Virginia State Health Department conducted a two-week inspection on behalf of the CMS, the federal agency that administers Medicare.
"Immediate jeopardy [status] was relieved in early July but triggered a full validation survey in all conditions of participation in all patient-care areas," said Pamela F. Cipriano, the hospital's chief clinical officer.
Problems in the hospital's psychiatric ward have since been alleviated, but a CMS report issued Sept. 4 found deficiencies in the Medical Center following the comprehensive hospital inspection. The CMS gave the Medical Center 10 days to outline measures it would take to remedy the hospital's present conditions.
The plan of correction identifies 16 problem areas - not a surprising number, considering the size of the hospital, University spokeswoman Louise Dudley said.
"Almost all of them have been corrected already," she said.
The report listed incomplete documentation on hospital records as one problem area. The CMS report concluded that many of the hospital's practices did not coincide completely with the hospital's actual written policies.
For example, in the area titled "Medical Staff," the report states that "resident physicians performed surgical procedures without documentation that an attending physician was present," and that "existing policy did not specify situations under which a resident might perform procedures."
In some circumstances, it is in fact acceptable and necessary for residents, or physicians going through specialized training, to attend to patients without a supervising physician, Dudley said. However, the hospital's written policies needed to be revised and updated to allow for any discrepancies, she said.
According to Medical Center spokeswoman Marguerite Beck, the plan consists of three tiers of standards to be met by Medical Center personnel. The first tier lists the most severe violations, and the third tier consists of the least severe infractions.
The report illustrates that the Medical Center had violated 1 out of 23 standards in the first tier, 2 out of 77 in the second tier, and 13 out of 297 elements in the third tier.
"We are actively implementing measures to improve patient care and safety," Cipriano said. Along with listing the hospital's infractions, the plan also states the corrections necessary to meet CMS approval, many of which already have been implemented.
Medical Center officials hope to receive feedback from the CMS by Oct. 6 regarding the corrective actions that they have taken. They do not expect an order to re-evaluate their practices, Dudley said.
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