Notice of Medicare termination is devastating to a healthcare system's bottom line and reputation. A hospital faced loss of Medicare and Medicaid funding as a result of a Centers for Medicare and Medicaid Services (CMS) survey citing multiple immediate jeopardy and condition-level deficiencies. The CMS surveyors also found that action plans the organization had previously submitted in its plan of correction, following a prior survey, had been ineffective in resolving serious issues of noncompliance.
A team of experts from ECRI Institute conducted a gap analysis of the hospital's compliance with the CMS conditions of participation. The gap analysis identified root causes for the deficiencies. From the root causes identified, ECRI Institute developed an action plan to correct deficiencies and prepare for the CMS validation survey.
ECRI Institute's experts helped the hospital implement the action plan. Then, after the initial implementation, ECRI Institute continued to provide monitoring throughout the year. The experts validated progress and prioritized remaining steps to help the hospital become fully compliant.
At the end of the monitoring period, CMS surveyors performed a validation survey with no immediate jeopardy or condition-level findings. Therefore, the hospital was able to continue patient care with improved patient safety and quality. Beyond this successful survey, ECRI Institute helped the hospital put processes in place, to ensure that the patient safety and quality of care achieved during this process were sustained and improved.