Skip to main content

As CMS Approves Parkland's CAP, Board Chair Resigns

 |  By Margaret@example.com  
   March 01, 2012

The Dallas office of the Centers for Medicare & Medicaid Services on Wednesday approved the most recent corrective action plan submitted by the consultants for Parkland Health and Hospital System. The CAP is in response to the 300-page gap analysis report prepared by Alvarez & Marsal Healthcare Industry Group, which details serious, ongoing deficiencies at Parkland.

The CAP will not be publically released by CMS until it has been reviewed by the CMS Freedom of Information Group (FIG) office in Baltimore. There is no timeline for the release. The FIG office is still reviewing the gap analysis report, which it received in early February.

Parkland is unlikely to release the CAP on its own accord. Hospital officials cited legal concerns in declining to make the gap analysis document available.  A press statement released Wednesday night by Parkland refers to the CAP and accompanying documents as "privileged documents."

In that statement, Thomas Royer, MD, Parkland's interim CEO notes that hospital officials have been working closely with A&M and many improvements are already underway. Key changes include improvements to nursing reorganization, the use of a mock survey team to monitor the implementation of all improvement plans, and enhanced leadership oversight to assure the sustainability of the plans.

"The Corrective Action Plan is comprehensive and designed to prepare us for a successful resurvey by CMS. It identifies areas of change that still lie ahead and we must fully implement the recommendations outlined in the plan," said Dr. Royer. "These are not temporary changes, but rather will be permanently incorporated into our operations to help assure positive, sustainable change that will improve our safety, quality of care and the patient experience at Parkland."

He added that the safety-net hospital will "provide monthly monitoring reports to the public that will track its progress toward full compliance" of state and federal requirements. "We will keep the public informed of our progress toward complete and sustainable compliance."

Board chair resigns

The approval of the CAP plan comes on the heels of news that Lauren McDonald, MD, the high-profile chair of Parkland's governing board, resigned on Tuesday at the end of a lengthy board of managers meeting.

McDonald has served 13 years on the board, including six as the board chair. Her resignation is effective March 6. Her replacement is expected to be appointed next week by the Dallas County Commissioners Court, which oversees Parkland's board.

In a statement released to Parkland employees McDonald said her decision to leave "is rooted in my personal life, with an aging parent who needs me and patients to whom I would like to dedicate more time to through my medical practice."

She made only a passing reference to Parkland's ongoing problems saying, "We have faced tremendous challenges in the past few years, but I know of no other community of people better able to face down serious challenges and overcome them."

Although McDonald is widely credited with increasing Parkland's status within the Dallas community and building support for its $1 billion replacement hospital, she leaves the board as the safety-net facility struggles to correct serious deficiencies that have endangered patients and put its Medicare and Medicaid funding at risk.

Since September 2011, Parkland has operated under a rare systems improvement agreement with the Dallas office of the Centers for Medicare & Medicaid Services. The 19-month SIA requires the hospital to work with Alvarez & Marsal to correct deficiencies and improve patient care.

McDonald's resignation follows a string of departures that have left much of Parkland's leadership in disarray. COO John Haupert left to head Grady Hospital in Atlanta and the head of human resources resigned. The contract with longtime CEO Ron Anderson, MD, was not renewed when it expired on Dec. 31.

At that time, McDonald told HealthLeaders Media that there was no internal heir apparent to succeed Anderson. In November the board of managers signed a six-month contract with Thomas Royer, MD, the retired CEO of Christus Health, to serve as Parkland's interim CEO. He has replaced the chief nursing officer and appointed an interim director of infection prevention following the director's resignation.

Royer appeared to have free rein. In a recent interview he detailed for HealthLeaders Media some of the changes he had recently implemented, including the hiring of an implementation officer, John Beall, to make sure the SIA stays on track.

However, Beall's tenure was short lived. Within days Royer announced Beall's departure saying "after further deliberation with the board of managers and our consultants at Alvarez & Marsal, we collectively came to the conclusion that Parkland would be better served by engaging a consulting expert in project management. Mr. Beall informed me that this was not the position he desired and some members of the board simultaneously expressed the view that, given this change, we should examine other applicants."

In a statement, Royer downplayed the episode as "a regrettable distraction," but the misstep was noted.

County commissioners contacted by HealthLeaders Media declined to directly comment on Dr. Royer's performance or the Beall situation. In an e-mail statement Dallas County Judge Clay Jenkins would say only "I am committed to working with all Parkland leaders to help Parkland Hospital successfully complete its action plan and come out of the system improvement agreement as a safe, compliant hospital and stronger institution."

See Also:
Parkland Signs Improvement Agreement, Remains Open
CMS Compromise Gives Parkland Reprieve
Immediate Jeopardy at Parkland Puts VBP Incentive Pay in Peril
Parkland: Leadership Change Unrelated to Report of Deficiencies
Parkland Hospital Audits Raise Troubling Questions

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
Twitter

Tagged Under:


Get the latest on healthcare leadership in your inbox.