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CMS Compromise Gives Parkland Reprieve

Margaret Dick Tocknell, for HealthLeaders Media, September 12, 2011

Parkland Memorial Hospital has agreed to bring in an outside consultant to “craft a plan of improvement” for the Dallas hospital. The move is among the requirements of the systems improvement agreement that hospital officials will sign by September 15 with the Centers for Medicare & Medicaid Services.

The agreement is the latest effort by Parkland to protect its participation in Medicare and Medicaid. The $417 million funding from both programs represents about 35% of Parkland’s total annual budget. The programs have been at risk since a July review by federal and state officials uncovered immediate jeopardy deficiencies in the hospital’s infection control and emergency department care. The safety net hospital submitted a corrective action plan to address the issues and a follow-up review was conducted late in August.

That review identified continuing deficiencies in emergency care that were deemed to still be at the immediate jeopardy level. However, problems in infection control were downgraded from “serious” to “significant.”

Based on the follow-up review findings, the Dallas office of CMS sent Parkland CEO Ron Anderson a letter on September 9th stating that Parkland “no longer meets the requirements for participation in the Medicare program” and that its Medicare agreement will be terminated on September 30th.

However, late Friday afternoon, CMS released an e-mail statement that acknowledged the “devastating impact the termination of Parkland Hospital would have on the citizens of Dallas County and the Medicare/Medicaid patients it serves.” To ensure that Parkland “promptly and substantively remedies the ongoing quality concerns identified by the recent onsite surveys, CMS has provided Parkland with an opportunity to enter into a systems improvement agreement,” the e-mail said.

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2 comments on "CMS Compromise Gives Parkland Reprieve"


Hannibal (9/13/2011 at 3:34 AM)
I think the authors of this article should make it clear that Parkland was indeed terminated from participating in Medicare programs as of Sept. 30 of this month. So, Parkland is the largest hospital in the history of the US to be terminated from Medicare, surpassing the previous title holder, King/Drew in LA. CMS only allowed a compromise for "probationary" terms for Parkland to continue to operate by forcing the hospital into a "service improvement agreement." That compromise occurred because Parkland is the only public hospital serving the Dallas area. If the hospital closed, then there were no other safety net hospitals to pick up the slack. The point is that Parkland was deemed such a bad hospital that it would have closed down, if it wouldn't have caused a catastophic collapse of public health services in Dallas.

Doug Keiller (9/12/2011 at 3:03 PM)
Public hospitals serving large Latino populations (Dallas, Houston, LA, Chicago, Phoenix, etc.) are a critical public resources, but face huge operating challenges. One cost-effective strategy the CMS-approved consultants should explore is improving ER and OB operating efficiency by training and sourcing more fully bilingual staff. Currently, a large portion of patient conversations require interpretation, which slows service delivery by up to 50%. Bilingual staff (RNs, etc.) have been shown to triage ER patients faster, for example, reducing wait times, and improving initial assessment accuracy. In OB, speeding patient communication with bilingual staff can free up time to focus on infection control and other safety procedures.