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Methodist Dallas Corrective Action Plan Accepted

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

Officials at Methodist Dallas addressed each deficiency separately and identified the steps that will be or have already been taken to correct the problems, including:

  • Revising staff rules to require medical screening to be performed by a qualified medical professional
  • Enforcing infection control procedures to reduce contamination
  • Implementing daily audits of medical records to ensure compliance with documentation of verbal and telephone orders
  • Enforcing requirements that directions for administering medications be made in writing

A follow-up review is expected to verify removal of the immediate jeopardy conditions at Methodist Dallas. Bob Moos, spokesperson for the Dallas office of CMS, said in an email to HealthLeaders Media that if the immediate jeopardy conditions continue, the hospital’s termination from the Medicare program will be effective September 23. However, “if the hospital removes the immediate jeopardy conditions, a full Medicare survey of all of the conditions of participation will be scheduled within 60 days. If any condition-level deficiencies remain following that survey, the hospital will again be asked to submit a corrective action plan, and the surveyors will return for one final revisit,” Moos wrote.

In a statement posted on its website, Methodist Dallas officials said medical center personnel “immediately began addressing the findings shared by the surveyor even before the completion of the survey, including policy and procedure updates relating to the emergency department. Most of the proposed changes were corrected either during the survey or have been implemented based on verbal feedback received from the surveyor.”


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