The hospital could also face state and federal financial penalties.
The primary focus of the second review will be to determine whether the problems in infection control and emergency room care have been corrected. "Once that's complete, they may also find compliance with other deficiencies," explained David Wright, acting deputy regional administrator for CMS in an e-mail exchange.
"If there is a finding of a new or continuing immediate and serious threat, termination of the hospital's Medicare and Medicaid provider agreement would take place on September 2."
If the immediate and serious threat is removed, but there is still non-compliance with other deficiencies, then the termination date "will be extended 67-days and Parkland will provide another corrective action plan," said Wright. "Surveyors would then go onsite for one final revisit to determine compliance with all of our requirements."
Even if Parkland Memorial is found to be in full compliance, the hospital may still face state and federal fines. The Texas Department of State Health Services has the authority to take enforcement action, including assessing financial penalties, but it is "too soon to know" what steps the state might take.
On the federal side the Office of the Inspector in the U.S. Department of Health and Human Services will determine if any fines will be levied related to violations of the Emergency Medical Treatment and Labor Act. CMS will not forward any survey records to the OIG until all of the current deficiencies are resolved.
In July the OIG assessed Parkland Memorial a $50,000 fine — the maximum allowed — for a 2008 case that involved EMTALA violations for failing to properly treat a patient who died of a heart attack after remaining in the ER without care for more than 15 hours.