Before CFVMC could respond to that letter, CMS received a complaint allegation related to a patient who died in November within an hour of his involuntary discharge from Cape Fear Valley. According to CMS documents, the nursing staff failed to reassess the patient after dispensing pain medication and at discharge, and failed to initiate the hospital's rapid response team after receiving telephone calls from two sources concerned about the patient's condition.
A survey noted additional deficiencies in the categories of patient rights, nursing services, and patient rights. The medical center's CAP, submitted on December 8, noted the hiring of The Greeley Company.
A second complaint allegation related to the death of a patient in CFVMC's telemetry unit was received in December. A complaint investigation conducted by CMS between December 20 and December 22 found that the nursing staff failed to report, respond and assess a change in the patient's heart monitor.
In a January 3, 2012 letter, CMS said the follow-up survey found the medical center in compliance for emergency services, quality assessment and performance, and physical environment, but that it remained in immediate jeopardy status for governing body, patient rights, and nursing services.
Parkland Memorial Hospital in Dallas faced a similar set of circumstances late last summer and signed an SIA in late September. At that time, officials in the Dallas office at CMS said Parkland was provided with "an opportunity to enter into a systems improvement agreement" in recognition of the hospital's importance to the community it serves.