CMS surveyors visited Galesburg (Ill.) Cottage Hospital four times in the last two months of 2021 before terminating the hospital's Medicare contract in January.
CMS terminated Galesburg Cottage Hospital's Medicare contract Jan. 14, meaning the hospital will not receive Medicare reimbursement for services provided to patients after that date. The agency pulled the hospital's funding for failing to comply with several Medicare rules, including those related to patient rights and nursing services.
CMS concluded that the hospital was understaffed and mismanaged and survey reports detail the patient safety and staffing issues the hospital was facing last year.
The hospital laid off 128 employees between March and November, according to survey documents CMS shared with Becker's Hospital Review. During a visit to the hospital in November, CMS investigators found a "Hospital Termination List" that was used to track the employees who had been laid off or quit, including intensive care unit and emergency department nurses.
A registered nurse told surveyors Nov. 16 that key staff were being terminated.
"The director of nursing works shifts all the time because there is no coverage," the nurse told CMS. "We have a decreased volume [of patients] because we have no staff."
The CMS reports also noted that key leadership positions were vacant. As of Nov. 19, the hospital lacked a COO and directors for the emergency department, surgical services, nutrition services, materials management, accounting, informational technology, imaging, health information management and case management.
Surveyors found expired medicine in the hospital's pharmacy on Dec. 7. The hospital's director of pharmacy told CMS surveyors that the medications — lidocaine and definity — were expired and shouldn't have been available for use, according to documents CMS shared with WQAD.
A pharmacist and a pharmacist technician at the hospital did not have documentation of required competency testing. The human resources department was aware of the issues but the employees were still permitted to perform their jobs, according to CMS documents cited by WQAD.
Survey reports also shed light on patient safety issues, including several instances of patients not receiving proper care or check-ins.
Psychiatric patients who are required to have checkups every 15 minutes sometimes missed several checkups per day at Galesburg Cottage Hospital. The report detailed one instance involving a patient diagnosed with dementia and behavioral disturbance who missed four checkups in one day.
In another instance, the hospital couldn't provide documentation of the required face-to-face checkup of a patient who was placed in four-point leather restraints. A review of five employees' personnel files showed four of them were missing documentation required for restraint training, according to WQAD.
The hospital failed to ensure there were enough qualified staff available to provide safe patient care, CMS said in the report provided to WQAD.
Galesburg Cottage Hospital abruptly closed Jan. 8. Hospital CEO Sanjay Sharma, PhD, said the facility was shut down because of CMS' decision to terminate the hospital's Medicare contract.
Dr. Sharma said he planned to appeal CMS' findings. As of Feb. 10, the appeals process had not been initiated, CMS told WQAD.