Medicare regulators: NHRMC remains “under review”

WILMINGTON, N.C. (WECT) - A spokesperson for the Centers for Medicare and Medicaid Services (CMS) confirms regulators went back to New Hanover Regional Medical Center on August 11 to do a follow up inspection, following a June visit that found serious “deficiencies” at the hospital that put patient health and safety at risk.

While hospital officials told WECT Wednesday they got verbal assurance from the inspector on August 11 that the hospital had sufficiently rectified issues on the reinspection, federal regulators stopped short of saying the hospital is in the clear.

When asked about the fact that the latest visit is still under review, a Novant NHRMC Spokesperson confirmed that is their understanding as well.

“We agree with what you heard from CMS, it aligns with what we said yesterday. We have verbal confirmation the action plans are accepted and working and we are not in immediate jeopardy. It’s still under consideration until we get the letter.”

CMS notified Novant Health New Hanover Regional Medical Center in July that it was in jeopardy of losing its Medicare contract if it did not address a number of serious patient safety concerns observed by state compliance officers during a visit on June 29, 2022.

Specifically, a letter from federal officials said that NHRMC did not meet “Conditions of Participation” regarding Patient Rights, Nursing Services, Emergency Services, Quality Assessment and Performance Improvement, and Governing Body.

“When a hospital is found to be out of compliance with one or more Conditions of Participation, and immediate or serious threat to patient health and safety exists, a determination must be made that the facility no longer meets the requirements for participation as a provider of services in the Medicare program,” the letter to New Hanover Regional Medical Center’s CEO Shelbourn Stevens reads.

“If the hospital is found to have significant deficiencies and therefore fails to comply with the Conditions of Participation, we are required to keep the hospital under State Agency monitoring until there is full compliance with all of the Medicare Conditions of Participation. Such a determination has been made in the case of Novant Health New Hanover Regional Medical Center and accordingly, the Medicare provider agreement between Novant Health New Hanover Regional Medical Center and the Secretary of the Department of Health and Human Services is being terminated. This termination will be effective August 12, 2022,” the letter continues.

The letter warned that Medicare would not make payments for patients who had to be hospitalized after August 12, and could also impact payment for extended care of patients admitted before August 12. Officials note in the July 20 letter that they will publish a public notice prior to the termination date, but WECT is unaware of any public notice that was published. The Centers for Medicare and Medicaid Services website does not list any action connected to NHRMC on its Termination Notices page.

“Termination can only be averted by correction of these deficiencies by August 12, 2022. Should we not hear from you, we will assume that the situation has not been corrected. If you believe that compliance has been achieved, you should notify CMS and the North Carolina State Survey Agency in writing on or before July 25, 2022, describing in detail the specific corrective measures taken to resolve these problems and include acceptable completion dates,” the letter reads.

Hospital officials say they narrowly avoided the contract termination by hiring hundreds of nurses since the peak of their nursing shortage to address the issues inspectors identified. Most of the newest hires were travel nurses.

“We knew that we had made the necessary changes to meet the deficiencies that they gave us. So we were very confident. We were just at the mercy of the state of their timing to come back. So we were very confident that we were going to get out of this,” Novant Health NHRMC President Shelbourn Stevens told WECT.

Hospital executives said at a press conference they were back in good standing with CMS, and just waiting for written confirmation that they were no longer under threat of losing their Medicare contract. But when WECT asked CMS for an update on the outcome of the reinspection, the answer was less clear. In an email to the station late Thursday night, a CMS spokesperson said, “The revisit findings are currently under review. More information will be available once that review is complete.”

NHRMC officials said issues like this used to be pretty rare for a hospital to have to deal with, but have become more common in recent years.

“Prior to the pandemic and the great resignation, it was relatively rare,” NHRMC Chief Clinical Officer Dr. West Paul said. “Since the pandemic, if you look at states other than North Carolina, it’s becoming more common, as hospitals are really trying to accomplish quality care with less staff, and really less experienced staff. Because a lot of the people we have lost have been those experienced nurses that have been traveling. So yeah, it is becoming more common just in this state. I haven’t seen three hospitals at one time be under the scrutiny, ever.”

Dr. Paul was referring to two other hospitals, UNC and a hospital in Wilson, that received similar notices recently that they were at risk of losing their Medicare funding.

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