, Corbin, KY

August 14, 2013

Hospital addresses compliance issues

The Times-Tribune

CORBIN — By Charlotte Underwood / Staff Writer

Barely two months after resolving issues that could have resulted in the loss of its status as a Medicare and Medicaid provider, Baptist Health Corbin hospital came under scrutiny once again, according to the Kentucky Cabinet for Health and Family Services Public Information Officer Beth Fisher.

The first investigation occurred in May and came after the death of an elderly patient. However, Fisher said she couldn’t yet provide details of the most recent investigation by the Cabinet’s Office of Inspector General.

CEO/President of Baptist Health Corbin Larry Gray released a statement acknowledging the most recent investigation, saying the concerns by the federal Centers for Medicare and Medicaid Services had been addressed and the hospital’s plan of correction had been accepted.

“Baptist Health Corbin has recently undergone another survey and some additional procedural and process concerns were cited. Again, the hospital has undertaken measures to assure surveyors of its compliance and has submitted a credible allegation of compliance as part of its ongoing effort to provide quality care to its patients,” Gray said, adding that “Baptist Health Corbin learned today that the Centers for Medicare and Medicaid Services accepted the hospital’s plan of correction.”

 Details of the most recent investigation have not been released yet by the Office of the Inspector General as the investigation is still pending, according to Fisher.

Documents about the May investigation were obtained through an open records request by the Times-Tribune.

That investigation found a “serious deficiency” following the death of a 90-year-old patient on April 24, according to documents from the Kentucky Cabinet for Health and Family Services.

State documents indicate a nurse didn’t obtain a required doctor’s order before placing a nasal tube that carries food and medicine to the stomach. The patient “turned blue and stopped breathing during the procedure and had to be placed on a ventilator.” She died when the ventilator was removed several days later, documents indicate.

 The investigation found the hospital failed to ensure that its staff took “appropriate action” when the patient experienced a “change in condition” after the tube was inserted.

Also according to state documents, the hospital acknowledged the registered nurse did not get a doctor’s order before the tube was inserted and the nurse was aware of the policy requiring the doctor’s order.

In order to avoid possible termination as a Medicare provider, the letter states the hospital had to take corrective action. As part of that action, the nurse who inserted the tube was placed on administrative duties as of May 8 and was to continue those duties until the nurse completed 40 hours of classroom and clinical lab retraining on the tube placement process as well as assessment and reassessment policy, the documents showed. After this training, the nurse was to resume clinical care, initially under the direct supervision by the charge nurse.

The documents also said the hospital revised policies regarding the placement of nasal tubes, including verification by registered nurses that a physician’s order has been obtained prior to the tube’s insertion.

According to the hospital’s plan of correction submitted to the state, “As of May 20th, the revised policy has been implemented and all clinical nursing staff members providing patient care have been educated on the revised policy.”

During a follow-up visit to the hospital on May 24, the Division of Health Care determined the facility was in compliance with all conditions of participation, according to a letter sent to Gray.