Federal officials notified Parkland Hospital Wednesday that it had met the requirements of its Systems Improvement Agreement and is in substantial compliance with the Medicare Requirements for Hospitals, pulling the Dallas hospital back from the brink after two years of improvements and safety inspections.
“We have reviewed the survey findings and determined that your hospital is in substantial compliance with all applicable Medicare Conditions of Participation and [Emergency Medical Treatment and Labor Act],” CMS associate regional administrator Gerardo Ortiz said in a letter to Parkland interim CEO Robert Smith. “Therefore CMS has determined that your hospital has fulfilled the requirements of the SIA and will rescind the pending termination imposed on August 9, 2011.”
The SIA went into effect on Sept. 27, 2011, and it required the hospital to retain independent experts to conduct a hospital-wide analysis of Parkland’s operations, in addition to developing a plan to bring the hospital in compliance with Medicare requirements. In all, the hospital was required to fix 499 issues. The agreement then required the hospital to undergo three onsite reviews of its operations to determine that compliance; those reviews took place throughout June and July, and were performed by Medicare surveyors from the Texas Department of State Health Services.
“Since September 2011, Parkland and the independent consultative experts have worked to make sure that care at Parkland reflects a focus on patient safety,” CMS deputy regional administrator David Wright said in an email to the media. “The successful completion of the Systems Improvement Agreement places Parkland in the best position to have a sustainable culture of patient safety.”
The hospital, Smith said, is now cleaner, more organized, and better structured. Communication has improved, he said, and the hospital places more weight on metrics and detail. He stressed structure, calmness, and discipline, three things that will help improve safety.
Relief and optimism filled the hospital’s auditorium during the announcement Wednesday, and several employees fought back tears. In the hallways, two employees conversed.
“Are you going to the press conference?”
“Press conference for what?”
“Just go to the auditorium.”
After two years—and, by hospital CFO Ted Shaw’s measure, $75 million in compliance measures—Parkland was on the upswing.
“We’ve gone from discussions of downsizing plans and talking about closing Parkland, to having what I think could become the best public hospital in America,” Dallas County Judge Clay Jenkins told a crowd of hospital officials and staff, elected officials, and media members Wednesday afternoon. “…the people that are responsible for this today are not the elected officials or the consultants, it’s the men and women of Parkland.”
Ortiz’s letter, while overwhelmingly positive, briefly mentioned corrective actions that still need to take place to remedy “deficient practices” before the hospital is completely removed from CMS’s survey jurisdiction. When asked, interim CEO Smith called the language “part of the normal process,” and expects the actions to be completed within the next two weeks.
“The focus remains on a relentless pursuit of excellence,” he said.
