UCI Medical Center put under state supervision

Among the most serious failings cited by federal inspectors was doctors' practice of filling out medical records in advance, suggesting specific outcomes before procedures were done.

Officials with the U.S. Centers for Medicare and Medicaid Services said Thursday that they had accepted the department's plan of correction, but if the problems are not resolved, the hospital could lose its federal funding.

The Orange-based UCI Medical Center will remain under the oversight of the state Department of Public Health until a second inspection confirms that the corrections have been made.

The 30-page inspection report, based on a May visit that was prompted by a whistle-blower complaint, listed problems dating back at least three years. They included substandard equipment checks, inadequate staffing and shoddy record-keeping

In one case, a patient's blank anesthetic record had been signed by a doctor and marked "stable," one day before the medical procedure. In another case, a doctor had filled out forms in advance for procedures that were to be performed by a different doctor. Records for 10 out of 38 patients revealed similar problems.

Some of these problems had come to light in a 2006 external audit, and the report criticized UCI for not documenting any action to improve quality of care within the department.

"What we're talking about is sloppy and outrageous record-keeping," said David N. Bailey, UCI's vice chancellor for health affairs. "We were shocked when we saw that and heard about it. . . . Of course, that is a no-no. The medical executive committee is dealing very seriously with this right now and the people" involved.

Even so, Bailey said that patient care and safety have not been compromised and that most problems cited in the report have been resolved.

The department has been beset by controversy since at least 2003, when half of the 26 professors signed a letter alleging that "the direction of the department has been radically altered to achieve financial goals at the expense of academic goals." Over three years, nine professors left the department, including four who had signed the letter.