Days after state officials announced that Southwest Healthcare System in Murrieta had received California’s first $100,000 fine for putting patients at risk of death or serious injury, federal regulators announced they plan to cut the hospital's Medicare funding June 1.
State public health officials also said they had warned Southwest on Thursday that the hospital's "license is in jeopardy due to ongoing systemic problems and a pattern of life-threatening lapses in care."
The federal action comes after a surprise inspection in January found deficiencies at the hospital in nine areas required for Medicare participation. Regulators wrote in a letter Thursday to Dennis Knox, Southwest's chief executive, that the inspection showed "the inability of the hospital's governing body to identify and take appropriate measures to eliminate clear threats to patient health and safety."
Among the problems cited:
* Medical staff failed to ensure that six physician assistants in the emergency room were competent to screen patients.
* Nurses failed to follow doctors' orders and administer antibiotics and blood pressure medications, failed to check on a patient with low blood pressure and failed to follow policies to prevent patients from falling.
* Pharmacy staff failed to decontaminate the area used to prepare chemotherapy medications, potentially exposing other patients to the drugs.
* Hospital staff removed and failed to replace an alarm system in the newborn nursery designed to prevent newborn abductions, and posted security guards out of sight of the nursery.
* Hospital staff admitted they and doctors failed to wear head coverings and face masks to prevent infections in the cardiac catheterization unit.
Hospital officials said they were in talks with regulators to avoid losing their funding.
"We expect to have a resolution very shortly which will enable Southwest to continue to provide care and treatment for our Medicare patients," spokeswoman Teresa Fleege said.
The hospital is entitled to appeal and have a hearing before a federal administrative law judge. If funding is cut, it may apply for reinstatement.
Regulators said Thursday that Southwest already has had years to fix its problems. "We have gone to great lengths to work with the provider," said Rufus Arther, director of hospital operations for the Medicare region that includes California, Arizona, Nevada, Hawaii and the Pacific territories.
Federal regulators first responded to a complaint at the hospital in June 2007. By July 2009, regulators were prepared to cut Southwest's Medicare funding, but instead gave hospital officials six months to fix the problems, according to Arther.
Only a handful of hospitals in the region face such cuts each year, he said. The last Los Angeles-area hospital to lose Medicare funding was Martin Luther King Jr.-Harbor Hospital, which was closed in 2007 after losing $200 million in annual federal payments because of ongoing lapses in care.