Medicare, Extended Medicaid Termination Notice for Galesburg Cottage Hospital


GALESBURG, Ill. (KWQC) – The Medicare cancellation deadline served at Galesburg Cottage Hospital earlier this week has been extended. The advisory comes after multiple health and safety violations at the hospital.

According to the Centers for Medicare & Medicaid Services (CMS), the Medicare program will not pay for inpatient hospital services provided to patients admitted after January 14, 2022. For patients admitted on or before January 14, payment may continue for up to 30 calendar days of inpatient inpatient service. CMS says the deadline has been extended “in order to meet a regulatory notification requirement.”

The termination notice states: “Notice is hereby given that on January 14, 2022, the agreement between Galesburg Cottage Hospital, Galesburg, Illinois, and the Secretary of Health and Human Services, as Medicare program, will be terminated. The Centers for Medicare & Medicaid Services (CMS) had previously notified that the agreement would end on December 27, 2021, but administratively postponed the termination date to January 14, 2022. “

In the notice, the Centers for Medicare & Medicaid Services said the agreement was terminated due to the hospital’s failure to meet four different sections of the Medicare membership requirements: governing body, patient rights, services. nurses and the physical environment.

According to the Cottage Hospital website, the facility is a 133-bed facility, the largest inpatient capacity hospital in the city.

On December 14, the hospital received a preliminary denial of accreditation from the Joint Commission, a national organization that accredits health systems.

A report from the Illinois Health Facilities and Services Review Board found that 59% of the hospital’s inpatient income for 2020 came from Medicare. Medicaid reported an additional 14%. Total Medicare and Medicaid inpatient income in 2020 was over $ 10.6 million.

CMS gave TV6 several pages of investigation results citing multiple breaches and safety deficiencies, including a lack of staff and patient care.

In a statement to TV6, CMS said, “Galesburg Cottage Hospital had four investigations between November 19, 2021 and December 23, 2021, with immediate danger identified in three of the investigations conducted at the hospital.

The facility has failed to ensure the health, safety and well-being of patients. In this case, CMS found that Galesburg Cottage Hospital does not meet basic CMS health and safety requirements and that the services provided pose an immediate risk of serious injury, impairment or impairment. death. CMS is committed to prioritizing patient safety and quality of care and we ensure current inpatients are transferred safely and we are working to ensure they are transferred seamlessly to a new hospital to receive the care they need.

According to the Illinois Department of Public Health, the hospital may choose to reapply for certification with the federal CMS, but this process can take 4 to 6 months. In an email to TV6, Melaney Arnold, spokesperson for the Illinois Department of Public Health, said, “Most private insurance companies won’t pay uncertified hospitals. Galesburg Cottage Hospital closed its intensive care and pediatric units in July this year and patients presenting to the emergency department were transported to other hospitals. Basically, unless the hospital can afford to operate without CMS payment for patients, it will most likely go out of business. “

A CMS spokesperson provided TV6 with a timeline of the termination and violations at Galesburg Cottage Hospital.

Chronology

• This hospital had four investigations between November 19, 2021 and December 27, 2021 with serious results.

• The last letter of involuntary termination was issued on December 23, 2021.

• CMS is required to give the hospital 2 days notice before the imposition of enforcement measures such as termination when an immediate danger to health and safety is present.

• After termination, CMS will pay for existing patients for up to 30 days to facilitate patient relocation.

• The Illinois Department of Public Health stands ready to facilitate the safe transfer of patients.

TV6 has contacted Galesburg’s other hospital, OSF St. Mary’s Medical Center, to find out if OSF will start taking Medicare or Medicaid patients refused at Cottage Hospital.

OSF Healthcare Media Relations Coordinator Colleen Reynolds responded, “We are concerned about our health colleagues at Cottage Hospital and the patients / families affected by today’s announcement. OSF St. Mary’s Medical Center and its excellent, compassionate providers stand ready, as always, to meet the current and future health and wellness needs of Galesburg and the local communities we have been called to serve.

Pam Gaither, executive director of the Galesburg area chamber of commerce, sent a statement to TV6 saying, “Galesburg is fortunate to have incredibly dedicated healthcare options, including two hospitals, in Galesburg. We hope that the challenges for any healthcare organization can be resolved to ensure continued care for residents in and around our local communities. “

You can read the full termination notice and violations here. An explanation of the conditions of participation for hospitals is available on the Code of Federal Regulation website. A copy of the survey results sent to TV6 by CMS is available below.

TV6 contacted Cottage Hospital on Wednesday, who said they had no comment. TV6 has contacted SBJ Group, the organization that owns the facility, on several occasions for comment, but has not received a response.

Copyright 2021 KWQC. All rights reserved.

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