Old Vineyard Youth Services has until Nov. 8 to resolve a compliance issue with the federal Centers for Medicare & Medicaid Services or face termination of its provider agreement.
Such a termination would mean that Medicare would no longer make payments to Old Vineyard for new inpatient services after Nov. 7. It would make payments for up to 30 days for those patients admitted before Nov. 8.
Old Vineyard has 111 beds, 57 dedicated to psychiatric residential care for ages 12 to 17, and 54 for acute mental-health care.
Lee Millman, the media-affairs officer for the agency's Atlanta office, said yesterday that its investigation was prompted by a complaint and is focused "on a particular incident involving delivering quality health care and/or a safe environment."
"There's been something found that is serious enough for Medicare to send out this termination-in-funding notice and request the correction of this deficiency," Millman said.
Old Vineyard said in a statement that the notice is the result of a "specific problem discovered on a recent survey. Old Vineyard has already remedied the issues and is working diligently with CMS to demonstrate that the hospital is in compliance with the Medicare rules."
The federal agency said in a legal notice that Old Vineyard was not in compliance with four conditions of participation in the Medicare program: governing body; patient rights; quality assessment and performance improvement; and nursing services.
According to local mental-health officials, governing body relates to a physician being assigned and responsible for each patient's care. Patient rights deal with care in a safe setting, Quality assessment and performance improvement also relate to patient safety and reduced risk. Nursing services requires that a registered nurse supervisor be available 24/7 to evaluate patients.
The N.C. Division of Medical Assistance also is conducting "an active program review" of Old Vineyard, spokesman Mark van Sciver said. A report on that review is expected before Thanksgiving. The report is being done in conjunction with the program-integrity unit of the N.C. Mental Health, Developmental Disabilities, and Substance Abuse Services.
Millman said that the federal agency recently contracted with the state for a survey of Old Vineyard. Millman said that the results of the survey elevated the case into what is considered as "immediate jeopardy," which requires a resolution by the provider within 23 days.
"However, it is rare for a facility to actually have their funding terminated," Tillman said. "The facilities typically work with us and the state to get the situation corrected."
Millman said that if the federal agency approves of Old Vineyard's plan, it still would have to pass an unannounced visit "to make sure the plan is in place and working."
CenterPoint Human Services, a local management entity that oversees mental-health services in Forsyth, Davie, Rockingham and Stokes counties, said in a statement that "it is confident the necessary improvements will occur, and Old Vineyard will remain a strong local provider of services."
Judy Briggs, the chief executive of Carolina Behavioral Health Alliance, said she is concerned that the federal agency's investigation has advanced to the potential of termination.
"All the reasons listed in the legal notice are all related to quality of care," Briggs said. "This is very disturbing and could be putting some of our most vulnerable citizens in harm's way."
It is unclear whether the investigations could affect Old Vineyard's bid to open a 24-hour psychiatric-emergency department in Forsyth County. Old Vineyard would gain 50 beds with the $13.8 million center.
The bid, which was conditionally approved in July by the N.C. Division of Health Service Regulation, has been put on hold by the appeal of a psychiatric hospital in Raleigh.
Disability Rights N.C. serves as the state's federally mandated protection and advocacy program for people with disabilities.
"The findings of CMS regarding the treatment of patients at Old Vineyard point to serious systemic problems which jeopardize patient safety and care," said Vicki Smith, the executive director of the agency.
rcraver@wsjournal.com
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