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Center given deadline to fix its quality issues
Experts question use of state money to repair deficiencies
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Published: November 25, 2009
A federal agency has given Old Vineyard Youth Services until mid-January to resolve quality-compliance issues on its Winston-Salem campus.
The agency, the Centers for Medicare and Medicaid Services, also said yesterday that Old Vineyard has been removed from its "immediate jeopardy" category, which makes it less likely that it will lose Medicare payments for new impatient services or face a management change.
The agency defines immediate jeopardy as "a situation in which the provider's noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment or death to a resident."
However, Old Vineyard has "some outstanding condition-level deficiencies" that require correcting by Jan. 14, said Lee Millman, the media-affairs officer for the agency's Atlanta office. If those issues are not resolved, Medicare payments still could be stopped.
The agency filed a legal notice regarding Old Vineyard on Oct. 26, saying that its audit was based "on a particular incident involving delivering quality health care and/or a safe environment." At that time, Old Vineyard was given until Nov. 8 to resolve the compliance issue.
Rob McCartney, the chief executive of Old Vineyard Behavioral Health Services, said yesterday that his group "continues to work diligently with CMS to demonstrate that the hospital has implemented corrective action to be in substantial compliance with the conditions of participation in the Medicare program."
The agency said on its Web site that providers considered in immediate jeopardy can be fined between $3,050 and $10,000 a day. McCartney said that Old Vineyard was not fined by the agency.
Leza Wainwright, the director of the state's division of mental-health services, said that having a condition-level deficiency "is still pretty serious."
"In my experience with our facilities, that would mean CMS thinks they have addressed whatever caused CMS to have immediate fear for patient safety, but the deficiencies are still fairly significant," Wainwright said.
Old Vineyard has a provider agreement with CenterPoint Human Services, a local management entity that oversees mental-health services in Forsyth, Davie, Rockingham and Stokes counties.
CenterPoint states on its Web site its support of Old Vineyard during the audit. It said it is providing "training and technical assistance in areas identified by Old Vineyard and CenterPoint."
Michael Cottingham, a spokesman for CenterPoint, said last week that although the CenterPoint support comes from state money, it was not over and above typical assistance.
CenterPoint's business plan says that "when corrective action is required, staff follow up with the provider until issues are resolved and/or report to oversight or regulatory bodies."
Cottingham said yesterday, however, that CenterPoint has no knowledge of the efforts by Old Vineyard to deal with its immediate-jeopardy status or the steps to be taken by Jan. 14. "As this is a matter between CMS and Old Vineyard, CenterPoint is not involved in past or future efforts," he said.
Some mental-health advocates have questioned CenterPoint using state money to deal with Old Vineyard deficiencies, likely those cited by the federal agency, rather than money from Universal Health Services Inc., its for-profit parent company.
Advocates said they want to know what technical assistance and training support CenterPoint is providing to Old Vineyard given that Old Vineyard already should be in compliance with state standards. They also want clarity on what is CenterPoint's responsibility for ensuring its providers provide a safe environment compliant with federal and state standards.
Wainwright said that providers are required to notify their local management entity of compliance issues, and the entity can terminate the contract immediately for cause.
The N.C. Division of Medical Assistance is conducting "an active program review" of Old Vineyard in conjunction with the program-integrity unit of the N.C. Mental Health, Developmental Disabilities and Substance Abuse Services.
A report on that review was expected before Thanksgiving. Jim Jones, an official with the state agency, said yesterday that there was no update on the review.
rcraver@wsjournal.com
727-7376
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