UNC to respond to investigations

A federal investigation has found UNC Hospitals at fault for refusing to care for a patient in March.

Hospital officials received a letter Monday afternoon from the Centers for Medicare and Medicaid Services' regional office in Atlanta citing UNC for failing "to provide transfer from another hospital in an emergency condition."

The investigation began in March when Claudine Lee went to a small hospital in Bladen County seeking emergency care for her son, whose finger had been partially detached.

The emergency staff was ill-equipped to handle the complicated reimplantation procedure, and a physician contacted UNC Hospitals.

When the physician called, UNC Hospitals officials redirected Lee to Duke University Hospitals because they said they also could not reattach the fingertip.

The delay in care ultimately resulted in the loss of the child's fingertip.

"The physician we were talking to didn't understand," said Karen McCall, vice president for communications for UNC Health Care. "She thought we were turning her down. We didn't communicate with her well."

The letter from CMS said hospital officials must reply within 10 days with a plan to rectify its inefficiencies, or it could lose its federal funding for both Medicare and Medicaid.

Though the threat of termination is real, it is rare, CMS officials say.

"We're not in the business to exclude providers from the program," said Lee Millman, director of communications for the Atlanta regional office. "So we work with the facilities to get back in compliance. - What's important is patients' health and safety."

CMS has conducted about 400 investigations each year for the past 12 years, and only one program has been so faulty as to be terminated, Millman said.

"That's less than 1 percent. Most hospitals are able to get their act together."

The CMS' finding is the second repercussion from the incident. In April an investigation by the state's division of facility services also found UNC Hospitals to be at fault.

In response to that finding, hospital officials drafted a plan that month to improve its operations, McCall said.

One of the changes made is the implementation of a waiver that a patient must sign when leaving the emergency room against the advice of medical staff.

UNC Hospitals will point to these initiatives in its forthcoming response to CMS, McCall said.

"We will come up with a very good plan that we hope they accept," McCall said. "In the process we'll make sure that we're all educated and our policies are up to date."

 

Contact the University Editor at udesk@unc.edu.