CMS orders CHC to resubmit ‘response’

The U.S. Centers for Medicare and Medicaid Services has ordered the Commonwealth Healthcare Corp. to resubmit the “response” it earlier turned in to the federal agency due to what it described as incomplete reporting.

CMS put off its decision on the hospital’s Condition of Participation to June 27 this year after finding out that there remains a number of concerns and deficiencies that have not been fully addressed by the corporation. A response, which was required for submission following that determination, was turned in to the federal agency last Feb. 7.

Interim corporation CEO Esther Muña told the board yesterday that CMS has asked for the resubmission of the “response” documents because the plan, according to the federal agency, had a number of “unclear” items.

As a procedure, once a response or corrective action plan is turned in to CMS, the federal agency issues a notification whether it accepts or rejects the plan.

According to Muña, CMS didn’t say if it accepts or rejects the corporation’s submission; the federal agency just simply asked CHCC to resubmit the plan.

“They didn’t accept it, but they didn’t reject it,” Muña told the board.

She said the new deadline for the “response plan” is April 25. She pointed out, though, that the deadline is only for the report and the June 27 timeline for a final decision remains intact.

CMS’ letter in January indicated that it requires “credible written evidence” documenting and demonstrating the correction of each deficiency identified by the agency. Of the 13 original areas of deficiency identified by CMS in a 2012 survey, there remain nine areas that are marked not rectified.

In response to the board’s questions yesterday, Muña said it was the corporation that initiated the conversation with CMS as it followed up on the status of the Feb. 7 submission. “We called them up and basically asked CMS if we can revisit the document [we submitted]; that’s why there was a conversation with them,” she said.

It was disclosed that CMS seemed unsatisfied with the report because not all required elements were in the document. Muna pointed out that the resubmission aims to clarify unclear areas by providing more descriptions, rather than just a summary.

“The plan is not clear to CMS and they want clarification,” she said, adding that the new report is almost done and would be timely submitted to the agency.

One specific area that reportedly concerns CMS is the status of the HVAC project, which remains unaccomplished to date and the report indicated no realistic deadline to complete it.

The HVAC project—which also includes the fire pump, elevator, and sprinkler system for CHC—is funded by federal funds and directly administered by the Office of the Governor’s. It was learned that the project was delayed due to an award protest and CHCC does not expect the project to be done by June. HVAC stands for heat, ventilation, and air-conditioning system.

Both Muña and interim CFO Cora Ada also disclosed that “hiring of personnel and facility upgrades for safety code” were among the deficiencies that have yet to be fully satisfied due to funding constraints.

When asked how much is needed to solve all CMS citations, both officials could immediately come up with a figure and promised to provide the board the information at a later time.