by Mindy Aguon

Guam - The Guam Memorial Hospital is confident that it will not lose its participation in the Medicare program, as was threatened in a letter sent to acting administrator Rey Vega earlier this week. Hospital officials have until Monday to not only respond to the concerns raised by the Centers for Medicare and Medicaid Services, but detail corrective actions for each deficiency noted in the 78-page report.

The organization has put GMH on notice that it's participation in the Medicare program could be stopped, which could result in the loss of tens of millions of federal dollars. CMS representatives recently completed an extensive report on their 5-day re-certification survey of the hospital's acute care facility and the findings were alarming.

Vega said, "They also cited us on standards. This has something to do with patient's rights, patient confidentiality, infection control, patient restraints, and seclusion mostly the violations involve non enforcement of policies and procedure."

From patient rights regarding personal privacy and confidentiality and receiving care in a safe setting, expired medicines and medical supplies lying around the hospital, concerns about medical staff credentialing to failure to properly administer drugs. The report details dozens of examples of violations the CMS team found during their visit to GMH. Standards regarding personal privacy of patients were not met as patients were seen sitting next to each other in the emergency room two receiving IV fluids while another receives respiratory treatment and another was given instructions for being discharged.

CMS also noted that the standard for patients to receive care in a safe setting aren't being met either specifically citing examples of expired catheters and medicine lying around in emergency carts, broken medical supplies, items not being adequately disinfected and failure of staff to provide cardiac cathertization in a safe setting as equipment overheated in the middle of a procedure on a patient that could have created serious complications. Medical staff credentialing was also questioned as they found that one reviewed one doctor's file that showed hospital privileges had not been suspended but further review revealed that privileges were suspended on May 25, 2008 and reinstated a day later.

The same unnamed doctor also had more than 100 reports that had either gone unsigned or lacked interpretation and were never finalized as required by medical staff bylaws. Concerns were also raised about the physical environment of the hospital. Vega admits these concerns were raised by the joint commission as well but are already being addressed. "The wall hardening, the fire sprinkler system upgrade and the wall penetration those are the ongoing projects that we are quite confident that given there is already a track record of how we are approaching the issues that CMS would be receptive and would find out responses responsive," he said.

Vega intends to respond to the CMS next week Monday. While he's confident that GMH will not lose its certification to participate in Medicare, he admits the worst-case scenario would be that the hospital would have to continue providing medical care to Medicare recipients without getting reimbursed.