Skip to content
Signage is seen along Ironbound Road for the Eastern State Hospital in Williamsburg on Tuesday, April 19, 2016. No Mags, No Sales, No Internet, No TV
Aileen Devlin / Daily Press
Signage is seen along Ironbound Road for the Eastern State Hospital in Williamsburg on Tuesday, April 19, 2016. No Mags, No Sales, No Internet, No TV
Author
PUBLISHED: | UPDATED:

Eastern State Hospital in James City County is losing its Medicare funding after federal and state surveyors found the facility failed to comply with requirements of participation for psychiatric hospitals.

Hospital officials were first notified of the deficiencies after a June 5, 2015, survey performed by the Virginia Department of Health’s Office of Licensure and Certification and consultants for the Centers for Medicare and Medicaid Services, or CMS, according to the termination notice sent to the facility.

The initial survey found three sets of deficiencies, two of which were corrected by a follow-up survey Sept. 17. The third deficiency, special medical record requirements for psychiatric hospitals, was still not satisfactorily corrected by a third visit on Oct. 14 and a fourth visit Feb. 24, 2016.

“CMS has determined that your hospital’s failure to comply with this condition of participation is of such a serious nature as to substantially limit the hospital’s capacity to provide adequate care,” the CMS termination notice states. “Therefore we are terminating your Medicare agreement effective April 21, 2016, based on your hospital’s failure to substantially meet the applicable Medicare conditions of participation for psychiatric hospitals.”

The notice does not state the specific requirements that were not met, and state officials did not disclose further details to the Daily Press. Officials are still waiting for a more detailed report from CMS, according to Maria Reppas, spokeswoman for Virginia’s Department of Behavioral Health and Developmental Services, the agency that oversees the hospital.

The condition of participation outlines requirements covering patient assessments, psychiatric evaluations, treatment plans, recording progress notes and discharge planning and discharge summary, according to federal regulations.

The termination will not affect patients, staffing or services, according to Reppas. The state’s Department of Behavioral Health is planning to provide additional resources to the hospital to make up for the loss and correct the problem, she said.

“DBHDS retained national experts to provide review and consultation for a plan of correction,” Reppas said in an email. “DBHDS will continue to support Eastern State Hospital at its current level of funding, and we’re bringing additional staffing resources to assist with implementing the plan of correction.”

Officials estimate the facility will lose $600,000 to $700,000 per year, according to Reppas. The hospital’s fiscal year 2016 operating budget is just under $71.5 million, she said. Officials do not yet have an estimate of how much the additional support will cost.

Officials also do not yet have a timeline for a correction plan, but initial efforts will focus on strengthening the hospital’s administrative and clinical operations, according to Daniel Herr, assistant commissioner of behavioral health services. Herr told the Daily Press officials are waiting for the report from national experts.

“When we have those recommendations, we will work on a plan of action,” he said.

The hospital is also trying to fill two vacant positions – a director of nursing services and a chief medical officer – that are critical to the facility’s operations.

“I think it’s important to have those key positions filled,” Herr said.

The loss of Medicare funding follows CMS’ removal of Medicaid dollars from the hospital’s geriatric unit last August. The funding was cut after CMS determined that the nursing facility could not be an institution for mental diseases or used to treat people admitted against their will and kept in a locked facility, according to that notice.

The Virginia General Assembly agreed to cover the $10 million loss to the hospital’s fiscal year 2016 budget to allow officials to determine a plan for the patients affected and the program moving forward, according to Herr. The legislature also agreed to pay for an independent review to assist with the plan.

“They will be looking at all…options and providing recommendations to the General Assembly,” he said.

Daily Press archives were used in this report. Ketchum can be reached by phone at 757-247-7478.