Feds threaten UNC hospital’s funding over ‘immediate jeopardy’ to patient health

Federal regulators have threatened another North Carolina hospital with the termination of Medicare funding over serious patient safety issues — this time UNC Health’s flagship campus in Chapel Hill.

In a letter to the UNC hospital’s leaders late last month, the Centers for Medicare and Medicaid Services said it would cancel UNC Medical Center’s Medicare contract on July 23 unless the facility fixes several problems identified as “immediate jeopardy.” An immediate jeopardy designation, according to CMS guidelines, means a hospital has “placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death.” It’s the least common and most serious result of inspections by health officials — and it carries the potential for the most severe sanctions.

Prompted by a complaint, state inspectors surveying UNC Medical Center on June 17 concluded the facility violated four federal health regulations on hospital oversight and patients’ rights, as well as quality assessment and infection control.

“During a recent complaint survey, issues were investigated including a patient suicide after discharge and infection prevention issues related to documenting the COVID-19 vaccination status of vendors and the physical spacing of patients and visitors in our busy emergency department waiting room,“ UNC Health spokesperson Phil Bridges said in a statement Monday.

Although potentially devastating to a hospital’s finances, experts say losing Medicare funding is an unlikely outcome — provided staff submit a detailed corrective action plan to federal officials. Bridges said the hospital submitted that plan by the July 5 deadline, and that a follow-up survey of the facility is expected in the coming weeks “to confirm that our action plans are in place and effective.”

“The care and safety of our patients is always our top priority,” Bridges said. “UNC Hospitals constantly strives to improve our policies and procedures to ensure we are providing excellent care to patients.”

The N.C. Department of Health and Human Services, which provided a copy of the letter in response to a public records request from The News & Observer Monday, declined to provide specifics about their survey findings at UNC Medical Center. They directed a request for their detailed report on the hospital to CMS, which has not yet provided a copy.

UNC Medical Center is licensed for nearly 1,000 beds, making it one of the largest hospitals in the state. It currently rates three of five stars on Medicare’s quality rating site.

The facility is at least the second North Carolina hospital in recent weeks to receive a similar threat from federal regulators. The N&O reported last week that patient deaths at Wilson Medical Center, about an hour east of Raleigh, led to a finding of immediate jeopardy there.

Such designations are rare among the hundreds of surveys conducted at hospitals nationwide every year, which can either be routine or triggered by complaints lodged with state or federal health officials.

Out of more than 30,000 deficiencies CMS identified at facilities across the country from 2007 to 2017, less than 3% were classified as immediate jeopardy. That’s according to a 2021 study in the Journal of Patient Safety authored by California anesthesiologist Dr. Joseph F. Antognini, who’s worked both in hospital administration and as a surveyor for the Joint Commission, a nonprofit health care accreditation agency.

“The (immediate jeopardy designation) is a bit of a cudgel in that it forces a hospital to take this seriously and change their process,” Antognini, who’s helped conduct more than 90 hospital surveys in his work with the Joint Commission, told the N&O last week.

But the medical centers at Wilson and UNC aren’t alone.

CMS data shows Cape Fear Valley Medical Center in Fayetteville also faced an immediate jeopardy finding following a complaint investigation in late February. The hospital corrected its deficiencies by early May, according to federal regulators.