Kansas hospital asked nurses to falsify records to pump up inpatient numbers, inspectors say

Ayla Ellison (Twitter) - Print  | 

Overland Park, Kan.-based Blue Valley Hospital asked nurses to falsify patient records to boost the facility's inpatient numbers, according to The Kansas City Star, which cited findings from a CMS survey of the hospital.

Here are nine things to know:

1. CMS terminated Blue Valley Hospital's Medicare contract in April after two surveys revealed the hospital was not in compliance with Medicare rules.

2. Under rules enacted last September, a healthcare facility must average at least two inpatients per day and an at least two-night average length of stay to be considered an inpatient hospital for Medicare reimbursement. Facilities that fall short of these requirements may instead be considered same-day surgery centers, which have different reimbursement rates.

3. CMS said Blue Valley Hospital doesn't meet the new federal requirements for Medicare participation. A survey by state health officials in November found Blue Valley Hospital did not have any inpatients at that time, and a subsequent report showed the hospital performed about 309 outpatient surgeries, compared with 146 inpatient surgeries over a yearlong period.

4. Blue Valley Hospital officials acknowledged that the hospital fell short of the two-night average stay requirement, but they argued the new federal requirements are arbitrary. They claimed the action taken by CMS was not related to any issues with patient safety or quality of care.

5. The hospital sued HHS and CMS over the decision to terminate its Medicare billing privileges, and U.S. District Judge Julie Robinson recently dismissed the case. The judge's dismissal ruling provided additional details about why CMS took action against the hospital.

6. "BVH was tagged with numerous deficiencies in both surveys, including compromise of patient care," Ms. Robinson wrote. "As such, the government interest in protecting patients through an expeditious provider-termination procedure is quite strong."

7. In the survey conducted in April, inspectors found several deficiencies. For example, the hospital used unsafe practices for medication administration, leading to the potential for drug overdose, adverse drug reactions and medication errors, according to Ms. Robinson's dismissal order.

8. The judge also noted that BVH leaders knew the facility was not in compliance with Medicare rules and took measures to boost inpatient volumes and average length of stay to get in compliance. During the follow-up survey of the facility in April, two nurses told inspectors hospital officials asked them to falsify patient records to include complications that would justify keeping patients in the hospital longer, according to Ms. Robinson's dismissal order.

9. BVH's Medicare billing privileges are set to be terminated June 15. However, the hospital appealed the district court's decision and has requested to retain its billing privileges until the appeal is heard, according to The Kansas City Star.

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