Central Texas hospital marred by lab deficiencies

AUSTIN, Texas (AP) — At least a dozen deficiencies in lab testing procedures at a new Central Texas hospital resulted in several patients undergoing unnecessary procedures and emergency room patients having to wait up to five hours for test results.

A report made by inspectors with the Texas Department of State Health Services at the request of the U.S. Centers for Medicare and Medicaid Services found deficiencies at the 100-bed, $210 million Lakeway Regional Medical Center, inaugurated last year, including poorly trained lab staff and a lack of policies and procedures.

The report also said the emergency room and nursing were affected by similar problems, according to a story in the Austin American-Statesman (http://bit.ly/ZtBSsD ). For instance, the emergency room did not have policies and procedures regarding the treatment of stroke and heart attack patients.

The hospital voluntarily closed the blood bank and the microbiology lab at Medicare's request. It also has replaced some personnel, brought in an experienced lab director and outsourced work to other facilities in Austin. Lakeway is about 20 miles northwest of Austin.

Hospital CEO David Kreye said a review of cases found procedures were done "exactly right," just not properly documented.

Twelve of the thirteen deficiencies found had to do with the lab, and four of them remain under Medicare's review. There is one other infraction related to the hospital's use of restraints. At least one patient was restrained longer than the four hours set by standards and two more were restrained while they slept.

The hospital was built with a $167 million government-insured mortgage loan, the largest ever given to a for-profit hospital. This meant Lakeway Regional Medical Center will save $91.2 million in interest and that it would be able to care for population that has been medically underserved.

It opened its doors in April. Five months later, a complaint about the lab prompted Medicare to request the investigation.

It revealed that a patient had received a surgical implant that had expired four months earlier to repair a broken arm and that same patient was anesthetized and waited six hours for surgery. The procedure was postponed by the surgeon because of the "the late hour" — after 6 p.m.

Medicare fined the hospital $10,000 and demanded a plan to correct the infractions.

Kreye said the problems have been corrected but declined to discuss individual cases with the newspaper. He said that most of the infractions had to do with lack of documentation, a view not shared by Medicare.

"The hospital was given several opportunities during the course of the on-site inspection to provide information that would demonstrate compliance with Medicare requirements," Medicare's spokesman Bob Moos told the American-Statesman in an email. "Further, the on-site inspection is not simply a review of policies and procedures, but an evaluation of how those policies and procedures are implemented to prevent adverse outcomes. The findings demonstrate the hospital's failure at the time to provide care in accordance with our requirements."

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Information from: Austin American-Statesman, http://www.statesman.com

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