Feds: Mount Carmel out of compliance with Medicare due to lack of training on new policies

File photo - Mount Carmel West (WBNS-10TV)

COLUMBUS, Ohio – The latest documents released by The Centers for Medicare and Medicaid Services show that Mount Carmel Health System remains out of compliance with federal Medicare requirements because not all nurses and physicians have been trained on new policies and procedures that have been adopted in wake of the patient overdose scandal.

After 35 patients were found to have received excessive doses of pain medication between 2014 and 2018, Mount Carmel made a series of changes in an effort to avoid losing its federal funding from CMS.

Most of the patients who received excessive or potentially fatal doses of pain medication were given those dose as they were being taken off of ventilators.

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In 24 of the 27 patient cases reviewed by state health inspectors who were working on behalf of CMS, inspectors found that Dr. William Husel used an override function to bypass the hospital’s pharmacy and gain access to large doses of pain medication.

Among the changes the hospital has made include placing restrictions on how “overrides” can be used to access medication from the automatic medication dispensing system.

A review by state health inspectors on Feb. 11 revealed that AMDS overrides “…should only be used in emergency situations when time does not permit the pharmacist review, such as circumstances when patient harm could result from delay in administration of a medication. This will require practice changes…”

Inspectors also reviewed communications that “went to all medical units that revealed changes to the Terminal Ventilator Withdrawal Power Plan, AMDS Override Process, AMDS medication override, Chain of Command, and Verbal/Telephone orders revealed they were to be reviewed by 3/6/2019.”

Because not all training had been completed, inspectors found that Mount Carmel “failed to ensure all nurses and physicians completed the education on changes to the Automated Medication Dispensing System (AMDS) and the changes to policies and procedures. This has the potential to affect all patients receiving care at the facility.”

The hospital fired Husel in December following an internal investigation. Twenty-three nurses, pharmacists and members of management were removed from patient care following the investigation. Pharmacy manager Janet Whittey has also left Mount Carmel.

Husel, Mount Carmel Health System and caregivers have been named in two dozen wrongful death lawsuits that accuse them of hastening these patients’ deaths.

The hospital has called these events “tragic” but said that most of the patients were near death and in intensive care.

Just last month, the hospital revealed that it had “concerns” that 5 of these patients could have possibly seen their conditions improve with treatment.

Mount Carmel sent the following statement to 10TV:

In February, the Centers for Medicare and Medicaid Services (CMS) accepted Mount Carmel’s action plans to address issues related to the patients under the care of Dr. Husel. To clarify, the document we submitted to CMS on March 1 was simply a status update of our original plan of correction. It did not include additional corrective actions.

We fully expected continued review of our action plans and the possibility of broader reviews, as is common after significant events. As previously shared, our corrective action plan addressed every concern raised by the initial CMS review. The extensive staff training that was specified in the original corrective action plan will be complete tomorrow, March 6.

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