Fallout continues from All Children's federal report

ST. PETERSBURG, Fla. (FOX 13) - Experts weighed in Monday on the damning federal report about Johns Hopkins All Children's Hospital in St. Petersburg, Florida, where investigators found problems that “represent immediate jeopardy to patient health and safety.” 

The findings put the hospital in danger of losing its Medicare funding.

"When they went in and did their deep-down analysis, they determined that circumstances were so bad that they were placing Johns Hopkins All Children's Hospital in this very rare category of basically extremely dangerous," explained Dr. Jay Wolfson, the associate vice president at USF Health and one of the state's foremost experts in the field.

Federal health officials with the Centers for Medicaid and Medicare Services (CMS) notified the hospital this week that its Medicare contract will be terminated Feb. 23.  

The termination follows an inspection earlier this month that found deficiencies in four areas. Specific details were not made public, but authorities say the deficiencies were related to infection control, its medical staff, its governing body, and its Quality Assurance Performance Improvement Program (QAPI).

The QAPI requires hospitals to develop and maintain an ongoing performance improvement program focused on improving patient health, and preventing and reducing medical errors. It also requires hospitals to keep track of adverse patient events.

An “immediate jeopardy” citation is rare. A CMS spokesperson says it indicates a significant failure that “poses a risk to the health and safety of the patients, and the facility’s ability to ensure... quality healthcare in a safe environment.”

"[Johns Hopkins] did not have adequate control of the operations clinically and administratively in that building in St. Petersburg," said Wolfson. "What they do in Maryland is one thing. And what the do in some of their other places in one thing. They lost control over what was going on down here. And because they were almost in a free-fall, things got out of control. "

There were seven “immediate jeopardy” citations issued to Florida Hospitals in the 2018 fiscal year. Nationwide, fewer than five percent of hospitals were cited for immediate jeopardy.

The hospital can avoid termination by developing a plan of correction for each deficiency, which must be submitted by Feb.10. 

"The stain on the hospital's reputation is something that's so difficult to come out from under," said Wolfson, who believes the problems began when Hopkins took over in 2011. "This may be a great opportunity for Johns Hopkins to reach out more aggressively to some of the entities and individuals that it pushed away beginning in 2011 -- the community physicians, the physicians and researchers at the University of South Florida, the other children's hospitals in the community, Tampa General Hospital -- to create a truly collaborative community-based system for providing the highest quality care for children. This threatens that right now."

Kim Hoppe, the interim VP of marking and communications for Johns Hopkins All Children’s Hospital, released a statement Friday saying the hospital takes “these findings seriously” and that a corrective action plan is already in the works.

“The safety of our patients is our top priority,” the statement says, in part. It continues: “We are confident that the work we are doing to ensure that our hospital continues to meet the highest standards of care will satisfy any concerns they, our patients, or our community may have. Every day, we deliver world-class care to our patients, and we will continue to do so with distinction and compassion.”

The enforcement action announced follows the resignations last month of five hospital executives, including CEO Dr. Jonathan Ellen, MD; Hospital VP Jackie Crain; VP of Medical Affairs and Chief Patient Safety Officer Dr. Brigitta Mueller, MD; and Dr. Gerhard Ziemer, MD, Ph.D., who was the director of the hospitals heart institute and chief of cardiovascular surgery.

Below is the full statement from Johns Hopkins All Children’s Hospital:

"Last month, surveyors from the Agency for Health Care Administration (AHCA) and the Centers for Medicare and Medicaid Services (CMS) conducted an extensive review of Johns Hopkins All Children’s Hospital.

In the weeks since their visit, we have developed and are actively implementing a comprehensive action plan to address areas that were identified by the surveyors as needing corrective action.

Yesterday, we received the results of their survey, which included citations for issues they identified as deficient. As a result of these citations, Johns Hopkins All Children’s Hospital has received a finding of Immediate Jeopardy. Immediate Jeopardy is a situation that requires an immediate response to avoid threats to the regulatory or accreditation status of the hospital. We take these findings seriously and are continuing to work in close coordination and consultation with both AHCA and CMS to immediately address their concerns.

The safety of our patients is our top priority. We are confident that the work we are doing to ensure that our hospital continues to meet the highest standards of care will satisfy any concerns they, our patients, or our community may have. Every day, we deliver world-class care to our patients, and we will continue to do so with distinction and compassion."