UNC, Wilson hospitals fix issues that risked Medicare funding; some complaints pending

Two Triangle-area hospitals say they have corrected serious problems with patient care that kept a major source of their federal funding in limbo for months.

The Centers for Medicare and Medicaid Services threatened to cancel Medicare contracts for UNC Medical Center and Wilson Medical Center after regulators found they repeatedly failed to meet federal health care standards. Violations were so serious earlier this year that regulators declared that the hospitals put the health and safety of patients in “immediate jeopardy.”

But after separate, follow-up inspections in September, both hospitals fixed those issues, keeping their federal contracts intact, representatives say.

“UNC Hospitals’ teammates worked closely with state and federal regulators during this process,” UNC Health spokesperson Alan Wolf said in a statement Thursday. “We are grateful for their commitment to providing excellent care for all of our patients.”

Staff at Wilson Medical Center is “committed to not only maintaining new processes and procedures we have put into place, but to continuing to strive to improve how we serve and care for our patients,” spokesperson Melanie Raynor said in a statement.

Wilson Medical Center and UNC Medical Center have been under scrutiny by state and federal regulators for months following complaints that led inspectors to examine several incidents at the facilities in the early months of 2022.

Federal officials cited UNC Medical Center for serious issues related to the treatment of 29-year-old Troy Simoncelli, who killed himself shortly after he was released from the emergency room over the repeated objections of his family. Regulators concluded those problems put patient health and safety in immediate jeopardy, the least common and most serious type of deficiency that carries the most severe regulatory sanctions.

Regulators also identified immediate jeopardy at Wilson Medical Center over the treatment of three patients. One man who fell in his room and was subsequently sedated died after staff failed to monitor him for hours. Another died shortly after his heart monitor was disconnected. In the third case, a suicidal patient locked himself in an emergency room lobby bathroom and threatened to overdose on medication.

Follow-up inspections at both hospitals prompted regulators to remove the immediate jeopardy designations.

But inspectors still found “substantial noncompliance” with Medicare rules — and each facility had until the end of September to fix any outstanding problems.

Wilson hospital still facing scrutiny

But troubles at Wilson’s only hospital, located less than an hour east of Raleigh and licensed for about 300 beds, may not be over yet.

In a statement to The News & Observer, a CMS spokesperson noted that regulators are still reviewing the results of an investigation into potential violations of the Emergency Medical Treatment and Labor Act at the for-profit facility. The law, enacted in 1986, requires hospitals to treat patients needing emergency care, including those in labor, regardless of their financial status.

In her statement Thursday, Raynor said the hospital team “continues to work with CMS as it reviews a few recent complaints.”

“We will share more information on these as it is available,” she said.

Raynor did not respond to follow-up questions about whether those complaints were related to potential EMTALA violations, whose penalties can include substantial fines as well as the termination of Medicare contracts, according to the American College of Emergency Physicians.

Wilson Medical Center is operated by Duke LifePoint, a joint venture between Duke Health and Nashville-based LifePoint Health, a for-profit company owned by private equity firm Apollo Global Management.

Concerns about the quality of patient care, bed capacity and understaffing at the hospital prompted the state attorney general’s office in late August to demand answers from LifePoint, which runs dozens of largely rural hospitals in North Carolina and across the country.

The company has replied to the request for information from the attorney general’s office, agency spokesperson Nazneen Ahmed said. But before releasing it publicly, she said the agency is now “evaluating whether their response has confidential information.”

“Our office has no objections to sharing the letter, but Duke LifePoint has made clear that their response contains trade secrets and confidential health care information that will need to be redacted,” Ahmed said in an email to the N&O last week. “They are currently reviewing their response for that information.”

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