Medicare, Medicaid termination notice extended for Galesburg Cottage Hospital

GALESBURG, Illinois (KWQC) - The Medicare termination deadline served to Galesburg Cottage Hospital earlier this week has been extended. The notice comes after multiple health and safety violations at the hospital.

According to the Centers for Medicare & Medicaid Services (CMS), the Medicare program will not make payment for inpatient hospital services given to patients who are admitted after January 14, 2022. For patients admitted on January 14, or earlier, payment may continue for up to 30 calendar days of inpatient hospital services. CMS says the deadline has been extended “in order to satisfy a regulatory notice requirement.”

The termination notice states, “Notice is hereby given that on January 14, 2022, the agreement between Galesburg Cottage Hospital, Galesburg, Illinois, and the Secretary of Health and Human Services, as a hospital in the Medicare program, will be terminated. The Centers for Medicare & Medicaid Services (CMS) had previously given notice that the agreement would terminate December 27, 2021, but has administratively extended the termination date to January 14, 2022.”

In the notice, the Centers for Medicare & Medicaid Services said the agreement has been terminated because of the hospital’s noncompliance with four different sections of the Medicare Conditions of Participation: governing body, patient rights, nursing services, and physical environment.

According to Cottage Hospital’s website, the facility is a 133-bed facility, the largest inpatient capacity hospital in the city.

On December 14, the hospital received a preliminary denial of accreditation from the Joint Commission, a national organization that accredits healthcare systems.

A report from the Illinois Health Facilities & Services Review Board found 59 percent of the hospital’s inpatient revenue for 2020 came from Medicare. Medicaid brought in another 14 percent. The total inpatient revenue from Medicare and Medicaid in 2020 was more than $10.6 million.

CMS gave TV6 several pages of survey results citing multiple safety violations and deficiencies including a lack of staff and attention to patients.

In a release to TV6, CMS said, “Galesburg Cottage Hospital had four surveys between November 19, 2021, and December 23, 2021, with immediate jeopardy identified on three of the surveys conducted at the hospital.

The facility has failed to ensure the health, safety, and well-being of patients. In this instance, the CMS has found that Galesburg Cottage Hospital is out of compliance with CMS basic health and safety requirements and the services being provided pose an immediate risk of serious injury, impairment, or death. CMS is committed to and prioritizes patient safety and quality of care and we are making sure that current inpatients are transferred safely and working to make sure they are seamlessly transitioned to a new hospital to receive the care they need.”

According to the Illinois Department of Public Health, the hospital can choose to re-apply to federal CMS for certification, but that process can take 4-6 months. In an email to TV6, Melaney Arnold, a spokesperson for the Illinois Department of Public Health, said, “Most private insurance will not provide payment to uncertified hospitals. Galesburg Cottage Hospital closed its ICU and pediatric units in July of this year and patients presenting to the emergency department were being transported to other hospitals. Basically, unless the hospital can afford to operate without CMS payment for patients, it will most likely cease operations.”

A spokesperson for CMS provided a timeline to TV6 of the termination and violations of Galesburg Cottage Hospital.

Timeline

• This hospital has had four surveys between November 19, 2021 and December 27, 2021 with serious findings.

• The final involuntary termination letter was issued on December 23, 2021.

• CMS is required to give the hospital 2 days’ notice of imposition of enforcement actions such as termination when Immediate Jeopardy to health and safety is present.

• Following termination, CMS will pay for existing patients for up to 30 days to facilitate patient relocation.

• The Illinois Department of Public Health is ready to facilitate safe transfer of patients.

TV6 contacted the other hospital in Galesburg, OSF St. Mary Medical Center, to inquire if OSF will start taking any Medicare or Medicaid patients turned away from Cottage Hospital.

OSF Healthcare Media Relations Coordinator Colleen Reynolds responded, “We are concerned about our health care colleagues at Cottage Hospital, and about the patients/families impacted by today’s announcement. OSF St. Mary Medical Center and its excellent, compassionate providers are ready, as always, to meet the current and future health and wellness needs of Galesburg and the communities in the region that we’ve been called to serve.”

Pam Gaither, Executive Director at the Galesburg Area Chamber of Commerce, sent TV6 a statement stating, “Galesburg is fortunate to have incredibly dedicated health care options, including two hospitals, in Galesburg. We are hopeful challenges for any health care organization are able to be resolved to ensure continued care for the residents in and around our local communities.”

You can read the full termination notice and violations here. An explanation of the Conditions of Participation for Hospitals can be found on the Code of Federal Regulation’s website. A copy of the survey results sent to TV6 by CMS can be found below.

TV6 made contact with Cottage Hospital on Wednesday, which said it has no comment. TV6 contacted SBJ Group, the organization that owns the facility, multiple times for comment but has not heard back.

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