St. Joseph reaches agreement to stay open, congresswoman says

St. Joseph Medical Center has reached an agreement that will allow it to maintain federal health care reimbursement crucial to its survival, U.S. Rep. Sheila Jackson Lee said Thursday.

The reported agreement means the hospital can stay open while it resolves concerns over patient safety and quality of care.

The Centers for Medicare & Medicaid Services had notified St. Joseph last year that it would be terminated from the Medicare and Medicaid programs on Dec. 3, after state investigators cited the hospital for numerous violations that posed "immediate jeopardy" to patients.

Neither St. Joseph nor CMS officials could be reached immediately for comment Thursday.

More than 60 percent of St. Joseph's patients are covered by Medicare and Medicaid. The loss of funding likely would have resulted in the closure of St. Joseph, Houston's oldest hospital and the only one downtown. It plays a key role in the city's safety net, particular for homeless and psychiatric patients.

The hospital, owned by the for-profit hospital company Iasis Healthcare, began negotiations with the agency to stave off termination and was given until Friday to work out a systems improvement agreement, or SIA. The agreement spells out how the hospital will come back into compliance. Specific details of the agreement were not available Thursday.

Such arrangements typically last for 18 to 24 months and include supervision by an outside monitor.

Jackson Lee, a Houston Democrat who has been lobbying federal officials on behalf of the hospital, issued a statement saying she was pleased the hospital had been granted the improvement agreement and would stay open.

"I stand for excellent health care in our community," the statement said. "I have worked with St. Joseph Medical Center for years and view the professional staff as being a committed staff eager in providing important and crucial medical care to their hospital patients."

Federal officials investigated the hospital after the August shooting of a patient by two off-duty Houston Police Department officers providing security at the hospital. The agency's report criticized the hospital's failure to train the officers to respond to crises involving confused or aggressive patients. Subsequent visits to the hospital also identified concerns with patient rights, nursing and infection control.

Inspectors cited sloppy documentation in St. Joseph's dialysis unit and failure to properly address suicide risks. A 61-year-old woman admitted in October was found unconscious in a bathroom with a bra wrapped around her neck and a bottle of pills by her hand, but her treatment plan did not indicate suicide risk.

CMS also found issues with infection control. In nine random observations, inspectors said, staff members did not remove gloves or wash or sanitize hands after contact with contaminated patients or items. The floor in the psychiatric ward intake was "smeared with copious amounts of what appeared to be brown fecal matter, " according to the inspection report.

CMS had previously given St. Joseph four extensions to correct deficiencies, according to a previous inspection report.