After nearly two years, Sharpe Hospital may regain Medicaid certification

2019-08-26 | The Register-Herald

Aug. 25-- Aug. 25--Nearly two years after losing its permission to accept Medicaid and Medicare, due to improper treatment plan documentation, Sharpe Hospital in Weston still can't accept Medicare/Medicaid patients.

A spokeswoman for the state Department of Health and Human Resources, though, said last week they may regain that certification soon.

In September 2017, the federal Centers for Medicare and Medicaid Services notified Sharpe Hospital, a state-owned psychiatric facility in Weston, that it would no longer be allowed to accept Medicare and Medicaid funding.

They said Sharpe employees were not showing that they were appropriately caring for patients through proper documentation of treatment plans -- a condition of Medicare and Medicaid participation. During one visit, CMS reviewed 10 treatment plans and found that, in seven, they were not ensuring treatment was "based on the individual needs of the patient," according to the Charleston Gazette-Mail.

In response, the state Department of Health and Human Resources began transferring forensic patients, typically those found not guilty of a crime by reason of mental illness, from other hospitals in the state to Sharpe Hospital, and transferring Medicare and Medicaid patients to other hospitals.

DHHR officials said they were contracting with The Greeley Company, a consulting firm, to help them become re-certified.

Approximately $1.5 million later, Sharpe is still only accepting forensic patients and can't accept Medicare and Medicaid.

In an email Friday, Allison Adler, DHHR spokeswoman, said they may become re-certified soon, though.

"William R. Sharpe Jr. Hospital (Sharpe) had a recent Centers for Medicare Medicaid Services (CMS) survey to validate maintaining compliance with CMS enrollment requirements and is awaiting notification from CMS that all requirements were successfully met," she wrote. "The Greeley Company has been on contract to assist with the recertification for nearly two years.

"Approximately $1.5 million has been spent over that period. DHHR has covered the costs of the Greeley contract by increasing Forensic admissions to Sharpe, resulting in fewer diversions to other hospitals and therefore, lowered state expenditures. DHHR estimates that it has saved more than $2 million in diversion costs since the loss of certification."

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