Health & Medicine

January 16, 2013

New federal report backs off threat to cut UCD Med Center funding

Federal regulators have backed off their threat to cut funding to the UC Davis Medical Center after a follow-up inspection found that the public hospital is now complying with regulations governing patient safety and care.

Federal regulators have backed off their threat to cut funding to the UC Davis Medical Center after a follow-up inspection found that the public hospital is now complying with regulations governing patient safety and care.

The latest findings by the Centers for Medicare and Medicaid Services are a victory for the university, which has endured withering scrutiny in recent months over the controversial activities of two neurosurgeons.

In a letter mailed Jan. 10 to the medical center, and released Tuesday to The Bee, federal officials informed UC Davis that the hospital has "demonstrated compliance" with all conditions for Medicare participation.

While inspectors found some deficiencies at the hospital, according to the letter, they were not considered serious enough to warrant further federal intervention – or even a formal response from the university.

"This is great news, and I congratulate each and every one of you for your role in this achievement," said Ann Madden Rice, the medical center's chief executive officer, in an electronic message to faculty and staff.

"Undergoing such rigorous surveys back-to-back is a measure of our commitment to safety and quality," she wrote. "These results underscore why we can all be proud of the truly life-saving care we provide every day in this institution."

The feds' seal of approval is a dramatic turnabout from the dire report released last month, in which the federal watchdog agency blasted the hospital for "serious deficiencies" that it concluded had threatened the safety of all patients.

That report was based on an August inspection conducted by the California Department of Public Health, at the behest of the federal agency. The first inspection zeroed in on the activities of the neurosurgeons, Dr. J. Paul Muizelaar and Dr. Rudolph J. Schrot.

The surgeons have been under fire, from within the university and from outside regulators, over their use of untested treatments on three critically ill brain cancer patients in 2010 and 2011. All three patients died, and the doctors were reprimanded by university officials in 2011 for failing to get proper approval for their novel treatments.

Despite the in-house discipline, Muizelaar remained chairman of the neurological surgery department and, in 2012, was named the first holder of the department's prestigious new Julian R. Youmans endowed chair. He has been one of the highest paid employees in the entire University of California system, earning $859,000 in 2011, according to UC salary data.

After The Bee first reported the controversy in July, federal investigators expressed interest in the case and the two inspections soon followed.

In its first report, focusing on the neurosurgeons' work, the federal agency found that hospital staff and leadership repeatedly failed to intervene or raise questions about the "non-standard, experimental treatments" – and that their actions or inaction jeopardized overall patient care.

While university officials rejected that sweeping assessment, the school responded with a lengthy plan of correction, as required.

The second inspection in December was more expansive than the neurosurgeons' three cases, looking at broader hospital operations.

Since the medical center was found this time to be in compliance – and the deficiencies uncovered were "standard level," instead of serious – the federal agency stated that no plan of correction would be necessary.

However, university officials have indicated they plan to respond to this report, as well.

"We view these as an opportunity to improve," said Bonnie Hyatt, spokeswoman for UC Davis Health System.

While the feds' letter was greeted as good news, the specifics of the latest investigation were not made public. The more detailed findings will be available once the university responds.

Despite the scathing nature of the first report, few believed UC Davis was ever in serious jeopardy of losing its federal funding. While the agency has taken such drastic steps – Martin Luther King Jr./Harbor Hospital in Los Angeles was forced to close in 2007 after its funding was stripped – federal regulators told The Bee that such a scenario here was unlikely.

But the controversy has not been without fallout.

In November, Dr. Claire Pomeroy, dean of the UC Davis School of Medicine, announced her resignation.

A month later, university officials said that Muizelaar would be taking a voluntary leave of absence from his clinical work while a medical peer review committee examined four new malpractice claims in which he was involved in the patients' care.

Muizelaar stepped down in late July as department chairman while investigations into his and Schrot's work ensued. One of those probes, being led by the university's provost and executive vice chancellor, Ralph J. Hexter, is still under way.

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