Hospital companies in Texas, many of which collect millions in state and federal funds, operate with minimal public disclosure of deficiencies. The state keeps information on complaints and inspections largely private because influential health care corporations want it that way, and Texas legislators have obliged.
As a result, it is next to impossible for the public to determine whether state enforcement works properly. Hospital lobbyists designed much of this system.
The Texas Department of State Health Services provides, on its Web site, a small amount of data on hospital fines. The department also furnishes limited and heavily redacted violation records to anyone who makes a formal open-records request, pays in advance and sometimes waits months for delivery.
The Texas Department of State Health Services has 34 surveyors to oversee more than 1,500 licensed hospitals, surgery centers and various health care facilities.
In 2007, the department received 1,430 complaints against 470 health care centers. The surveyors investigate most of these complaints, but the department does not release the surveyors’ reports to the public.
State inspectors cited PSI’s Millwood Hospital in Arlington in 2007 because five geriatric patients at risk for falling did fall. After finding that “no interventions were implemented,” the department’s enforcement safety manager assessed a fine of $110,000, according to the state’s notice of violation.
But hospitals have the right to negotiate such assessments in settlement conferences with the health department. After a conference with PSI attorneys, health department officials slashed the Millwood fine to $10,000.
Of the 470 facilities that received complaints in 2007, the health department took action against only 44. One had its operations suspended. The rest were put on probation or paid fines.
In 2007, state health department officials met with PSI to consider surveyors’ four separate recommendations that PSI hospitals lose their licenses for violations. Each time, the officials reduced the recommended revocations to fines.
Settlement conferences take place in closed sessions with no outsiders present and no transcripts preserved. No Texas law requires that the meetings be closed.
Hospitals for which state officers have recommended license revocation are given another chance if they can show that they have addressed their problems.
Here is where to look:
• Information on fines and suspensions can be found on the Texas Department of State Health Services Web site: http://www.dshs.state.tx.us/hfp/enforce.shtm
• Members of the public also can file an open-records request with the state health department for notices of violation against hospitals and for the department’s complaint/information logs. The department charges for copies, redacts many details and may take months to deliver.
To make an open-records request, contact:
Open Records Coordinator, Professional Licensing and Certification Unit, Mail Code 1982, P.O. Box 149347, Austin, Texas, 78714-9347
• Violations findings by state inspectors also are compiled by the federal Centers for Medicare and Medicaid Services. Request Form CMS 2567 for a specific health-care facility by email at cms email@example.com.
Or write to FOIA Coordinator, CMS, 1301 Young St., Suite 714, Dallas, Tex., 75202.
Include your phone number in your request.
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