The federal Centers for Medicare and Medicaid told Mount Carmel's West and St. Ann's hospitals that their pharmaceutical services continue to be out of compliance.
CMS informed Mount Carmel it was in “immediate jeopardy” of losing federal funding in January, after the hospital announced it fired doctor William Husel for giving “excessive” doses of painkillers to dozens of patients.
Both Mount Carmel West and St. Ann’s were required to submit corrective actions plans that address the pharmacy process, which they did on February 4. The hospitals were removed from “immediate jeopardy” status after a February 11 on-site survey found that patient health and safety was no longer in danger.
In letters dated February 22, CMS said that “while the immediate jeopardy to patient health and safety has been removed at both Mount Carmel St. Ann’s and at Mount Carmel West, condition level non-compliance remains at both facilities.”
A hospital spokesperson says the health system was unable to complete extensive training for hospital employees by the February 22 deadline imposed by CMS. The trainings are slated before March 6.
CMS authorized the Ohio Department of Health to conduct a full review of both Mount Carmel West and St. Ann's, to certify they're complying with all conditions of Medicare particpiation beyond pharmaceutical services.
Mount Carmel says it is preparing a formal statement.
Mount Carmel’s corrective action plans, which were acquired by WOSU, cited an Ohio Department of Health report that found policy deficiencies and failed safeguards around painkiller dosing and medication dispensing. The report found Mount Carmel “failed to prevent patients from receiving an overdose” from painkillers like fentanyl.
Among the major findings of the Health Department was that Mount Carmel employees could override the approval process of an automated medication dispensing system in order to get more medication. In addition, the hospital lacked written policies on how much fentanyl would be appropriate for palliative care.
Mount Carmel’s corrective action plan included changes such as limiting the availability of opioids in the medication dispensing system, reducing the number of medications available through system overrides, and requiring daily reviews of high-risk medication overrides.
Many of the 35 patients identified by Mount Carmel as receiving “excessive” doses of fentanyl were considered near-death and placed on life support. All patients died after receiving the painkillers. A subsequent press release from hospital announced the possibility that five of those patients could have improved in their conditions.
At least 23 employees, including pharmacists and nurses, have been placed on administrative leave since Mount Carmel began its investigation. The hospital previously said such employees “ignored the safeguards we had in place.” However, several Mount Carmel employees told WOSU that the hospital’s policies were not clear enough to justify punishment of staff members who followed the orders of their doctor.
The State Medical Board of Ohio suspended Husel’s license last month, and warned it could impose further discipline. Husel recently requested a hearing to appeal his license suspension and possible permanent revocation.
At least 19 wrongful death lawsuits have so far been filed against Mount Carmel and Husel, and lawyers say a 20th suit is forthcoming.
The Franklin County Prosecutor's Office is currently investigating.
If you are a Mount Carmel staffer who has information to share, or you believe your loved one or family member was impacted by this case, contact WOSU at email@example.com.