Senators Max Baucus (D-MT) and Charles Grassley (R-IA) have requested that the Government Accountability Office (GAO) initiate an inquiry of patient safety and quality of care in long-term care hospitals (LTCHs). The senators are respectively the chair and ranking member of the Senate Finance Committee, which covers Medicare legislation and oversight. The senators sent letters to the GAO and to Select Medical Corporation in light of a recent New York Times article on alleged incidents in some Select Medical long-term care hospitals such as high rates of violations of Medicare requirements; poor health care quality; inadequate staffing; high staff turnover rates; and inadequate patient monitoring.

The senators are requesting that the GAO review "...the level and type of oversight that is conducted related to patient care provided at LTCHs relative to other facilities and long-term care settings, including hospitals and skilled nursing facilities." The Senators are also requesting information on what types of quality and patient safety information the Centers for Medicare & Medicaid Services (CMS) collect regarding LTCHs, and an examination of the coordination between CMS, state survey and certification agencies, and private accrediting entities regarding LTCH quality care.

The letter to Robert A. Ortenzio, Chief Executive Officer of Select Medical Corporation, asks for information on several issues including the number of physicians and hours worked, communications regarding any "condition level" violations from 2007 on, corporate-wide policies and protocols to address emergency situations in LTCHs, and corporate-wide policies and protocols on or related to patient monitoring.

Select Medical has since released a response, saying it would cooperate fully and quickly with the inquiry because it wants to demonstrate that the allegations in the New York Times article are inaccurate. "We look forward to providing the committee with accurate facts -- untainted by plaintiffs' lawyers' pleadings -- that make plain that Select Medical provides high-quality care to thousands of high-risk and fragile patients each year. Last year alone, Select Medical's long-term care hospitals provided nearly 900,000 patient care days and underwent 96 federal and state inspections, and received full accreditation in every one of our 21 Joint Commission reviews."

Based in part on a press release from Senators Baucus and Grassley.

Link, with letters and New York Times article: http://finance.senate.gov/press/Bpress/2010press/prb030910c.pdf

Select Medical Corporation's response: http://www.selectmedicalcorp.com/downloads/SMC-SFC-Response-10-0309.pdf

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