After months of revamping treatment plans to satisfy federal regulators who had found lapses in care, Springfield Hospital Center has earned near-perfect marks for tending to its patients and maintaining their records.
The Centers for Medicare and Medicaid Services, a federal agency that provides health insurance for more than 74 million Americans, conducted a three-day survey last week at the state-run psychiatric hospital in Sykesville. The team of medical consultants found no deficiencies in care in its review, the third conducted this year.
"Our consultants found the hospital had fully regained compliance with federal regulations," Carol Messick, a CMS spokeswoman, said Friday from the agency's headquarters in Philadelphia. "Springfield has addressed and corrected every previously identified deficiency."
When CMS interviewed staff and patients during an unannounced survey in January, the consultants filed a 23-page report listing deficiencies at Springfield. The agency conducts similar inspections periodically at 530 hospitals, 59 of them psychiatric, in the mid-Atlantic region.
The report detailed instances of patients being left unmonitored and nurses occasionally sleeping on night duty, but the most notable problem was a lack of documented individualized plans of care, the surveyors wrote.
The group returned to the hospital in May expecting to find the problems corrected. Paula Langmead, Springfield's superintendent, had implemented the recommended changes on three pilot wards but had not been able to complete the work. She asked for an extension until the changes were made throughout the hospital.
Langmead then ordered her medical staff to rewrite treatment plans for all 325 Springfield patients and to make them detailed and consistent, in keeping with CMS guidelines. She stressed the urgency of complying with the federal agency, which oversees annual payments of about $360,000 from Medicare and $1.5 million through Medicaid to the hospital.
Langmead said the work added hours to the staff's workload, but that was the only way to accomplish the task.
"Redoing every chart involved so much time for the staff, in addition to all their other duties," she said. "But now every chart is consistent and shows every aspect of care. We could have tried a patchwork approach, but instead we reworked everything."
The charts reflect individual diagnoses and treatment plans, as well as what each patient is doing, where and when. The hospital hopes to computerize its records when state funding becomes available.
"CMS looked at many different aspects of care and found us with absolutely no deficiency," Langmead said. "The surveyors were extremely complimentary about our patient care."