The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

JAMESTOWN REGIONAL MEDICAL CENTER 436 CENTRAL AVENUE WEST JAMESTOWN, TN 38556 Feb. 5, 2019
VIOLATION: GOVERNING BODY Tag No: A0043
Based on review of accounting records, review of letters from vendors, and interviews, the facility's Governing Body failed to provide financial resources to meet the facility's contractual responsibilities.

Refer to A-073
VIOLATION: INSTITUTIONAL PLAN AND BUDGET Tag No: A0073
Based on review of accounting records, review of letters from vendors, and interviews, the facility failed to ensure financial resources were available to meet financial obligations to 165 vendors providing services to the facility.

The findings included:

Review of facility accounting records revealed a Vendor Aging Report dated 1/30/19. Further review revealed the facility owed 165 vendors a total of $2,937,505.83. Continued review revealed 11 vendors had discontinued services with the facility due to failure to pay on accounts.

Review of a letter from the hospital's emergency room (ER) Physician's group dated 1/24/19 revealed "...Breach of Contract Notices for Emergency Services Agreement...We have previously given notice that Hospital has breached the Agreement...The hospital owes Group a total of $257, 284.24 for services provided by Group under the Agreement, of which $194,173.44 is past due...If payment is not received on past due balances...by February 1, 2019, or a payment scheduled agreed to by the parties we will pursue the following course of action...Terminate the Agreement, effective February 1, 2019...Cease all scheduled coverage at the earliest possible date..."

Review of a letter from the Environmental Services vendor dated 1/14/19 revealed "...This letter is to inform you that Jamestown Regional Medical Center is in material breach of our Statement of Work...As of today Jamestown Regional Medical Center owes...a total of $92,706.69 in past due fees...if payment has not been received by January 28, 2019...will be exercising its right to terminate the Agreement...effective midnight on January 29, 2019..."

Interview with the Administrator, Chief Nursing Officer (CNO), and Controller, in the CNO's office, on 1/30/19 at 10:30 AM revealed the facility had financial difficulty since 12/1/18. Further interview revealed the facility begun using a new computer system on 12/1/18 which caused a delay in the facility receiving payment from insurance and other third party providers. Continued interview revealed payments were expected to resume soon, but for the moment the facility's owners were applying for loans to help finance the facility's expenses. Further interview revealed the facility had negotiated with many of the vendors to continue services and have made agreements for payment plans.

Interview with the Controller and the CNO on 1/31/19 at 10:00 AM, in the Administration Conference Room, revealed:
1. The facility owed money to the ER Physician's group but had negotiated a payment plan agreement with the ER Physician's Group on 1/31/19 and their services would not be interrupted or discontinued.
2. The facility owed money to the On-Call Physicians and the facility had negotiated a payment plan agreement with their On-Call Physicians and services were being continued without any interruption.
3. The facility's dietary/food services vendor had discontinued services on 1/25/19 due to accounts not being paid and the facility hired the vendor's staff and contracted a dietitian so services were not interrupted.
4. The facility's environmental services vendor was terminating services effective 1/31/19 and the facility made agreements with the environmental services employees to work for the facility so services were not interrupted.
5. The facility's anesthesia provider had discontinued services on 1/18/19 and the facility made an agreement with another provider to provide services as of 1/30/19.
6. The facility's Magnetic Resonance Imaging (MRI) vendor notified the facility it would terminate services on 1/31/19 if not paid, but the facility a payment plan on 1/31/19 and the vendor continued services without interruption.
7. The controller had been in contact with all the other vendors and discussed payment and/or payment plans and all had agreed to continue services without interruption.