Regulators warn Blue Springs hospital that lab’s ‘deficient practices’ could put patients at risk

by Suzanne King, Beacon: Kansas City
January 22, 2025

Regulators recently warned officials at St. Mary’s Medical Center in Blue Springs that “deficient practices” at its laboratory, including lax testing procedures and insufficient training, could endanger patients.

The Missouri Department of Health and Senior Services informed hospital officials that they had found the lab to be in “immediate jeopardy,” the most severe level of noncompliance in health regulation.

The state’s Dec. 20 letter said the finding was based on a “complaint survey” completed on Dec. 17. This survey, or inspection, included an onsite visit Dec. 10-11, a phone interview Dec. 16-17 and additional documentation, the state’s report said.

Citing federal regulations, the letter said a finding of immediate jeopardy was made because the lab’s noncompliance “has already caused, is causing, or is likely to cause, at any time, serious injury or harm, or death, to individuals served by the laboratory or to the health and safety of the general public.”

In a written statement, the hospital acknowledged the finding and said it had submitted a corrective action plan to the state. 

"We take survey findings very seriously and have taken proactive steps to implement changes addressing issues identified by the Missouri Department of Health and Senior Services," the hospital said.

The hospital’s statement said the hospital is fully operational with "comprehensive laboratory services."

“No St. Mary’s patients were ever identified as being harmed throughout the survey process,” the statement said.

The Missouri Department of Health and Senior Services (DHSS) conducts surveys of health care facilities in the state on behalf of the U.S. Centers for Medicare and Medicaid Services (CMS). 

In this case, said Sami Jo Freeman, a DHSS spokeswoman, CMS identified concerns and directed the state agency to perform a complaint investigation into the laboratory, which led to the immediate jeopardy findings.

Freeman confirmed that St. Mary’s officials had responded to the state report in writing. 

“Their response has been forwarded to, and is currently under review by, CMS, who will decide if the response is adequate and decide the next steps,” Freeman said in an email.

St. Mary’s, an 80-bed hospital owned by the for-profit chain Prime Healthcare, said the immediate jeopardy finding was related to blood bank processes and based on inspections conducted in October 2023, a month before the hospital shifted blood bank services to St. Joseph Medical Center, another Kansas City-area hospital owned by Prime.

St. Mary’s statement said blood bank services “will continue to be provided to St. Mary’s patients uninterrupted through this partnership.”

A hospital spokeswoman did not explain why the blood bank process had been shifted to St. Joseph Medical Center in 2023. 

She also didn’t answer questions about more recent issues raised in the state’s December report. The report said the laboratory “failed to provide blood bank procedures for all blood bank processes that started October 2023.”

The hospital spokeswoman also declined to respond to questions about concerns raised in the report that did not involve blood bank services.

A finding of immediate jeopardy could result in fines, onsite monitoring and the loss of Medicare accreditation. Such a finding is relatively uncommon. One study from 2021 found that less than 3% of hospital citations reached that most serious level.

In 2022, St. Mary’s Hospital faced another immediate jeopardy finding, according to a database of inspection reports. That time regulators raised concerns about physical force used against patients in the hospital’s emergency department. The immediate jeopardy finding was removed after the hospital implemented an action plan, which included the dismissal of an employee directly involved, executives spending more time in the department and staff education.

The state’s December report cited a range of problems with St. Mary’s laboratory, many of them relating to testing procedures, documentation, quality control and training. 

Overall, the report said, the lab’s director “failed to provide overall management and direction of the laboratory.” 

This included failure to “ensure overall operation” of the lab’s blood bank; failure to properly train staff before they performed patient testing; a lack of remedial actions when “significant deviations” were identified; and quality control lapses, such as a failure to ensure that follow-up crossmatch testing was performed.

The lapses, regulators said, could lead to inaccurate patient test results, which could cause issues or delays of patient diagnosis and treatment. The failures, the report said, “have a significant potential to cause patient harm.”

The position of lab director is currently posted as an open job on the hospital’s website. It isn’t clear who was director during the period of time covered by the inspection.

The state also called out the lab’s failure to maintain analytic systems, including a lack of laboratory procedures and a failure to perform and document quality control measures. 

For example, the report found that the lab didn’t document the inspection of whole blood before issuing it. In one case in November, the report said, blood was given to a patient “without units being labeled and proper procedure was not followed.”

The report said the lab also did not perform alarm inspections on a blood bank refrigerator, and lacked or failed to document certain test control procedures. 

The state called out problems with the lab’s procedures for urinalysis, saying the machine used in tests, a urinalysis centrifuge, was operating at the incorrect speed. In another instance involving a test for vitamin B12 levels, a test control was not within acceptable limits for several hours, the state said.

This article first appeared on Beacon: Kansas City and is republished here under a Creative Commons license.

Missourians vote to increase minimum wage, require paid sick leave

by Clara Bates, Missouri Independent
November 5, 2024

An effort to hike the state’s minimum wage to $15 an hour and guarantee paid sick leave won the support of Missouri voters Tuesday night. 

Proposition A was approved by Missouri voters 58% to 42%.

The approval follows a trend of Missourians using the initiative petition process to increase the minimum wage — and more broadly, of Missourians using that process to advance policies at odds with the beliefs of the state’s Republican dominated legislature.

Proposition A was backed by various unions and workers’ advocacy groups, social justice and civil rights organizations, over 500 state business owners and others. 

Some business groups, including the state Chamber of Commerce, have opposed it, especially the guaranteed sick leave portion. But there wasn’t a coordinated opposition campaign. 

The campaign in favor of the measure, called Missourians for Healthy Families and Fair Wages, raised nearly $6 million — including from out-of-state groups that don’t disclose their donors — and collected 210,000 signatures to have the issue placed on the statewide ballot.

The current minimum wage in Missouri is $12.30, which is equivalent to $492 per week, before taxes. The ballot measure would raise the state’s minimum wage to $13.75 next year and $15 in January 2026. 

The increase would affect over 562,000 workers in the state, according to the Missouri Budget Project, or nearly 1 in 4 workers. The minimum wage would be adjusted based on inflation every year after 2026.

Voters approved a minimum-wage hike in 2006, with 75% of the vote, and again in 2018, with 62% of the vote.

And businesses will be required to provide one hour of paid sick time for every 30 hours worked, up to five days per year for small businesses and seven days per year for larger businesses. Small businesses are those with fewer than 15 employees.

The paid sick time provision will go into effect on May 1, 2025.

Without sick leave, proponents argue, workers have to choose between their financial and physical wellbeing — going into work sick or losing out on a needed paycheck.

Missouri will join 15 states that require employers to provide paid sick leave. The United States, unlike nearly every other country, lacks federal paid sick leave, so states, as well as cities, have taken the lead. 

Some business groups raised alarm particularly with the sick leave provisions, saying the proposal constitutes government overreach in what should be the decisions of business owners.

At the same time, a coalition of hundreds of businesspeople in the state have signed on to support the ballot measure, arguing the policies help their bottom line, causing lower employee turnover, increased productivity and better health and safety conditions.

The ballot measure would change the state law but not the constitution, meaning the legislature could overturn it, but those on both sides of the issue told The Independent last month they see that as unlikely.

This article has been updated to reflect final, unofficial results.

Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: [email protected]. Follow Missouri Independent on Facebook and X.