Funding for Hillcrest Hospital in Jeopardy

San Diego County’s mental health hospital in Hillcrest, under attack from various state and local agencies since summer, is on the verge of losing its eligibility for federal Medicare and state Medi-Cal funding, county officials acknowledged Thursday.

David Janssen, the county’s acting chief administrative officer, said state licensing officials told him and other county officials Wednesday that that they will recommend that the federal government revoke the hospital’s right to receive Medicare funds. The state would then automatically follow suit and stop making Medi-Cal payments to the hospital.

If the hospital were to lose the money, it would probably close, because the county could not afford to replace the subsidies with money out of its general fund.

Janssen said state inspectors who visited the 60-bed hospital in November and December found that the medical records section had still not been improved enough to meet minimum standards. As a result, the hospital’s management was also faulted.

Medical records and management were among six areas found to be out of compliance with federal standards when the hospital was last inspected in June. A state report issued in August warned that the hospital would lose its certification if problems in all six areas were not eliminated. The report also said that at least two deaths at the hospital in 1985 could have been prevented.

Janssen said four of those six areas--nursing, dietary programs, special staff requirements and special medical records requirements--have been improved enough to meet minimum standards. But he said state officials told him that because two areas remain out of compliance, they must recommend that the federal government revoke the hospital’s certification.

As an example, Janssen said the regulators ordered that a registered records technician be hired to run the hospital’s records division. But he said the county has no such job classification, and it takes several months for the Office of Employee Services to obtain Board of Supervisors approval for the new slot, then develop the job requirements and civil service exams needed to screen applicants.

A team of county officials will travel to San Francisco in coming weeks to try to persuade federal regulators that the medical records section will soon meet the requirements.

State and federal health officials could not be reached for comment Thursday.