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California Hospitals Face Scrutiny Over Nurse Anesthetist Care

Issues at Stanislaus Surgical Hospital and Doctors Medical Center

Two hospitals in Modesto, California, have come under scrutiny after being cited for care issues related to certified registered nurse anesthetists (CRNAs). This year, the California Public Health Department conducted surveys at Stanislaus Surgical Hospital and Doctors Medical Center following reports of patient harm. Doctors Medical Center was cited for immediate jeopardy by CMS for permitting CRNAs to oversee procedures they had not previously performed at the hospital. Inspectors also uncovered flaws in the credentialing of 19 CRNAs at the facility. Stanislaus Surgical Hospital was found to be out of compliance with several Medicare conditions of participation, including the handling of patient emergencies post-surgery, infection control, sterilization processes, and governance.

Impact on Hospital Operations and Patient Care

The citations have led to significant operational disruptions at both hospitals. At Stanislaus Surgical Hospital, dozens of CRNAs have been laid off, while Doctors Medical Center has sent CRNAs home until a corrective plan is submitted. These actions have resulted in the cancellation or rescheduling of hundreds of surgeries. The surveys have intensified the debate over the use of physicians versus advanced practitioners in patient care. The California Society of Anesthesiologists has raised concerns about patient safety, emphasizing the need for physician-led anesthesia care and citing questionable decision-making by CRNAs at Stanislaus.

Ongoing Debate and Industry Response

The debate over the roles of physicians and CRNAs in anesthesia care continues to evolve. The California Society of Anesthesiologists highlighted issues such as improper drug prescriptions, inadequate paperwork, and insufficient communication by CRNAs at Stanislaus. In response, the California Association of Nurse Anesthesiology criticized the survey findings, suggesting a broader agenda by physician groups to reclaim a larger share of business from CRNAs. Despite the increased independent practice of CRNAs from 2020 to 2023, there has not been a significant rise in patient harm, according to Kaitlin Perry, a communications consultant for the association. Perry emphasized that CRNAs are highly qualified and capable of providing safe care

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