Neither politics nor changes to state health regulations influenced either the timing of the recent survey of FemCare or the loss of the Asheville abortion clinic’s medical license, according to statements from the North Carolina Department of Health and Human Services.
“On average we’re able to inspect the medical component of abortion clinics every 3-5 years — and that’s on average. So obviously, this is about six years,” says DHHS Communications Director Ricky Diaz.
FemCare was last inspected in 2006 and found in violation of personnel and quality assurance rules. The most recent July 18-19 licensure survey, however, found 23 separate health violations. A July 31 statement from DHHS called the violations “egregious” and also said they “revealed an imminent threat to the health and safety of patients.”
The findings concluded that the facility failed to keep anesthesia delivery systems in good working condition, specifically citing torn masks and tubing found “held together with tape” — putting patients at risk for pain and physical harm due to inadequate sedation dosages during surgical procedures.
The same evening that DHHS announced the suspension of the local clinic’s medical license, Dr. Lorraine Cummings released a statement on behalf of FemCare. In the statement, she said, “Since the State’s last site visit in August 2006 there have been no changes in our operating protocols, but increasing regulations require us to make changes. Standards that were acceptable when we were last inspected have changed and, as soon as we were notified of them two weeks ago, we began the process of meeting each one of them.”
However, Azzie Y. Conley, who serves as the Section Chief of the Acute and Home Care Licensure and Certification Section of the state’s Division of Health Service Regulation, says Cummings is mistaken in her understanding of the reasoning behind the center’s medical license revocation.
“The survey conducted on July 18, 2013, through July 19, 2013, was conducted as a routine inspection under North Carolina’s licensure requirements for ambulatory surgical facilities as set forth in 10A NCAC 13C. These regulations have not been revised since 2003. Therefore, it is inaccurate to suggest that increasing or changing regulations led to the closure of your facility,” Conley said in an Aug. 1 letter emailed to Cummings (see the letter in full below). Attempts to reach Cummings for comment were unsuccessful.
The 10 inspectors who work for the Acute and Home Care Licensure and Certification Section of the Division of Health Service Regulations are responsible for licensing, regulating and inspecting hundreds of facilities across 19 different program areas, ranging from ambulatory care centers to hospitals and nursing homes.
Diaz explains that the division conducts three different kinds of inspections. For instance, a federal mandate requires that the state inspect the lab component of abortion clinics every two years. The state is also required to investigate complaints and complete follow-up inspections as well.
Despite campaign promises that he would not sign any bills into law that would further restrict access to abortion, Gov. Pat McCrory signed a bill into law on Monday that will require abortion clinics to meet the same standards of outpatient surgical centers. In a July 3 article, investigations by Xpress found that the only abortion clinic in the state that would meet those new requirements was Asheville’s FemCare. It also requires that a physician to be physically present in the room with a woman upon taking the first dose of an abortion-inducing drug. However, it does not require that a physician be present beyond the initial dose. Critics say the legislation, entitled “Health and Safety Law Changes,” will effectively shut down abortion clinics across the state.
But Diaz maintains, “People are asking if it [FemCare’s closure] was political. That’s absolutely not true. The new law has nothing to do with the closure of FemCare.” He continues, “The rules haven’t changed at all. The legislation asked the department to write those rules and we haven’t started the rule-making process.”
However, the recent violations do not mean FemCare’s medical license can’t be restored. There’s still a chance for the clinic to reopen its doors after the state ordered that the clinic to be closed yesterday at 5 p.m.
“They have to correct the immediate jeopardy. We work with facilities across the state,” Diaz says. “Whether it’s a nursing home that we suspend their license or someone else, they are given an opportunity to correct the problem and correct the violations that pose an immediate threat.”
According to the 49-page report issued by DHHS, FemCare has 10 days to respond with proof that it has brought its operations into compliance with the relevant rules and 60 days to file an appeal of the summary findings. After that, the changes must then be verified before the summary suspension can be lifted.
— Caitlin Byrd can be reached at firstname.lastname@example.org or 251-1333, ext. 140.