REHECCA . MARY FALLIN CHIEF EXECUTIVE OFFICER GOVERNOR STATE OF OKLAHOMA OKLAHOMA HEALTH CARE AUTHORITY November 2016 CERTIFIED MAIL, RETURN 71.3% ?i?i?ll 7?035 HERE ELIES RECEIPT REQUESTED Patricia A. Rogers 10'h Floor, Two Leadership Square 211 N. Robinson Oklahoma City, OK 73102 Attorney for Shadow Mountain And Shadow Mountain Behavioral Health System, LLC RTC ?ll 71.99 ?i?l?ll 7035 HERE 2955 Attn: Michael Kistler 6262 S. Sheridan Rd. Tulsa. OK 74133 And 7035 EHHL Universal Health Services, Inc. cu? 71"? ?ml Attn: Chief Executive Of?cer 367 South Gulph Road King of Prussia, PA 19406 Re: Termination of SoonerCare Contract Provider for failure to comply with Corrective Action Plan Dear Ms. Rogers and Mr. Kistler, This letter is written to notify Shadow Mountain Behavioral Health System. LLC RTC (Shadow Mountain) that the Oklahoma Health Care Authority (OHCA) is hereby terminating its SoonerCare Contract for its failure to comply with the Corrective Action Plan that it was placed on by OHCA on March 2016 in lieu of termination at that time. (Incorporated by reference into this termination letter are March 2016 response and CAP letter, the notice of 4345 [.Incoln Blrd. Oklahoma City,OK TJIOS 0 (405) 512-7300 3133131133?! A An Equal Opportunity Empluurr intent to terminate letter dated December 2015, the August 2015 response and CAP letter. and the March 2015 notice of intent to terminate letter.) Based upon a review of your staf?ng, Shadow Mountain continues to be non-compliant with the minimum staf?ng requirements of O.A.C. and O.A.C. Additionally, Shadow Mountain continues to be non-compliant with federal and state rules and regulations that require a minimum of one (1) Registered Nurse (RN) per acute unit. Both of these staf?ng requirements were speci?cally addressed in the previous CAPs implemented by OHCA on Shadow Mountain. By way of example, during an onsite review in July 2016, Shadow Mountain's staf?ng report for April 2016 was reviewed for compliance with the requirements of the CAPS. Based upon a review of the information provided during the July 2016 onsite, there were numerous days and shifts that the minimum staf?ng requirements were not met. Mike Kistler. CEO of Shadow Mountain stated that the information provided was incorrect due to computer programing issues and asked to be able to provide additional information for review and the auditors agreed to the request. However, even after additional documentation was provided to OHCA, it was clear that Shadow Mountain was non-compliant with the minimum staf?ng requirements including multiple instances where the proper ratio of staff to patients was not met and, most alarming, instances where acute units were left with no RN coverage for all or part of a shift. The position is that Shadow Mountain's Medicaid contract for the units associated with Provider will terminate on November 2016 pursuant to section 8.1(i) of the SoonerCare contract. The effect of this termination is that Shadow Mountain will no longer receive payment for services billed using the above provider number. If the clinic bills and receives payment for services after November 2016, an overpayment may be determined by OHCA. Please note that at this time, OHCA has decided t0 0an terminate one (1) contract location rather than all 0 the contract locations that are currentlv sub'ect to APs ursuant to the above-referenced and incorporated letters. However. this does not preclude OHCA from taking [urther action should Shadow Mountain continue to tail to comglv with federal and state rules and regulations as well as CAP reguirements imposed bv OHCA. Additionallv, acknowledging that the safe transition of all SoonerCare members currentlv residing in the tenninated contract location is a hieh prioritv for OHCA, OHCA will work with Shadow Mountain on a case-bv-case basis and up to seven (7) days will be allowed for the relocation and/or dischartze of these patients. While the termination of the contract is effective November 2016 as noted above, 0H CA has the administrative discretion to approve or denv payments for services provided post-termination of the contract to ensure an orderlv and safe transition. Anv discretionary decision to approve or denv pavments for services provided post-termination is not appealable pursuant to OHCA rules. Based upon OHCA regulations, at Oklahoma Administrative Code (O.A.C.) 317:2-1-12, you have the right to appeal this decision and request a desk review of this termination notice if you believe OHCA has acted in error. A copy of the rule is enclosed. To appeal this decision, 4315M Lincoln Blvd. Oklahoma City, OK 73105 (406) 522-7300 ??wwt?v??g A 03g An Equal Opportunin Employer you must write a letter that must be received by OHCA no later than the close of business 20 days from the date of this letter. Your letter must state the reasons you believe this decision to be incorrect and provide written documentation to support your position. Please send the letter to: Termination Docket Clerk Oklahoma Health Care Authority PO. Drawer 18497 Oklahoma City, OK 73 l54-0497 [f we do not receive a letter by close of business in 20 days the contract will remain terminated. This letter serves as notice that the hospital may not bill for SoonerCare services after midnight on November 2016. Sincerely, Becki Burton Deputy General Counsel cc: Becky Pasternik-Ikard Provider Enrollment 4345 N. Lincoln Blvd. Oklahoma City, OK 73MB HUS) 322-7300 An Equal Onwlunu Employer