JOEL NICO GOMEZ MARY FALLEN CHIEF EXECUTIVE OFFICER GOVERNOR STATE OF OKLAHOMA OKLAHOMA HEALTH CARE AUTHORITY December 2015 CERTIFIED MAIL: RETURN ?Fifth ?i?i?il. 7U33 Etta? IDLE RECEIPT REQUESTED Shadow Mountain Behaviorai Health System, LLC RTC Attn: Michael Kistler 6262 S. Sheridan Rd. Tulsa, OK 74133 And 33 1083 Universal Health Services, Inc. :1 1? mu! Attn: Chief Executive Officer 367 South Gulph Road King of Prussia, PA 19406 Re: Notice of Intent to Terminate SoonerCare Contracts Provider and Dear Mr. Kistler, This letter is written to notify you that the Oklahoma Health Care Authority (OHCA) intends to terminate your SoonerCare provider contracts for the abovemeferenced locations. There are multiple reasons for the contract termination. As you are aware, OHCA previously sent a notice of intent to terminate on March 2015 on Provider ?for which you submitted a letter for review. After review of our letter, OHCA responded in a letter dated August 29": 2015, and placed Provider?on a Corrective Action Plan (CAP). (The March 25?h notice of intent to terminate and the August 19?h response and CAP letters are hereby incorporated by reference.) It has become apparent to OHCA that the staf?ng insuf?ciencies cited in the March 25'h letter are a common and recurrent issue across all of your contracts at the Sheridan Road location. 1. Pursuant to O.A.C. 340: 10-3-168 and 317:30-5-9524, the required Residential Treatment Facility (PRTF) staf?ng coverage ratio during hours of sleep is one (1) tech for eight (8) patients and during waking hours is one (1) tech for six 4345 N. Lincoln Blvd. Oklahoma City,OK 73105 (405) 522-7300 0 mm; S?Ktit?A QRQ An Equal Opportunity Empbyer (6) patients On-site review results make it clear that the required staf?ng ratios are not complied with as required. Based upon on?site reviews, staf?ng ratios on the PRTF units have ranged from a ratio of 10:l to 22:1. These ratios exceed the maximum ratio and are a violation of policy and the terms of the contract; 2. Pursuant to O.A.C. the required staf?ng coverage ratio for a specialized PRFT during hours of sleep is one (1) tech for six (6) patients and during waking hours is one (1) tech for three (3) patients Additionally, there must be 24 hour nursing care supervised by a Registered Nurse (RN). Based upon on-site Observances, the staf?ng ratios requirements are not consistently met and there is not always a RN solely assigned to a specialized PRFT unit as required. 3. Additionally, there continue to be compliance issues regarding the lack of RN coverage for incidents of seclusion and restraints as required. 4. Furthermore, there continues to be issues involving the sharing and cross-counting of staff for different units within the same facility, especially for acute and residential units. There must be separate and distinct professional staff for both entities at all times. all staff responsible for patient care must be fully dedicated to either the acute or residential unit). The staff must not take care of or supervise acute hospital patients and PRTF patients at the same time during the staff assigned hours of work. When a provider enters into a contract with the OHCA, the provider agrees to abide by all terms of the contract. The Contract states that providers agree to comply with all applicable laws, including but not limited to, state laws, federal laws, and federal and state Medicaid statutes and regulations. OHCA believes that you have failed to abide by the terms of your contract and have failed to adhere to the regulations, policy, and laws governing Residential Treatment Facilities. For the above reasons, the OHCA intends to terminate your contract pursuant to Section Based upon OHCA regulations, at O.A.C. you have the right to request a review of this decision by submitting documents and written arguments stating why you believe your contract should not be terminated. A copy of the rule is enclosed. If you would like to request a review, your request must be received in writing by the 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 the letter?s reasoning. If the OHCA receives a letter from you with written documentation, the OHCA will consider the letter and issue a decision. Please send the letter to: Termination Docket Clerk Oklahoma Health Care Authority PO. Drawer 18497 Oklahoma City, OK 73154-0497 4345 N. Lincoln Blvd, Oklahoma City. OK 73165 (405)522-7308 0 WV. 1 - A. An Equal Opportunity Employer If the OHCA does not receive a letter by close of business in 20 days then your contract will terminate effective January 29th, 2016. Sincerely, ecki Burton Deputy General Counsel Enclosure as stated cc: Garth Splinter, MD. Sylvia Lopez, MD. Melody Anthony Kelly Kenneth Goodwin Jennifer King Becky Pasternik-lkard Traylor Rains, ODMHSAS Provider Enrollment 4345 N. Lincoln Blvd, Oklahoma City,GK 515195 (405}522?7306 An Equal Opportunity Employer