Just when it barely survived blows that would have jeopardized the health and jobs of scores of local residents, Sullivan County’s only hospital must face another huge challenge.

Catskill Regional Medical Center, which narrowly avoided bankruptcy and a state takeover last year, has been found lacking in several areas by the national organization that accredits hospitals.

The Joint Commission, which evaluates and certifies more than 15,000 American health organizations, recently found deficiencies that include: a doctor who operated on one side of a hip writing a report saying he worked on the other side, staff members working without hospital ID badges and the failure of Catskill to write an evaluation of its intensive care unit.

The CEO of Catskill’s new partner, Scott Batulis of Orange Regional Medical Center, calls the Joint Commission evaluation “a serious thing.”

Another medical official familiar with the Joint Commission’s surprise visit in late 2007 terms it “a huge, huge thing.”

But while the evaluation is used to accredit the hospital, Catskill’s new CEO, Steve Ruwoldt, says its accreditation is not in jeopardy.

“It wasn’t in regard to poor patient care,” he said Thursday. “But sometimes it speaks to documents and paperwork and if the documentation isn’t there, then it is considered patient care (by the Joint Commission).”

Documentation is considered part of patient care, according to Joint Commission spokesman Ken Powers.

The results of the accreditation survey won’t be released until next month, when Catskill has had time to try to correct its problems, a process that already has begun. But the doctor who wrote a report about the wrong hip is already “under review,” said Ruwoldt.

“They’re trying to clarify these things and submit areas of compliance. We won’t release the specifics until our official decision is made by our accreditation committee,” said Powers, of the Illinois-based organization comprised of the American College of Physicians, the American College of Surgeons, the American Dental Association, the American Hospital Association and the American Medical Association.

The critical evaluation comes after Catskill barely survived a series of near-fatal blows. They centered on the hospital’s bottom line and charges of poor care by Crystal Run Healthcare managing partner Hal Teitelbaum.

Catskill board members know that the news of the accreditation evaluation may hurt the hospital’s reputation. They also know that the hospital still carries about $50 million in debt — about $25 million more than it should, says Catskill board president Gerry Skoda.

But Catskill Regional has survived near-bankruptcy and a state takeover, which would have decimated it. Now it must survive yet another critical challenge — that accreditation exam.

“Are we out of the woods yet? No,” says Skoda. “Have we made a lot of progress? Yes.”

Click HERE to be redirected to the Times Herald Record website to read this extended article.