DALLAS (AP) — After almost two years of oversight, federal officials say a Dallas hospital system is in substantial compliance with Medicare program requirements.

The U.S. Centers for Medicare & Medicaid Services said Wednesday that Parkland Health & Hospital System meets requirements of a “systems improvement agreement” that took effect Sept. 27, 2011. The agreement required the hospital to retain independent experts to analyze the hospital’s operations and develop a plan to comply with Medicare quality-of-care requirements.

David R. Wright, CMS deputy regional administrator, said in a news release that the completion of the agreement “places Parkland in the best position to have a sustainable culture of patient safety,”

Parkland, Dallas’ only public hospital, entered into the agreement as a way to prevent losing Medicare funding that was jeopardized by problems at the facility. Hospitals must be Medicare-certified to get Medicaid funding, so terminating Medicare would have also meant the loss of Medicaid.

An inspection in July 2011 triggered by the death of a patient earlier that year in the psychiatric emergency room found significant violations related to infection control and emergency care. In a follow-up to that inspection, CMS said that while Parkland had corrected its infection-control problems, patients still faced “immediate jeopardy” in the emergency room and that the hospital system’s Medicare agreement would end unless it entered into the agreement

Robert L. Smith, interim CEO at Parkland, told The Associated Press that it has “been a very long work effort” over the last nearly two years for those at Parkland.

“While we are no longer subject to the systems improvement agreement, we within our responsibility to care appropriately for patients continue every day, every hour to focus on doing the right thing all the time for every patient,” he said.

He said that changes through the agreement include putting more structure into the organization so there are clear lines of accountability and authority. He also said there have been physical changes to improve care processes, including renovations in the psychiatric emergency room, urgent care center and behavioral health unit.

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