Upper East Side clinic that treated Joan Rivers loses second accreditation

NEW YORK (WABC) -- The Upper East Side clinic where Joan Rivers underwent a procedure right before her death has lost another accreditation.

One day after the federal Dept. of Health and Human Services said it would pull Yorkville Endoscopy's Medicare certification, word comes that the clinic has lost accreditation from the American Association for Accreditation of Ambulatory Surgery Facilities.

Losing accreditation from the not-for-profit AAAASF doesn't mean Yorkville Endoscopy has to close, but it can no longer boast that it meets what is widely considered in the industry to be the gold standard for patient safety. The move could also affect reimbursement from private insurance carriers. Pending an appeal the clinic is set to lose Medicare reimbursements January 31.

AAAASF declined to elaborate on its decision. "Yorkville Endoscopy is no longer accredited by AAAASF and we have no further comment on the matter at this time," said Kim Kubiak, a spokeswoman for the organization.

No immediate comment from Yorkville Endoscopy.

On Monday, the federal Centers for Medicare Services (CMS) announced it had determined Yorkville Endoscopy "no longer meets the Conditions for Coverage (CFC) for a supplier of Ambulatory Surgical Center (ASC) services. Therefore, CMS is terminating the Medicare Health Benefits Agreement between Yorkville Endoscopy and the Secretary, effective Jan. 31, 2015. As of January 31, 2015 Yorkville Endoscopy will no longer be eligible to receive federal funds for services provided to Medicare and Medicaid beneficiaries."

Last month, Yorkville Endoscopy had proposed a plan of correction to the federal Department of Health and Human Services that included an unannounced survey conducted by federal officials. If the survey found that corrections have been made and that the clinic was in substantial compliance with federal regulations, the facility would no longer face termination of federal Medicare and Medicaid funding.

In a statement following Monday's ruling, the clinic wrote "We are continuing to work with all regulatory bodies. We intend to communicate with CMS and appropriate authorities to have the decision reversed. Yorkville continues to be a licensed facility and perform procedures while cooperating with the regulatory process."

Rivers died in September after going into cardiac arrest during a procedure at the facility.

The New York City Medical Examiner's report on the investigation into Rivers' cause of death concluded that the comedy legend died from low blood oxygen during the medical procedure. The report said the death was caused by "anoxic encephalopathy due to hypoxic arrest during laryngoscopy and upper gastrointestinal endoscopy with propofol sedation for evaluation of voice changes and gastroesophageal reflux disease."

The report said the manner of death is therapeutic complication.

The finding was that Rivers was sedated with propofol before she died of low blood oxygen during a procedure to treat voice changes and acid reflux.

Anoxic encephalopathy means that she did not have sufficient oxygen to her brain tissue for a prolonged period of time, which caused damage to her brain.

The classification of a death as a therapeutic complication means that the death resulted from a predictable complication of medical therapy, the autopsy concluded. The classification is not commonly used; more deaths are certified as homicides, suicides or natural causes.