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A three-month Modern Healthcare analysis of hundreds of pages of federal inspection reports reveals the 1,268-bed Cleveland Clinic Hospital spent 19 months on “termination track” with Medicare between 2010 and 2013 as a result of more than a dozen inspections and follow-up visits triggered by patient complaints. The Cleveland Clinic is far from alone in facing the only sanction the CMS can apply to hospitals when serious safety problems and violations of informed consent rules are brought to light by patient complaints. An analysis of Medicare inspection data found that between 2011 and 2014 there were at least 230 validated serious incidents— dubbed “immediate jeopardy” complaints—that led the agency to threaten hospitals with losing their ability to serve Medicare patients unless they immediately fixed the problems. Overall, there were at least 9,505 CMS complaints lodged in that time against 1,638 hospitals, which included low-severity “standard level” violations; midlevel “condition level” violations; and the less common but most serious “immediate jeopardy” complaints. Only the most serious and condition-level complaints can lead to threats of being cut off from government funding. Only in very rarest of circumstances has the CMS followed through on the threat. The CMS' ultimate goal with hospital inspections “is to ensure compliance with Medicare rules, not close down hospitals that are essential to local communities,” a CMS spokeswoman said.