Under private equity ownership, Memorial Medical Center’s extreme focus on “profit over safety” apparently has torpedoed morale, endangered patients, undermined collegiality, and could violate its lease and the law.
[Please note that this column is my opinion. Maybe MMC has answers, excuses, or explanations to these questions. I’ve been trying to interview MMC CEO John Harris.]
Any hospital depends on oversight and collegiality. MMC was part of a National Physicians Advisory Board related to Duke University. Then it wasn’t, and used [obviously less rigorous] questionnaires instead. A Medical Committee that was a counterweight to the administration, safeguarding patients’ interests, reportedly has been weakened. Meanwhile, doctors who questioned problems were retaliated against. But doctors should ask questions!
“The profit over safety motivation, particularly during COVID, was appalling,” commented ex-MMC Doctor Jonathan Owens. Another doctor said that during that public health emergency, “all the administration wanted to do was find ways around the governor’s mandate against doing elective surgeries. They wanted to do joints, heart surgery, and weight-loss surgery because those were profit centers. It was incredibly disheartening.” Several said Harris initially “was denying that COVID was even a thing” and “spinning conspiracy theories,” which was “completely demoralizing to the medical staff.” Doctors watching patients suffer, or even die, were hearing that MMC needed to do weight-loss surgeries.
MMC set up a Pediatric Intensive Care Unit (PICU), and hired Dr. Jorge Saenz to run it. Soon an unusually high percentage of pediatric admissions were “intensive-care.” Pediatrician Heather Owens, some of whose patients got admitted as “intensive-care,” says that “for PICU admissions of the magnitude MMC saw, we’d have to be suffering an order of magnitude increased illness.” PICU admissions reportedly were several times the national average of 10-15%. (Hospitals, of course, can charge more for treating someone in intensive care. Maybe MMC didn’t. Authorities should investigate whether “maximizing profits” became “defrauding medicare.”)
Saenz’s abrasiveness exacerbated tension. Doctors should be collegial. Efforts to help him improve on that score failed. Dr. Heather Owens said that twice Saenz’s conduct toward her resulted in complaints to medical staff. Several sources said Harris stepped in to protect Saenz.
Did MMC sometimes prioritize especially lucrative departments over important but less profitable ones? One doctor, “worried about patients because of an antiquated medical-records system. The Emergency Department repeatedly requested new monitoring machines. Unsuccessfully. Patients suffered. When one died, the malfunctioning machine failed to notify staff. No one knew of the death until someone went in to check vitals. Had the machine alerted ER staff, could that patient have been saved? Reportedly, even after that event, it took a long time to get new monitors.
Several said MMC is understaffed and overworks people. That helped cause Dr. Jonathan Owens’s departure. MMC’s RN/patient ratio is reportedly low. One patient, herself a nurse, described substandard care and staff “consisting of floats, traveler, and often tired and disgruntled aides and LPNs.” She said, “MMC has given me two near death experiences.” Doctors, though they acknowledged nurses have been more scarce since COVID, criticized MMC for its nursing shortage.
Activist Yoli Diaz calls MMC’s refusal to treat indigent cancer patients, and treatment delays, “atrocious, barbaric, and illegal.” She contends it violates state law and a lease provision requiring continuation of service to indigents. She adds, “as a private equity firm operation, they are a profit driven, price gouging business with aggressive collection practices and predatory billing.”
This is the second of three columns.
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[The above column appeared Sunday, 4 February, 2024, in the Las Cruces Sun-News and on the newspaper's website on the newspaper's website, as well as on KRWG’s website under Local Viewpoints. Sorry to be posting this here so late, by the way! Since publication, I received a written statement from MMC which I'll post here later today.]
[There’ll be a lot more to say about this; and, obviously, a lot that I can’t say, but that may await some investigation by appropriate authorities. So far, I have not been able to elicit any information from MMC. I hope and trust that within the next couple of days that will change. Although this is an opinion column, I want always to be fair to everyone; and in offering my opinion, I want that opinion to be as well-founded and fair as feasible.
[Certainly the bottom line right now is that there are problems in MMC’s service to the public. Basic publicly available data and scores would confirm that much. Some problems, such as an unfortunate ration of registered nurses to patients, are not entirely MMC’s fault. Others, such as a poor climate for discussion, in which there are fewer and fewer truly independent voices on MMC oversight committees and people are afraid to raise questions or criticisms lest they (or their patients) suffer some retaliation, MMC could deal with. And should. Aside from views on any specific incident, anything that unduly hinders freedom of discussion on any issue – political, medical, philosophical – hinders the pursuit by all of truth, not merely the freedom of any one speaker. It sure wasn’t like that on House!]
[Having said that, I’ll say little more for now. Although new voices keep whispering to me about MMC, my main hopes for a third column are to give some voice to MMC’s comments, clarifications, excuses, explanations, etc. My secondary purpose will be to at least shine some light toward the city and county. This was a public hospital. Someone decided to sell it. Eventually it ended up in Lifepoint’s, then ultimately Apollo’s, hands. However, city and county each retained a member of MMC’s board. I think those were the respective managers, Mr. Fernando from the county and Mr. Ifo Pili for the city. What have they known, and when? If their knowledge has been minimal, what are the causes? Finally, if I’ve erred, or if the answer to a pending question is one that favors MMC and MMC shares it with us, we should make any necessary corrections or clarifications. ]
[Above, I quoted Activist Yoli Diaz. She’s the President and Executive Director of CARE (Cancer Aid Resource & Education, Inc.) Her more extensive comment was:
1
“Memorial Medical Center’s C-Suite denying and delaying cancer treatment of chemotherapy and radiation and other needed health care services is an atrocity and has been a form of genocide to some of our Doña Ana County residents and is a violation of the lease with Doña Ana County and City of Las Cruces and is a violation of Current New Mexico Statutes Annotated 1978, Chapter 27, Article 5. Section 27-5-5.2 and Section 27-5-11. This illegal action is exacerbated by Doña Ana County and City of Las Cruces’ leadership because they were complicit in this atrocious action when they were supposed to be “watch dogs” --- even after I notified them of this crisis towards some residents in 2021. Both lessee LifePoint Health/Apollo Global Management and lessor Doña Ana County/City of Las Cruces have failed in compliance, failed in oversight, failed in accountability, failed in enforcement – to include the failure written in the lease in Vol 2_Part 1, Page 20, Section 6.5 Indigent Care/Continuation of Services, “Lessee will provide Expanded Care Services, as hereinafter defined, for the sick and injured in Doña Ana County who seek treatment at the Hospital, regardless of the cost of that care…”. When a hospital denies and delays needed health care services by putting profits over patient care, it is harming the residents it is supposed to serve creating imminent danger to life and safety. Our health care system: When the first hospitals were built, they were built by their communities to serve their communities. Many hospitals were built to care for the sick, poor, indigent and mentally disabled. Many were built by the wealthy business leaders as a donation or a charity. Many were built by churches. Our original hospital was built to serve our community at a time when there was confidence that government could do good things to improve our nation’s health. I have witnessed premature deaths and I have met children who were left orphaned because their parent did not receive the health care they needed, when they needed it, where they needed it, because of these denials and delays by Memorial Medical Center all in the name of “money”…instead of lives. When our health care system and hospitals were allowed to become profit and price gouging businesses with aggressive collection practices and predatory billing, our community with our social determinants of health and demographics suffered all in the name of this greed – what an inhuman and barbaric shift in this current modern era from why, and by whom, our hospitals were built! I personally question if our county and city leaders failure and duty to take action have committed nonfeasance, misfeasance or malfeasance because they had the knowledge, opportunity and contractual responsibility to take action. Memorial Medical Center and our local leaders took a 180 degree turn away from serving all Doña Ana County residents and Memorial Medical Center and our local leaders need to take that 180 degree turn back. I believe there needs to be an investigation, all parties held accountable and corrective action taken to benefit all of our residents.”
Me, I’ve asked MMC for its response to what Ms. Diaz has been saying and writing on the issue, but, as yet, received nothing. ]
[I did think, as I wrote at the time [See “Las Cruces Needs Hospital's Psych Ward Open" - 2023 01 29 "City and County Should Press Corporate Hospital to Honor their Contract" - 2023 07 30 ], that MMC was violating the lease when it went quite some time without the required mental health department. I have not researched this other issue as I would if litigating it, and am looking forward to MMC’s response.]
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