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.
–
30 --
[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.]