Will the Many Current Investigations of Memorial Medical Center Spark Change?

Embattled Memorial Medical Center’s “retirement” of its CEO, John Harris, was a first step, but the hospital still has a long, tough road back to some semblance of public trust.

More than a half-dozen public entities are investigating MMC, which has tended toward an unfair balance of profit margin and patient care since private-equity firm Apollo Global bought MMC’s parent company, Lifepoint, in 2018.

Initially, Memorial was a Hill-Burton public hospital, city- and county-owned, in the small building across Lohman from the County Courthouse. I visited folks there 50+ years ago. Memorial moved up to Telshor. Still later, City and County sold it. Now it’s private-equity-owned. City and county still own the land; and the hospital made promises under the Lease and the Asset Purchase Agreement.

There’s a legal obligation to extend care to people who need it, even poor folks. As publicized largely by Yoli Diaz, MMC has turned away patients with advanced cancer but thin wallets. In a City Council meeting, MMC seemed to deny they’d done such a thing. Good luck, MMC!

State Attorney-General Raul Torrez has initiated a much-publicized investigation of that. Las Cruces and Doña Ana County are both looking into whether or not MMC has breached its contract. I’m betting at least one concludes fairly soon that a breach (or breaches) occurred. City and county also aren’t happy that MMC allegedly is blowing off stringent reporting requirements.

Meanwhile, Medicare and the State are asking whether MMC has defrauding the public.

I wrote in January of two troubling situations. MMC declined to answer my questions, then wrote a response that didn’t deny anything I’d written, but accused me of “a false narrative.”

First, some doctors believe MMC’s cardiac folks are doing unnecessary procedures, when less costly and less invasive procedures would suffice.  I've heard anecdotal evidence; but these are complex issues. A public entity should get the facts on how many trans-esophageal echocardiograms, watchman procedures, and aortic valve replacements MMC does, whether those have increased, and, if so, fairly inquire why. (Have stress tests decreased?) I’m surely not qualified to reach a conclusion; yet experienced doctors have questions, but fear alienating MMC-Apollo.

Second, a disproportionate number of kids admitted to the hospital reportedly go to the pediatric intensive-care unit. There’s a normal range of percentages of hospitalized kids who need intensive care. Unless we’ve some weird local epidemic, MMC’s percentage of PICU admissions should be close to that norm. I’m told it isn’t. Has MMC’s pediatric ICU set protocols under which doctors have no choice but to classify more kids as needing intensive-care? Assuming that MMC charges ICU rates for kids classed as ICU patients, MMC could be taking in more than it should. Medicare folks likely wonder. Someone with subpoena power should determine this.

New Mexico’s Superintendent of Insurance is also investigating MMC, in tandem with state legislators considering passing legislation to curb private-equity abuses of hospitals. Even the U.S. Senate is investigating Apollo Global, as I discussed in my 28 January column.

I hope Apollo and MMC up their game, and adopt a more caring balance between profit and patients. However, if City and County find contractual breaches, they should put the owners on notice, formally – and be researching what our options are if MMC doesn’t cure the breach(es). Asserting public rights might encourage MMC’s owners to improve more quickly.

Let’s hope a new CEO improves both openness and care.

                                                   – 30 –

 

[This column was to appear Sunday, 25 August, 2024, in the Las Cruces Sun-News and will presently be up on the newspaper's website and on KRWG’s website, under Local Viewpoints. A shortened and sharpened radio commentary version will air during the week on KRWG (90.1 FM) and on KTAL-LP (101.5 FM, streaming at www.lccommunityradio.org/). For further information on the topic of this column, please go to my blog, https://soledadcanyon.blogspot.com/ .]

[This column is one of several on MMC. While the recent firing of MMC’s CEO appears to be (and MMC has suggested it was) a step in the right direction. MMC is still owned by Apollo Global. (Too, recent statements by MMC say the former CEO merely “retired.” ]

[ I’m hoping that Apollo’s MMC, pressured by investigations and public concern, will engage in more open dialogue and either respond to some of the many allegations against it and/or make welcome changes. That will only happen if new local management sees the need for it, and if city, county, state, and the public remain interested. Although MMC is no longer our only hospital, it’s important to our community. We need to see Apollo up its game OR evict Apollo if contracttual breaches warrant that. The usual course for a private-equity-owned hospital is ultimately grim. Can we / will we avoid that here?]

[Sorry the column wasn’t in the newsprint Sun-News people received today. The opinion page is made up for the whole area, sometimes without our editor’s involvement in the process, so that stuff happens.]

More Questionable Conduct by MMC

An old friend called, in distress. Memorial Medical Center had just fired Dr. John Andazola. Folks who work at MMC were deeply concerned about what that meant for MMC and the Southern New Mexico Family Medicine Residency Program.

In 2009, that program was in disarray. The Accreditation Council for Graduate Medical Education had it on probation. Since it was responsible for training resident-physicians, some of whom might stay here, it mattered to our health.

Andazola took it over. Apparently he specializes in quality control and in medical education. He got the program off probation and obtained 10-year certification. The program has had no citations. It has a high return/retention rate, meaning folks it teaches often stay here. At least 30 area physicians, including several emergency care doctors, received education from it. MMC fired him.

Worse, MMC replaced Andazola with a pencil pusher, its non-doctor CFO, Laurie Thomas. Since Andazola was both Program Director and Designated Institutional Officer (responsible for quality education and maintaining accreditation), Thomas becomes a key person in the future of area medicine. She may have little or no experience in providing graduate medical education. If the ACGME ultimately suspended the program, that’d stop residency education both here and in Alamogordo.

A possible way to preserve the residency program would be having La Clinica take it over. La Clinica is reportedly willing. But because Andazola built the program from a borderline money-loser to a highly profitable project for MMC, MMC might not agree.

Maintaining the residency program is also required by the Asset Purchase Agreement that turned the hospital private. The landlords, City of Las Cruces and Doña Ana County, are [finally!] investigating. Each has hired an outside attorney to do that.

Alert readers might ask, why would we fire a guy actually born in Memorial Hospital [the old one], graduate of Mayfield High, NMSU, and UNM Medical, who’s doctored here 15 successful years, is nationally recognized, and turned your moribund training program into something both helpful to the community and profitable?

My informants tell me he was kind of what I’d call the conscience of the hospital. He cared about patient care and professionalism, and accountability enough to speak truth to power. They say that in meetings he questioned hospital administration policies that unduly favored profit-margin at the expense of maximizing patient care and safety. Local physicians I spoke to thought highly of him – and worried about how Apollo’s ownership affects health care here.

It’s a nationally-known fact that safety and outcomes tend to be less successful in entities owned by private-equity firms. Apollo Global has owned Lifepoint, which owns MMC, since 2018. Andazola was so well-regarded that he was on the National Physician Advisory Board for the entire Lifepoint hospital system – until that was disbanded after Apollo bought the show.

Apollo isn’t publicly traded. What it does and how it does hides in a deep, dark inaccessible hole labeled “proprietary.” At MMC, committees supposedly responsible for safety and quality control can’t even gain access to needed information. That’s so weird that a visiting state official recently suggested the committees should hire an independent outside lawyer to fight for access to the information they need!

My next column will discuss the many current investigations of MMC, for problems that could include defrauding medicare, and the possibility of changing state law to gain some control of rogue institutions with private-equity investors.

So much public attention may help.

                                                      – 30 – 

 

[The above column appeared Sunday, 18 August, 2024, in the Las Cruces Sun-News and on both the newspaper's website and on KRWG’s website, under Local Viewpoints. A shortened and sharpened radio commentary version will air during the week on KRWG (90.1 FM) and on KTAL-LP (101.5 FM, streaming at www.lccommunityradio.org/). For further information on the topic of this column, please go to my blog, https://soledadcanyon.blogspot.com/ .]

[This column is part of a long and detailed investigation of MMC. While the recent firing of MMC’s CEO appears to be (and MMC has suggested it was) a step in the right direction. MMC is still owned by Apollo Global. City, county, state, and the public need to keep a sharp eye on developments.]

Welcome, Governor Walz!

Welcome, Gov. Walz!

Parties aside, let’s see how genuineness plays against falsity and self-betrayal.

Walz and his wife are teachers. Walz is a good guy, whose affability and good nature made him a quick favorite with Kamala Harris’s staff. Those qualities helped him challenge and whip a six-term U.S. Congressman in a red district that went red again when Walz became governor. You figure he’s also tough when he has to be. He did coach football.

J.D. Vance is a fake. Whereas Walz has made his six-year governorship about actually helped average folks, Vance’s Hillbilly Elegy celebrates his personal success and suggests others were lazy. Vance, though fairly conservative, loathed Donald Trump as a dangerous demagogue until Trump became a convenient handhold for Vance to climb the political cliffs.

Whereas Walz initially upset an entrenched opponent, Vance ducked, the first time he considered running for the Senate, as a non-Trump Republican, but later ran from the safer position of Trump bootlicker. Vance won the VP nomination by aping Trump’s angry rhetoric and insults. Walz prevailed through humility, cooperativeness, and a clear commitment to his ideals.

Walz is right about Trump and Vance being “weird dudes.” How does Vance feel, happily married to an Indian woman, when Mr. Trump regularly insults non-Caucasians, and mocks Harris for wearing a sari on a visit to her mother’s family’s home in India? Does Vance contemplate his close law school friend, a transsexual, when demonizing such people publicly. Walz noted that Trump never laughs, except at people. We also never hear of close personal friends of Trump, or even a dog – let alone a cat!

Trump’s team will attack Walz’s record – as they’re currently blaming VP Harris for the stock-market dip. (Did Harris also cause Simone Biles’s fall the other day?) Minnesota Republicans opposed much that he’s accomplished, using a Democratic trifecta he helped create. They’ll say he spent too much money helping people. They’ll say he didn’t call out the national guard quickly enough after the George Floyd killing. (Oops – Trump praised Walz’s response.) Walz successfully governs a “swing state,” rolling up his sleeves and getting a lot done, while consistently displaying character and integrity.

They’re attacking the choice as antisemitic, because it wasn’t Pennsylvania Governor Josh Shapiro. I’m half-Jewish, but hoped Harris wouldn’t pick Shapiro amidst a controversial war. I wouldn’t have picked a Palestinian, either. (I’m betting Harris’s Jewish husband doesn’t think she’s antisemitic.)

The allegation is hilarious. Shapiro is a Jewish Democratic Governor. One of three, nationally. All Democrats. Last October, nine states were represented by Jewish U.S. Senators. All Dems. And Diane Feinstein had just left. There is no Jewish Republican U.S. senator. None. The last was Arlen Specter, who switched to Democrat in 2009! Of the 24 Jews in the House, only two are Republican. How come Speaker Johnson ain’t complaining about that.

One reporter described Walz’s “‘happy-go-lucky’ warrior manner and joyful presence.” Trumpist commentator David Brody of Christian Broadcast Network said Harris and Walz “were VERY good tonight in Philadelphia. She came across as measured, confident and fully in control. It was an optimistic speech full of hope and change (cue 2008). Meanwhile, Walz showed off his folksy and feisty Midwestern persona."

Joy and hope ain’t a bad recipe, so long as you recall that not everyone feels joyous in these tough times. So far, it’s baffling Mr. Trump.

Will we be dancing the Kamala Waltz November 5th?

                                                  – 30 --

 

[The above column appeared Sunday, 11 August, 2024, in the Las Cruces Sun-News and on the newspaper's website and on KRWG’s website, under Local Viewpoints. A shortened and sharpened radio commentary version will air during the week on KRWG (90.1 FM) and on KTAL-LP (101.5 FM, streaming at www.lccommunityradio.org/). For further information on the topic of this column, please go to my blog, https://soledadcanyon.blogspot.com/ .]

[We should add that in 2004 a teacher took his students to a George Bush rally to see citizenship and politics in action. Security noticed on one student’s wallet a sticker favoring Bush’s opponent, John Kerry. Security therefore denied entry to the group. The teacher was so appalled that he volunteered to help the Kerry campaign, ending up as head of Veterans for Kerry in his state. Later he took a sort of “beginner’s boot camp” run by some associates of the late U.S. Senator Paul Wellstone (known for his powerful integrity and fairness of mind, dead from an airplane crash in 2002) to help everyday folks who might want to try to run for office. The teacher went, and later made the crazy decision to challenge an entrenched Republican U.S. Congressman. The teacher, Tim Walz, won. That’s a “made-in-America” origin story people should reflect on.]

[Walz initiated the “weirdness” line regarding Trump and Vance. It seems to have worked well. Aside from Mr. Trump’s narcissism, disinclination to laugh unless its’ at someone in a sardonic way, and the absence of pets in Trump’s life, Mr. Trump, as a columnist noted, “repeatedly mentions Hannibal Lecter at his rallies, speaking about the fictional cannibal as though he were a real person. 'He’s a lovely man. He’d love to have you for dinner,' must be one of the strangest things a candidate has said while trying to attract votes.”

[Ruth Ben-Giat, an expert on authoritarian dictators has noted that it’s laughter that most angered them. (see Matthew Chapman story on Raw Story. Authoritarians have no problem with being called evil, but they despise being called weird — because it means they aren't being taken seriously; it means they're being made fun of, rather than feared. They understand that when they become subjects of satire, people necessarily question everything about them.

Despots don’t mind orchestrating sadistic spectacles riduling or punishing others, but can’t abide being the target of jokes. (Is that why a key motivating moment for Mr. Trump finally to run for president was being publicly made fun of by President Barack Obama at a gala dinner/roast in New York?) The expert gave as an example an Italian who named his pet rabbit Mussolini, in fascist Italy, and took it to a bar so others could enjoy watching him order it around. That joke cost the man a year in jail.

"When we laugh together, fear and distrust lessen, which is the opposite of what authoritarians want," Ben-Giat concluded. "That, too, is why such leaders can’t take a joke."]

[Meanwhile, not surprisingly, the same Sun-News Opinion Page contained an op-ed from an Ingrid Jacquez calling Walz’s progressive programs in Minnesota, such as free school-lunches, “socialistic.” That’s an old-style attack. Neither pure socialism nor pure capitalism ultimately works out very well. Any successful government has to merge the two a bit, toward a government that values enterprise and creativity but maintains compassion and justice for those capitalism spits out or leaves behind. Minnesota seems to be doing that. ]