KVHD April 1, 2009 board meeting

The juggernaut of truth rolled into the KVHD cafeteria Wednesday evening, April 1, removing roadblocks of information while illuminating the failure of the board to follow its own policies and procedures to stop the reign of mismanagement as well as flagrant obstruction of justice which occurred during the 2006/2007 nursing center investigations.

The board meeting began with questions from the audience, one of which was a follow up question from the March madness meeting.

A former employee of the skilled nursing center had asked the board of directors to talk to staff about morale and other issues they may have in the nursing center. Each of the directors claimed to have talked to staff. However, there was no elaboration beyond that.

VIDEO: Did they ask?

Not that I need to point out the irony here, but one simple question lead to all of the board members actually saying they went to the skilled nursing facility to talk with staff.

Now, what was the obstacle for the board members to do this when the hospital SNF was under investigation in 2006/2007?

What if they had listened to the employees three years ago and took a stroll into the SNF?

Could there have been intervention and residents could have been kept safe?

Three years ago, board members, Bob and Kay Knight were practically run down by the Director of Nursing in her wheelchair for coming into the SNF during a Christmas party. And, former, CEO, Pam Ott, knew about it and, condoned it. According to the DON, she was told to keep them out.

This was the middle of December and the word was out that the SNF was in trouble.

What or who were the obstacles to keeping the residents and the hospital safe? Read on.

During public comment, I asked the board’s legal counsel, Scott Nave for an update on Dr. Pormir and Debbie Hayes’ legal cases.

Nave could not say much about the criminal case, but said that the two will be in court sometime at the end of the month. I will have exact dates for these court appearances posted so that those who really know what happened can show support by attending the hearings. This doctor and pharmacist need us just like we needed them at one time or another for health reasons. These are families, careers, lives, finances at stake. And these charges are put on the backs of two people who did not work the SNF alone.

(And anyone with further information and evidence about this case and the top management and board, should contact the state elder abuse department.)

Let me put this to you and see if you can see any reasonability: how could the oversight agencies charge Dr. Pormir and Debbi Hayes with elder abuse from Aug. 1, 2006, until January 31 2007, while allowing them to work at the hospital for another two years, into 2009?

If they were indeed a threat to patients, wouldn’t they have been removed immediately, or shortly after?

The only person noted as an immediate threat, was DON, Gwen Hughes. And she went off and got another job and continued working.

The state’s case is based on elder abuse, Penal code section 368(b)(1). So, why did DHS allow them to stay and work for two years before filing charges? Could they have not suspended them first?

That would mean if the state is correct and the doctor and pharmacist are “a threat” to the health and safety of the patients, then DHS is incorrect, wrong for leaving them there, and the charges should be brought against the agency.

Now if DHS is correct that Pormir and Hayes were able to treat patients and function then the state is incorrect to bring these charges against them.

I mean the Attorney General, Jerry Brown and his crew, used fighting words in their press release regarding the indictments. Brown is quoted as saying this is the worst he’s ever seen. Well, it's the worst I've seen too, but we are not seeing the same things.

But apparently mistakes were made at a juncture that was investigated. I have the DHS records for Feb. 2006 survey, and the skilled nursing facility was being run by former CEO, Pam Ott, and former CNO Sharon Brucker. Things were bad then. DHS and CMS sent threatening letters with fines and ability of the unit to accept patients and be compensated. This is the timeline. (See CNO steps down)

DHS cited the administrator Ott for not having an administrator’s license to run the nursing center. They also cited the need for a full time, director of nursing, (DON) as well.

Ott wrote a letter back to DHS stating that the CNO, Sharon Brucker, was in charge of both the acute and the SNF and that she was the interim DON.

Board counsel wrote back that Ott did not need an administrator’s license.

I don’t know what DHS found in Ott’s resume, but it might have been that she was a CEO running a hospital and a skilled nursing facility with only an AA degree and raking in over $140,000 a year.

I called the state licensing office to find out what the regulations are regarding administrators. Well, it is true that a CEO can administrate the nursing center without a license as long as it’s a distinct part of the hospital.

For the fun of it, I asked what it would take to get this license. I was told a BA; 1000 hours of training; passing state and federal exams. (Well, Ott was zero for three.)

Maybe DHS realized or not probably, that she didn’t hold the qualifications really of a CEO even, and that it would be best to keep the SNF covered with a full time DON.

But Ott holds a registered nursing license which is still current and active. However, she did overstate in an email to me that she was a nurse practioner and wanted to help me with my medical problems.

Back to the meeting as Scott Nave prepares to tell the audience about the chain of command. The three procedures adopted by the board, were open policy, grievance and disciplinary.

Open policy, Nave explained is not a substitute for the grievance procedure or sexual harassment issues, but rather an informal dispute process. Employees can go to their department manager, up the chain all the way to the CEO, where the trail of tears ends.

Nave video honest employees honest management

This policy was in place in the fall of 2006 when nurses, staff, took their complaints to the CEO. Not trivial complaints either. The CEO and board members were told by many reliable people about the new DON, the short staffing. But again she was the end of the road in this informal process. And as we see, nothing was done by Ott, other than to say she didn’t know anything until January 2007.

Mr. Nave explained the next rung on the ladder (slippery with grease) was the grievance procedure. This isn’t about outside work issues or personality conflicts. This procedure requires some studying of those employee handbooks as it contains time frames.

Nave said all employees got these handbooks. I’ll stop here to say absolutes such as “everybody” received their handbook, would be like saying everyone working in the hospital had the right qualifications and did all the correct things.

I myself stopped by the hospital for a blood test and found an arbitration agreement in my packet to sign. I asked about it, and was told the agreements would be collected up as it was a mistake.

Since the hospital is not perfect and employees are not perfect, I imagine caught in an emergency situation in the SNF and trying to decide how to proceed would have been difficult.
Regulations on reporting suspected elder abuse, injury or incident are clear that it must be self reported by the facility within 24 hours.

Employees caught in the flack at the end of 2006/7, had to decide what to do based on two laws: the employee manual or the DHS regulations. Some employees instead took it to the board where they were turned away by an angry chairman, Brad Armstrong.

This reaching out tells me there was no satisfaction with supervisors and eventually the CEO herself. She referred to these employees as a “pack of wolves.”

Could these pack of wolves also have used the whistleblower laws which protect the employees from being terminated because of a complaint involving illegal and unsafe practices?

Mr. Nave didn't go over that. Maybe at the next meeting.

Maybe DHS used a clause in the law which says that complaints that are unsubstantiated can constitute harassment. Did Ott tell DHS she and her gang were being set up or harassed by the Knights, the Grosses, the disgruntled employees?

And DHS had received calls and paperwork from nurses on the inside as early as August 2006. Ott, the unlicensed administrator, responded by reporting the failings of the employees to do their jobs noted in the DHS survey records.

So, as Nave is explaining at the board meeting about chain of command and grievance procedures, I’m wondering how does that work if the problem is the CEO. I had originally thought it went straight to the District attorney.

Nave said it would then go to Human Resources, HR.

I asked what if HR is also involved. Then he admitted it would have to be investigated.

Then the bombshell dropped when an audience member followed up the line of questioning of who investigates the CEO and HR.

Nave said that goes to the board. The board of directors who vehemently denied any wrong doing on the part of the CEO or themselves in the matter of the SNF.

They did not investigate her or HR. I don't understand, that's part of the procedure and I thought "everybody" knew that.

VIDEO audience response

All this talk about procedures and you look back that calls went out to DHS- letters were sent - jobs were threatened. Employees went out on stress leave. People were threatened and fired; But not at the top, that's where the spankings stopped.

Where was the board in all of this? Why didn't they investigate Ott and the HR manager or CNO, Sharon Brucker? They stuck with these people and blamed it on the employees; Scapegoating even a dedicated doctor and pharmacist to save their own reputations. Do they even have a conscience?

I wonder if the new board would call for an investigation, retroactive and forensic; but well worth the time. Maybe they could set some things right by doing this. Set things right for the families and residents who trusted the facility, the employees who were harassed or fired, and the community who needs to hear the truth.

This investigation should be paid for by Cal Mtg and Brim Management considering they hired the CEO. And they were the ones who supposedly signed off on her credentials.

Just so the board knows: I say call for an investigation. (big surprise)

The first to take cover as the SNF storm came rolling in, was Sharon Brucker, the CNO, in charge of the acute and nursing center. After employees came to the board in Oct. 2006, and pointed fingers at the CNO, she stepped down and took another position in the hospital. (She’s in quality control now; I feel safe, don't you?)

As the flames moved toward her once untouchable position, Ott stepped down, at the May 4.2007, board meeting and the board allowed her a month to stay on as CEO. She used the month for all it was worth.

On May 5, the day after the resignation, employees began to be fired. Anyone who was a threat, or I should say who knew the truth, was immediately discharged; But not in a nice way.

Former Human Resources Manager, Michelle Rosato, sent the terminated employees to the curb off hospital property with their boxes of personal items in their arms. No notice, a blind strike.

The HR manager gave a rough time to some of the terminated employees by delaying their pay /vacation/sick time/ insurance and pension.

One employee, who was fired, and is listed as a witness in the indictments, called me and told me about her issues with HR. I went over and talked to the HR manager myself. Things didn’t go well, as Rosato seemed to be uninterested in using any compassion or empathy with this woman. I yelled at her and asked her if she enjoyed being cruel. My impression is that she indeed enjoyed what she was doing. (The state may want to reinterview their witnesses)

But once Ott left at the end of May 2007, the HR manager was out the door behind her. She left her position to move on to another job. Too many people knew the truth of what these two top managers were doing.

So, the hospital violated its own personnel policies and procedures when the board did not investigate the CEO and the complaints against her. Whether these complaints complied with a manual or not, the problems could have been halted simply by listening and then acting.

This would mean to me that there was malfeasance, obstruction of justice, and some very blind or malable investigators from the outside.

I don’t think the three sticky board members can claim they knew nothing about what was going on. Especially since Mr. Jamison of QAB radio, brought Ott on his program with him for a final parting shot as the fleeing CEO was on her way out of town.
(The radio show is up and boy is it interesting. I wouldn't want to be a young DA with this witness on my side.)

So, CEO, Pam Ott, CNO, Sharon Brucker, and HR manager Michelle Rosato all left their positions which would have linked them to the direct mismanagement, criminal conduct, obstructing investigators, intimidating employees who told the truth, not following board personnel policies, short staffing, of the skilled nursing facility, and elder abuse.

These are the top three people in the chain of command who ran the hospital and SNF from 2006 to 2007. Two are gone, but not forgotten, yet one remains.

Since Treasurer of the board, Bradley Armstrong, remains silent, and has since May of 2007, during this April fools meeting, I thought I would ask him a question which would fit his hostile recalcitrance.

I told him, it would be best that he keep his vow of silence, as my question to him was a loaded one.

I asked him if he knew that short staffing the nursing center was actually elder abuse. Then I told him if he were to answer that question with a “yes” then he should be in jail.
I explained a “no” answer to that question would mean he shouldn’t be on the board.

VIDEO ARMSTRONG

But that question doesn’t just apply to Mr. Armstrong, it goes down the line to the CFO, Chet Beedle who budgets the departments. The board members, the managers, the employees; anyone who knew there were not enough staff to properly treat the residents is responsible.

Cal Mtg. again casts a shadow over all of this. Don't let them forget.

And considering the board and CFO knew clearly what was happening to the nursing center, they are just as much at fault as the others mentioned.

Short staffing is not unusual at the hospital. If there is not enough staff to cover the acute wing, then patients can’t be admitted. The hospital simply loses business and money.

However, short staffing the skilled nursing facility is a different set of circumstances. That is a home for a static number of patients who require a certain number of staff to properly care for them.

If there’s not enough staff, then they should be moved to another hospital or facility, not under treated. Any hospital administrator worth their salt would know that. Any simply decent person would also know it.

During public comment I asked Chet Beedle, CFO, if he had spoken to Cal Mtg. the insurer that owns our healthcare district and if he had the numbers for the nursing registry which were requested at the March meeting.

VIDEO BEEDLE

Beedle said he had no formal talks with Cal Mtg., but did have those registry figures with him. Chairwoman, Kay Knight, asked if he could give those numbers to the audience. Beedle replied, if you ask me to.

Well she asked and the numbers were exactly what everyone feared and figured.
For 2006, the hospital paid $13,142 for outside staff.
In 2007, they paid $351,004.
2008, they paid $1,386,162.
Year to date in 2009, $881,567

Beedle announced that they have hired on several nurses from the nursing registries. The nursing registry is a temporary agency which sends out staff to hospitals in need and those who can pay those high prices along with expenses and housing.

I asked Beedle if these nurses were coming in at KVHD level pay rates and he said they were. Now I don’t know much about details, but all these nurses dumped their high salaries to work for this hospital in the SNF? Could be true, but I have a hard time believing it since nurses are in shortage, they have many options for employment.

In a meeting in Sept. 2006 with Chet Beedle, Pam Ott, Sharon Brucker, and Michelle Rosato (its on tape) Beedle complained to me (probably illegally) about a certain department manager who wanted his assistant to be paid her worth. Rosato brought me the records for these employees so I could see that they had been given raises years ago and how much. Beedle explained that he cannot allow new employees to be hired at the top rate at the start, because it would be more money than employees who have been with the hospital for many years. The employees would quit and come in at the new rate. (That sounds fair)

However, that particular notion from 3 years ago seemed to go out the window as the nursing registry figures imply. Nurses working for the hospital do not get anywhere near the hourly rates that the traveling staff do.

And now we are to believe that these travelers are working at the starting rate for this hospital? I don’t know, but it doesn’t sound solid.

I could ask for the personnel records and see if this is indeed the case, but apparently that is illegal. So, in 2006, when the gang showed me employee records, it was an illegal act.

As Beedle explained this miracle of the transferring, traveling nurses, he also mentioned that they now have full staffing in the SNF. (Meaning, they didn't before.)

I said, you mean now, and he confirmed that. But went on to imply that there was never any understaffing, they followed the laws.

However, the Department of Health Services records and surveys indicate that was not the case. And employees who worked in the SNF will tell the same story of understaffing, overwork, and inability to maintain proper conditions for the elderly residents.

VIDEO BEEDLE staffing

I would like to thank a somewhat misinformed member of the public for coming to the meeting and asking questions that elicited some information we would not have received without his persistence.

This persons concern was about the contract with Dr. Gross as hospitalist and the addendum to his contract to take over as Medical Director for the skilled nursing facility.

Though his concern was unfounded, because this member of the community didn’t understand that doctors are in high demand and can find better, more profitable positions than we have to offer here.

But what we learned is that Dr. Gross and his group will be taking over as the Medical director of the SNF, formerly held by Dr. Pormir.

As Chet Beedle explained the wages Gross will get for the extra responsibilities, he didn’t even mention Dr. Pormir’s name. He said he’s taking over for the “former” medical director. That former medical director has a name and it was a good one until the mismanagement at the skilled nursing facility.

The audience member was not impressed or happy with the response, then Beedle eked out that other doctors had been asked to take on this position, but only Dr. Gross responded.