UPDATED: Pamela Ott on QAB 2007/here's your witness Jerry Brown

UPDATED: Preliminary hearing set again for August 20th.
as the preliminary hearing for June 22 looks like another delay until we find out if there will be a trial, the most infamous post on this blog is the day board member and radio jock, Bob Jamison, allowed Ott to go on his talk show and defend all wrongdoing and blame others.
It is the most read post on the blog, as the California Department of Justice had gone off the scent and had Pam Ott as a "witness" in their case as opposed to being charged with elder abuse and other crimes such as covering and removing information, lying to investigators, firing employees for trying to get help and on.
After Ott was brought in by the DOJ she was fired from her CEO position at Sierra Kings District in Reedley California. A recent audit by the familiar company HFS, now in town at KVHD, and a bankruptcy lead to the conclusion that Pam Ott's pattern continued. She used monies Reedley voters supported on a GOB for a construciton project for "other things." The IRS audit showed that Ott and her financial manager, Barbara Jennings may not have paid employee pension accounts for a few months as well.
Read it again, as even with a continuance in the case this week, there will be another day and the judge will have to decide if the DOJ did their job and found the evidence and the crimes.
But this interview has to be the most telling as Bob Jamison made every effort to mislead the community regarding the meltdown. And still does...)

Here’s your witness to the prosecution of Dr. Pormir, and Gwen Hughes, in the case of the State vs. KVHD: Pamela Ott.

QAB radio allowed, KVHD board member, Bob Jamison to set up a departing radio show for the ex CEO, Pamela Ott, who resigned her position amidst troubles at the hospital.

Thank you QAB, this was some really good stuff. I guess ABC allows these things to be done by their affiliate stations.

It was a media war.

In her own words (and a few of mine)


After Pamela Ott stepped down as CEO, her friend, and board member radio broadcaster, Bob Jamison brought Ott on his radio program to prove that she indeed was a victim of the horrible reporter, employees, Department of Health Services, and of course, the Knights.

Because of his incredible adherence to rules, Jamison, brought on former Sun newspaper reporter and former owner of the Kern River Courier to interview Ott, because he said if he did it would conflict with his role as a board member.

This was a long program so I will have to truncate at least the questions to save time. But I will leave Ott’s responses verbatim. Apparently, Jamison had only two commercial breaks during this incredible hour of radio; so it ran long.

Ott’s media man

Bob Jamison: We have a special program this morning and we have a special guest in the studio as you may have heard. Our special guest is the current CEO of KVHD as many of you may know she tendered her resignation-and we’ve invited Pam Ott here to talk about the situation at the hospital and hopefully clear some things up.

Before we begin, I have to once again remind everyone and to be perfectly honest about this, I am an elected member of the hospital board and as such, as Pam her tendered her resignation, it would not be considered a correct thing for me to be the one interviewing her this morning. For that reason I have invited into our studio, Dolly Ogwalla, who is the publisher of the KRV Courier. Good morning Dolly how are you?

Dolly: Oh, good morning Bob I brought a little happy spray with me and I’d like to get started asking some questions since I have plenty.

Bob Jamison: I should tell you that I’ve told Dolly that she is not under any restriction whatsoever to what questions to ask or not ask, that is strictly up to her and, other than to tell her when it’s time to take a commercial break, the show is being turned over to Dolly.

Dolly: Then Good morning Pam
Ott: Good morning Dolly

Dolly: …one of the questions about the current situation at the skilled nursing facility is the employees at the hospital. I understand they have a new management team at the SNF and people are saying that employees in general at the hospital, one in particular are not very happy. Maybe you’d like to talk to us a little about that Pam.

Ott: Let me start before the management company was brought in by the board of directors. Because a local publication which had some fact and much fantasy that was very painful-that was very painful for the staff to have that kind of information about their practices delivered in newsprint. (the reporter did it)
We had several people out on stress leaves, one with cardiac complications, at that time it was a very serious thing. More importantly is our residents who love where they live. And that is their home. And the fear and anxiety that all of that set up was, umm, pretty much unfair. Then it turned into anger for them, because they know the facility that have is fine and they’re receiving TLC. So, getting on with that after bringing in the management firm is, uh, they’re here to change systems and to assist employees in learning new and updated skills. That meant that our licensed nursing staff were not able to work as licensed nurses at the time-they are being trained now, and they are loving the training they are receiving, learning all kind of new updated skills-the nurses aides are just thrilled with all the changes being made and so think we’re going to live happily ever after with that.

Did you say that DHS?

Dolly: …the reports showed something less than standard practice.

Ott: Well, let’s just talk about what really happened there. We had hired a new director of nursing, she came from, Kindred Care, which is one of the top nursing care facilities in the country, and came to us with 36 years of experience and began to work with our interdisciplinary team which is a pharmacist, nursing, social services, etc., and stated that we are not providing standard of care, there were many things we could change, including the types of medication we used for, for residents we had with behavioral issues such as kicking, biting, screaming, punching, that kind of thing. So, she made recommendations to our chief pharmacist and our medical director on those medication changes and those changes were made.
An employee began to believe that this was somehow detrimental to our residents and so rather than reporting through the normal chain of command, reporting since the director of nurses was involved, reports to the Chief Nursing Officer, or even reporting to me, or even a board member, they went directly to the department of health who came into to do an investigation, but that’s absolutely appropriate.
So, what happened was the department of health, came in and said, based on the use of these medications we need you to go get a psychiatrist, in fact, that came in at 10:30 am in the morning, you need to hire a psychiatrist by five pm. Well finding psychiatrists in Kern County it would be easier to find the pot of gold at the end of the rainbow (laughter), but I was able to accomplish that goal through networking. And the psychiatrist came into evaluate the residents-there’s about 17 of them whose medications had been changed and the psychiatrist said upon evaluation of each of those residents, not only are these appropriate, but recommended increasing dosage of some of the residents.
So, that was perplexing so I went back to the surveyors of DHS and said well this was the result of the psychiatrist. And they said well, psychiatrists are just padding their own pocketbook. So, of course, they’re going to tell you to keep them on those medications cause then they get to see the residents more frequently (laughs). So, that was a bit confusing and they told us, the interdisciplinary team, to go back and review all of those residents once again and we make recommendations, we, without, without, a medical license were to make recommendations to DHS on how to deal with the medication reduction. So, we did that. I was rather uncomfortable with that, because I am not an MD nor is any of the staff (laughing).

Dolly: where was the other guy from?

Ott: DHS pharmacist.

Dolly: Okay, what is DHS stand for?

Ott: The department of health services

Dolly: and he wasn’t a physician either?

Ott: He was not a physician and he was telling us that our pharmacist was acting outside of her scope of practice, but then, telling us that, uh, that we needed to make those changes without MD input. So, being uncomfortable with that, I found a psychiatrist, decided we needed a second opinion and two weeks later that other psychiatrist came in, very thoroughly evaluated each resident, called families, talked to staff and at the end of all of that recommended that all of those residents stay on those particular medications and a matter of fact, recommended increasing some of those medications based on behaviors the residents were exhibiting. So, that’s where we stood. In the meantime, DHS, came in for the annual survey which is something we do every year and they’d already pretty much made up their minds that we needed some system changes. They evaluated our staff for their ability to pass medication and I want to explain to you what that means. That every nurse introduces themselves by name. They use two identifiers for the patients, hello Mrs. Smith, what is your birthdate-we have pictures, we can match the picture with the patient, which medications they’re to receive before we administer medications, then come back to an administrative record, where we document each medication which is given.
Well these nurse who have been working with these exact same residents for many years-some of our residents have been there for up to 15 years. They know their residents like their own mother, father or grandparent, and they missed some of these steps. And they may not have necessarily said, hello I’m Susie, and I’m here to give you your medications, what is your birthdate (laughing) And so, and then, because there are sometimes four pages of medication records, we know they gave the medication, because everything is in bubble pack, and if a medication were missed being given it would still be in the bubble pack, but the counts were correct, but they did not write the medication in the medication record at all time. So, there were holes, where there should have been documentation.
So, that’s where we got into this problem with medication administration.

Dolly: (she says its tough for change with employees, people can be resistant about it)

Ott: Change is difficult for all of us, you’re absolutely right. Many of the staff were saying there were too many changes, too fast, this is just making me crazy.
(To shorten the length, I’ve edited out several items, but if anyone wants the whole transcript, let me know.)

Measure M is the biggest concern

Dolly asks Pam about Measure M, the general obligation bond, which would have cost community members property taxes. Ott says the seismic and construction are the biggest things to worry about.

Ott: But the biggest concern for me as I leave this valley is that we have a very serious issue with meeting AB1953 which is the earthquake seismic standard that California state says you will be earthquake safe in your acute hospital by the year 2013, and I want to tell you that is January 1, 2013, or you will no longer have a license to have an acute care hospital.

The Sticky Three board members, support their CEO

Dolly: As a resident that terrifies me, that we, that could ever be a possibility. How supportive are your board of directors in this? Have they been behind you and supportive?

Ott: I will tell you that Brad Armstrong is one of the strongest chair of boards that I’ve had the opportunity to work with in my career. Bob Jamison is brilliant, he asks the difficult questions, he challenges to make sure we do a great deal of research. Barbara Casas studies diligently, knows the issues and they’ve made tough decisions about what we need to do. And that is that retrofit would cost many millions of dollars then we end up with still a small facility. Oh, and an old building. So, they decided we do need to build a new acute care wing of the hospital.

(finally a commercial)

Ott and board responsible/employees didn’t use chain of command

Dolly: (getting phone calls from people adamant about culpability in the situation. She mentioned unhappy, disgruntled employees.) Do you take responsibility for any of the things your employees are concerned about, about being afraid to report, and some of the things.

Ott: Oh, absolutely. I am the CEO and I take responsibility for everything that happens within the organization, that’s my role, uh, interestingly enough that, uh, the board even takes responsibility, they, they, we all understand our responsibility in this, we actually, the management team being the Chief Nursing Officer, the director of nursing and myself put together an agreement with all of the staff in the nursing center to state that they understand their responsibility to report because that is part of their licensure and we signed that agreement with them stating that there would never be any punitive mechanism for reporting concerns through the normal chain of command.
Sadly, there was that director of Nursing, who, umm, who had been there during that time had put a lot of fear and anxiety into the staff by telling them that if they reported up the chain of command, to the CNO or to me, that they would lose their job and she would report their license so that they would lose their license. So, that fear kept the staff from reporting like they normally would through a chain of command.

Dolly: The other thing I’ve been hearing about is the lay offs and the firing and it’s all because they’re unhappy with there reporting or whatever, but I would like to clarify the new team has done some laying off.

Ott: Right, as happens when you bring in management team, they have a completely different focus on how to staff the nursing center and they have a very interesting model where they have RN care managers that are out on the floor doing treatmentsand the kind of thing. They believe because our nursing center is a 74 bed nursing center that we should have an administrator, or an associate administrator, who is specifically for the nursing center and that is a Chief nursing Officer model doesn’t work as effectively as have an administrator type person and so we have had to make some changes in our organizational chart, uh, just to accommodate the changes they believe will improve the functioning of the unit itself. Of course there are other issues like competency issues, etc. that have to come into play and we had to relinquish our, umm, rights to keep or not keep employees to that management team, so they can do what they need to do.

(According to the contract signed by Sycamore Management on 5/27/07, I have a copy, there is a clause where they can only “recommend” policy and staffing changes. And the firings began the day after Ott resigned, which was 5/4/07 three weeks before the management company. The owner of the management company told me he saw the articles in the newspaper and gave the board his business card and they were in; for a while until the money climbed into the millions and the problems with being in compliance were continuing. Then they were sent packing. More careful planning I see and obvious care for the residents)

Urban legend more like truth

Dolly: One of the things we talked about, I have heard this rumor several times so I want to tell it to you because to me about, but I would just like to have your response to this new urban legend. That there was an 82 year old woman in the skilled nursing facility who was overmedicated to the point where she fell out of her wheelchair that she sustained terrible injuries that she later died from. And, uh, actually it said you’re suffering under the fear of indictment, (laughing), from the ……..and you maybe charged with, what was it? Um, some kind of negligent homicide that was the term I heard (laughing harder) used. I find that just a tad amazing but especially since that didn’t make the newspaper, even the other one. So, I’d like your response to that. (still laughing)

Ott: It’s actually not even funny that someone would even say something like that but, I will tell you that the employee that reported to DHS had reported something similar to what you’re describing and we have down our own internal investigation, DHS has done a very thorough investigation, and we know of no incidents such as that.

Dolly: (asks if she had said at a board meeting that the patient would have died anyway)

Ott: Oh, for heaven’s sakes, I can’t even respond to that (laughing)

Dolly: thank you, I wouldn’t tell you if it were not something , you know.

Ott: (cuts in) We love our residents, we’re passionate about the care we our residents and we care deeply about them, that is, that’s all I have to say.

Dolly: (wants to talk about achievements)

Ott: Well, actually they are not my achievements they’re the achievements of a fantastic team, including those three wonderful board members that I discussed earlier and we have made great strides and I think this community understands this through all the terrible reporting, umm, patients continued to use us, our volumes are up. (edited: she listed achievements such as echo cardiogram, several eye surgeons, surgeons like Dr. Holly Spohn Gross, endoscopy and Gemcare.)

(Again, Ott worked with the quorum of board members, Bob Jamison, Brad Armstrong and Barbara Casas. But there are five board members, two of which, don’t get mentioned until its negative. Brown act violations as well violations of their own reporting and personnel and policy procedures occurred with these people.)

Why are you leaving then?

Dolly: Do you have anything to say about why you’re leaving us?

Ott: It’s hard to say goodbye, we have the most incredible auxiliary and so many beautiful women and men who work so hard for our healthcare services-the foundation that does such a great job. The staff that are just amazing in the care they provide and how much they care about the community as well, and I just want to say thank you to all of you for the great four years (crying).

(They begin taking a few phone calls)

Jamison: Good morning you’re on the talk show.

Caller: …I wanted to know why she is leaving? Why did she tender her resignation?

Dolly: I guess you’re going to have to answer that Pam.

Ott: eeewww, um, we have had a board that has had difficulty working together as a whole, and I’ve talked about my successes, but I have failed to help pull that board together as one-and we have so many difficult things ahead of us especially the seismic issues, I need to step aside and see if a new CEO can come in and help pull this group together so that they can make those tough decisions and move on.

(I’m gleaning that if she only had the three board members she would have stayed and everyone would live happily ever after? Except the residents of the SNF and the scapegoats)

Which story is it? There are so many

I called into the show and asked her which story was the cause of the SNF disaster: The Knights, the ECHO program was down for a year, the evil director of nursing, disgruntled employees.

Ott: when we look back it was a systems issue, about every five years this hospital no matter who the administrator was including Mr. Knight, Mr. Dalgren, and some others, has had a situation of immediate jeopardy. I believe part of that is that we are not JACHO (joint commission), we don’t belong to an accreditation group, so we just didn’t do tune ups on an on-going basis making sure we were compliant with everything.

Hart: why did you tell me last year…

Ott: (cuts in) With this new management team in place, they will be back every year making sure we’re compliant.
(of course that didn’t happen. Lots of pie in the sky promises just like with the indicted director of nursing, she had great qualifications, 36 years of experience, and Ott talked the staff into trusting this woman.)

Hart: Can we afford it? (no look at the nursing registry figures from the board meeting)

Ott: With this new management team in place, they will be back every year making sure we are compliant in all issues.

Hart: these problems could have been fixed if we looked at them three years ago; these problems aren’t new-do we have that kind of money to spend on 39 thousand, a hundred and some odd thousand, to pay in penalties?

Ott: we’ve actually been successful setting aside reserves.

Hart: that could be paid for a lot of better things like equipment and services.

“They just got a little lax, that’s all.”

Caller: do you not believe inadequate and sloppy healthcare falls to the board and the CEO that they should’ve checked in on that before.

Ott: I don’t want anyone to believe our healthcare is inadequate or sloppy because…

Caller: (cuts in) that what you said they we’re giving medicines without writing down and so forth, you know I’m just wondering.

Ott: They just got a little lax that’s all.

Caller: You can’t do that in a hospital.

Ott: And we’re fixing that and you’re absolutely right I take full responsibility for that.

Caller: That’s what I want to hear because I’m getting elderly and I want to know that it is fixed up, we need a good hospital here. (Ott always seems to be able to tell people what they want to hear)

Ott: You bet we do.

“What do we know about him”

Dolly: The new management team, Don Doyle, what do we know about him?

Ott: He actually started his career as an LVN, his father was a minister, and he has spent his entire life in nursing centers and so he just has an absolute passion for, um, nursing centers.
(Ott knew little about them, KVHD was ambulance chased by this firm, but she can still tell a story)

Dr. Pormir part of good staff

Dolly: (talking about good staff, and Dr. Pormir)

Ott: Dr. Pormir is over there as the director of the nursing center and he is such a compassionate, caring physician, and he has taken it upon himself to study deeply into geriatric care and long term care services.

(I’ll tell you one of the only people I saw in the skilled nursing center in Dec. 2007 was Dr. Pormir bringing presents to the residents bought out of his own pocket. Every one of them. Mrs. Knight made blankets for each of the residents as well. Celia Juni put on a show of animated characters she moved from her home to the SNF for Christmas. )

My mother was on antipsychotics?

A concerned caller asked Ott about the use of the Depakote and Zyprexa on her mother, who she said was 97 years old.

Caller: …why, why wasn’t my mother notified of this?

Ott: You know that was part of what our problem was is that, um, the DON sort of bullied the pharmacist and staff into these changes without, without properly talking to families with documenting the need. And if you call me up at work I can sit down and review all of that together because it sounds like you’re hurting from that, we can sit down with Dr. Pormir and that out together.

Caller: I mean this nurse was bullying the pharmacist? Why didn’t she say no, you want this medication go through the physician.

Ott: Because the pharmacist believed that she had current knowledge and she did some research, the interesting thing is, is that the pharmacist still working there-not in the nursing center-but here’s the interesting thing for you is that the DON and I went ot a Lumetra conference which is the quality improvement for CMS, that’s Medicare, for DHS, and we went to take some training and when we went to the training the great physician, guru of behaviors gave a lecture and these were the medications we recommended we use for the center behaviors, so he, even CMS and DHS are being trained that drugs like Zyprexa are safer than some of the old drugs like we used to use, xanax.

I visit them everyday

Dolly: there are a lot of people who like the SNF. I personally like to go over there to there (parties) and some of the things they do.

Ott: I’m actually one of them, if I actually don’t get to make my rounds every morning and get hugs and kisses from the residents; it’s not a beautiful day for me. It’s just such a special place.

(So, Ott was doing her rounds in the SNF everyday she says, looking at her special residents. But also touching them and interacting. Then she must have had some knowledge about them. She would have noticed if anything was wrong; she is a nurse of sorts. Ott would have seen that nurses were short staffed and her beloved residents were sometimes sitting in soiled clothing. Everyday strolling through the SNF would have given her a better look at the situation than Dr. Pormir or Debbie Hayes. And obviously employees were in contact. She would have known that the meds were being delivered late because of short staffing. She was administrating the SNF with the former CNO, Sharon Brucker, shortly before the investigation time frame of Aug. 1 to Jan. 25, 2007. The SNF was already in trouble as the state was imposing penalties and denying their correction efforts. Patients had lost weight, some significant, and it just went away overshadowed by the new problems. Ott and Brucker left the SNF in charge of Gwen Hughes because they were in trouble for their own restraint issues.)

The last thing Ott said before getting off the air, was don’t forget Measure M, “…because 300 employees depend on their jobs and because people in this community need healthcare services.”

Umm, thanks.

Recommended reading: Ott's interviews, emails, and newspaper quotes. And Dolly's first interview with Ott, called "tracking down the troubles at KVHD." Another clarifier would be, "Urban Legend/Revelation/responsibility.