The Sticky Three or why we brought cameras to the board meetings

In early 2007, I realized we had a serious problem in the hospital. Employees were talking about short staffing, rumors flew about the new Director of Nursing, alleged abuse was whispered through the halls, but the leaders of the Kern Valley Healthcare District boldly lied where no hospital has ever gone before.
So, I thought we should film it. Not to alarm the paranoid leaders, I told them I was doing a documentary, called, "from bond to building," about the new general obligation bond measure to replace the ill fated Measure M.

They weren't stupid and so darn paranoid, they cancelled the April 2007 board meeting.

Around this same time, I went on that fateful day into the skilled nursing facility to look at the CMS annual survey report I had been told about. It was hanging in the hall, a public document, but when I went to look at it, I had scads of nurses trying to keep me from reading it.

Mr. Jamison, in his famous video, tells the story as if I ran into the nursing facility just to use strong language. I can do that at home Mr. Jamison.

I did use strong language with these nurses or whatever they were, who intentionally tried to keep me from reading.

Code blue skies for the Mt. Mesa Clinical Pharmacy: Breaking news from the Kern Valley Healthcare District Finance Commit me meeting

After last month's Kern Valley Healthcare District Board of Director's meeting where the pharmacy was looking like a lost cause, a weakened branch needing to be cut to save the whole tree: now, three weeks later, new data entered the picture and the pharmacy is getting another chance.

After board member, Bob Jamison, made a motion last month to close it down, as it was "inevitable", the board will again have the opportunity to view the new information, and possibly begin a new run at developing the customer base all over again.

But during the last Oct. KVHD meeting, the board members asked questions but didn't get the real deal regarding the information needed to make such a major decision...

Though, Brad Armstrong, voted in favor of looking at the pharmacy situation in detail, and even questioned if Chief Financial Officer, Chet Beedle had tried to market the slumping pharmacy, others at the KVHD board meeting next week may not look so good.

Chet Beedle gave us a detailed analysis which included a quirky twist, utilizing a ten year old report from a consultant firm which analyzed the hospital's problems back in 2000, which I imagine would look much different than the current situation.

My question to the board is do we really need a full time, Chief Financial Officer?

And I don't mean just this one who relies on an Ouija board or at the least, obscure data to educate the board and other administrators, like, CEO, Tim McGlew.

We are a small hospital where every penny counts and the position of CFO, maybe a place where we can save some money. (Now do you think the CFO ever thought of that, and if he did, would he really make the recommendation going against his own cozy situation.)

I say consultant. I also say consultant in human resources.

The question for our hospital is always how to survive on little money. We're a small business.

When they come to us now talking about the money problems even I could predict, I wonder how did they survive paying the salary of the former CEO, Rick Carter? Not just his salary but the plane tickets, lunches, train transportation and housing, to name a few too many.

The two million dollars which went in haste and waste to Sycamore Asset Management, a company which ambulance chased the hospital nursing center, finding a closure notice in the newspaper, said the owner of Sycamore, Don Ermel Doyle.

KVHD, in submission on it's back after the disaster in the nursing center, proceeded to write them up a time and materials contract. That is like giving them your credit card in front of the mall.

How did we survive this?

How did we make the bond payment from our long term debt to Cal Mtg? I guess we didn't pay all our vendors what we owed and moved money out of places where it should not have been taken. Maybe the pharmacy felt this pinch. And the vendor of pharmaceuticals (the real drug dealers), the distributor, did not like the slow pay and no pay status, and the stress began.

But I feel so much better that our bond payment was made even though we lost our footing because of it. And I'm so glad we never tried to negotiate with Cal Mtg. for a deference on the bond payments because we don't have anyone with a financial green thumb overseeing our "growth."

So, next week, the Kern Valley Healthcare District Board of Directors meeting Wed. Nov. 4, at 5:30 pm in the cafeteria at the hospital.

The update for now is the pharmacy will remain in operation with some staff cuts likely coming, and hopefully a new plan on how to get the medicines to the customers more quickly.

Other issues still smoldering, how to keep other losses down, like in the surgery department; and the skilled nursing facility is just on going; staffing properly not using that as a money saving tool as the CFO suggested; and many things like keeping patients at the hospital and keeping physicians of merit here.

Then the expanding must occur, and maybe even having a service that is so special it can't be found in most locations, whatever we have to do to bring service, follow it up, unlike getting mammography and never using it. (selling the trailer and parting it out, that's a huge failure we don't talk about much.)

We need plans for the future which can be effectuated, really manifested, not just talked about. I am so tired of hearing it and never seeing it, not just at KVHD, but with our government in general, but KVHD is so egregiously hypocritical that we have to start with what is in front of us: a nebulous future.

No more plans to cut a limb without first doing the homework. No more copying the homework from ten years ago. This is ridiculous, inane, and somehow there is always another excuse to go with it.

When does it end? The hospital has been under the direction of the CFO, who has not always been forthcoming, now using outdated data, and made the board and CEO look ridiculous as they were counseled to make a decision to close the pharmacy based on the financial officer's data.

What are we going to do about this situation? Let it go on, and lose more money? Make poor decision making into an art? Never knowing what is real or true in the financial reports?

I don't know, I guess I'll ask the board.

The disaster, the crimes, when does it end?

Bradley Armstrong, current Treasurer of the Kern Valley Healthcare District, sits in front of his computer deflecting all scrutiny of his activities within the district for more than 20 years. Brown Act violations, conflict of interest issues, bullying, and ignoring serious problems highlight his stay on the board of directors.

They worked together hiding their activities from the public, the employees, and other board members, and created the biggest disaster in the history of the Kern Valley healthcare district when idictments came down from the state Attorney General's office for elder abuse earlier this year.

The charges, stemming from an investigation during the time period between August 2006 and January 2007, were only against a long time doctor and pharmacist, and a director of nursing, who was hired and left during the same time frame. Others got away with their part in the downfall of the skilled nursing facility; and some are still here...

Bob Jamison, 2nd vice chair, still with the board of directors, spent much of his time at his radio job with QAB media protecting the truth about mismanagement and the rest of the time attacking employees along with anyone who questioned the former CEO, Pam Ott. Jamison was one of three board members, a quorum, who ran the hospital into the ground.

Jamison blogged on the QAB media, an ABC affiliate station, website creating a media war as the three board members and administrators were being scrutinized while investigators were roaming the nursing facility at the hospital. When CEO, Pam Ott, stepped down, May 2007, during the impending disaster, Jamison further aggravated the situation, by bringing Ott on the radio and allowing her an hour to defend and blame others for the problems.

The board of directors was lopsided, as Bradley Armstrong, Bob Jamison, and former member, Barabra Casas defied all laws surroung legislative bodies, the Brown Act, putting votes aside when one of the members was absent, thus losing their private quorum. They even went to the extent of canceling a meeting in April 2007 when the questions started coming about what the problems were with the hospital nursing facility.

Email from Barbara Casas RE: April 2007 meeting: Bob Jamison was elected to the office of First Vice President, which was his desire, so he could Chair Board Meetings if Brad had to be absent. Bob Jamison chose to not have the Board Meeting on Thursday as he was afraid that everything would be a 2 to 2 vote without a third positive vote from Brad who is Chair, and the third person to vote for anything positive.

....….Know this—If I was acting as First VP or Chair, I would have carried out meeting on schedule, I would have only tabled the action mentioned before the meeting—that could have been accomplished by a telephone vote of all Board Members—I would have chosen to go ahead and let them make fools of themselves, but then, that is me, and I “charge ahead”-----that is what I would have done!

Pamela Ott, former KVHD CEO, from 2003 until her resignation in 2007. Ott shown here at the South Fork Woman's Club attempting to get the organization to back a general obligation bond for 12.5 million to build a new wing on hospital. The bond was lost, but the building plans were never feasible anyway.

The former CEO spent most of 2006 dealing with the Department of Health Services as the Skilled Nursing facility was fined for noncompliance regarding physical restraints of residents. DHS requested that there be a full time Director of Nursing in the SNF, and though Ott, and then CNO, Sharon Brucker, stated compliance when they brought on a DON in March 2006, she lasted only a few weeks.

2006 documents

regarding the use of physical restraints. Ott, an RN, had little knowledge of long term care laws.

But as the district was trying to push its general obligation bond, Measure M, onto the November 2006 ballot, a new employee arrived who took over the skilled nursing facility as the director of nursing, Gwen Hughes.

Ott glowed about the acquisition of such a qualified manager, and reported in her September 2006 CEO board report that things were going well. At the time employees had already begun to make rumblings that trouble was in the SNF and the hospital. But Ott insisted things were "wonderful."

"Nursing Center Update: Things are going very well in the nursing center. We admitted six new residents in one week. The total census is 72. Our new director of Nursing, Gwen Hughes, is organizing, making appropriate changes, adjusting to her role and the staff really seem to be enjoying her leadership."

Then in Oct. 2006, employees came to a board meeting to let the directors and management that there were serious problems with staffing. Chairman, Bradley Armstrong instructed the speaker to go up the proper chain of command. Rather than see the situation as an alert that problems were afoot, Armstrong, reprimanded the employees.

Suddenly, in November 2006, a month later, the problem was investigated and resolved. All assertions made by the employees, the report says were not substantiated. A committee was formed to appease the group.

both of the employees who were in charge of the recruitment and retention committee are no longer employed with the hospital. One nurse was called "one of the best" by doctors and fellow staff.

By April 2007, then board Chairman, Bradley Armstrong, began refusing to answer questions regarding the skilled nursing facility or any short staffing suggestions.

That was the month he had to have the board meeting cancelled because he couldn't attend, suddenly. The meeting went April 16.

Brad Armstrong backed Pam Ott, as no questions were asked of her in a public forum, questions were deflected, and no accountability was offered.

Armstrong also strongly backed the architectural firm, Aspen Street Architects, the company owned by David Yarborough, as the hospital was working with Rural Health Design Network, owned by wife, Kathy Yarborough.

The plans produced for the concept modular building tied to Measure M, were faulty, yet because the district had a long relationship Aspen Street, already paying much money over the course of several years.

When the project went up for bid in March of 2007, (by law, projects costing more than 25K have to go up for bid) Armstrong, Jamison and Casas all voted for Aspen Street.

The other two board members, Robert and Kathryn Knight, picked another company after doing research and finding out about the cost overruns Aspen Street had been having on their other projects.

Barbara Casas said she wanted to go with Aspen Street after working with them for five years. Even after the renderings were made for the previous GOB, and they were faulty at a partial cost of $5000.

Chairman Armstrong only researched two of the three firms, and went with Aspen Street in spite of their previous errors. Partial records indicate Aspen Street Architects was paid more than $30K. Not clear what services were provided which were correct and finished.

The hospital has dropped it's contract with Aspen Street and denied for months knowledge the relationship between the architects and the other organization, Rural Health Design network.

Chet Beedle, Chief Financial Officer, contracted with two different management companies for the ailing nursing center. After minimum or short staffing, Beedle spent more than a million dollars to rehabilitate the SNF.

The board of directors signed off on the strategy which has cost the district dearly.

Chet Beedle, who pushed for Measure M, going on TV with Bob Jamison, selling the bonds without any true construction plan or detailed figure.

Beedle, who came to the district through a management company called BRIM, in 2001 as the controller, was then hired on as CFO.

The CFO worked closely with Armstrong, Jamison, Casas and Ott as they closed in on the bond meant to pay for a structure that was amorphous at that time, and still is not settled.

With the Knights disagreeing with the process, the group went about telling stories about the Knights which ranged from being thieves to walking the halls at night talking to employees.

Beedle targeted an employee he called a "Knight supporter" who said he didn't trust management and was not behind the bond which would have the community paying for the project with property taxes.

Email following a meeting in December 2006 regarding the Knights and an employee:

What I said was that Tom received double digit salary rate increases while most of the other employees' salaries were frozen. All of these salary increases were granted by Bob Knight. The actual history is al follows:
1) 9/28/97 - Annual increase of x%.
2) 12/1/97 - Special salary adjustment based upon survey of comparable positions - Increase of xxxx%.
3) 7/1/98 - Special salary adjustment for increased responsibility for Durable Medical Equipment - Increase of xx%.
4) 9/27/98 - Annual increase of xx%.
I am sending copies of the Personnel Action Forms signed by Bob Knight for these increases to Pam as per her request. I think this tells the story.

(Figures have been removed for privacy purposes.)

Mr. Beedle has firmly said that there are no billing problems at the hospital. And even after the end of the contract with EMCARE in 2006, the company he blamed for the overcharges, there were still complaints coming in.

One public comment stated that when he was dealing with the billing department he felt they were not up to speed on what everything was and that they always turn and talk to someone above them.

Other residents have claimed they still get bills over and above their own insurance, though Beedle denies having any complaints.

Currently, the board of directors consists of Kathryn Knight, chairwoman, Secretary, Victoria Alwin, 1st vice chair, Dr. Robert Gross, Bradley Armstrong, Treasurer, and Bob Jamison, 2nd vice chair.

A new CEO, Tim McGlew, has recently joined the district and will be attending his first board meeting this week, July 1, at 5:30 pm in the hospital cafeteria.

Even with evidence that there were leadership problems, board members voting together and violating laws to make sure they had the vote, personnel records revealed, slanderous statements about board members and employees, there has been little recourse or action by any oversight agency.

Currently, Armstrong and Jamison have been subversive in their activities trying to blame other board members for mistakes, yet neither of them has yet to even take responsibility for their own actions. But two people who have served the district are now in criminal court, Dr. Pormir and Debbi Hayes. And the hospital insurance company has denied that they have to pay for their defense.

Armstrong seems to not be able to let go of his former power to control the board and administration, and has berated and harassed the new chairwoman as she took over just this January. Upon taking over the middle chair, Kay Knight, had a sudden surge of visits at her workplace by Beedle, former CEO Rick Carter, and a reportedly pushy Armstrong.

The incidents were reported to the board counsel, Scott Nave. He has also recieved evidence to the facts and has chosen not to act.

Reporting on a special meeting, I was kept from getting the report from the legal counsel via telephone as Armstrong reached in front of me and hung up the phone.

Records have been denied and kept from me over the past two years. Which again is illegal. It hasn't ended.

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