KVHD Board Meeting 2/1/07 CEO Report and interview

(This is a transcript of the CEO report given by Pamela Ott in February of 2007. It is unedited. Lot's of freudian slips in here)

Pamela Ott:
So, the question in the audience tonight was the nursing center focus survey. Indeed the Department of Health Services has been visiting our nursing center this past week and the week before-and, of course, I wrote this report on Sunday night, so forgive me, it was the last week- so forgive me for that-they haven't been here this week.

So, basically, they came by invitation by an anonymous concern. And I know there has been a rumor out there that our Director of Nursing, who has left us, was put in handcuffs and taken away by the Sheriff's department and that there are some arrest situations there were felony, all of that is absolutely not true. It was just one of those rumors that happens in small towns.

Miss Hughes, umm, was not meeting these standards that we-all-probably should be met of our quality of care that we expect and she gracefully said, she umm, didn't belong in our organization and she left.

Now the survey results are not in- we should get our statement of deficiencies- we know we have some issues we need to fix. It's mostly around these medications in the area of psychotropic medications for people who have psychiatric conditions and we did not have a psychiatrist working with us- we have hired a psychiatrist- we've had the psychiatrist meeting with a patient, everyone of our patients, or residents, who have psychiatric conditions.

That psychiatrist has found that each and every one of those residents was not only appropriate to have those residents on this medication, but also actually recommended some dosage increases.

So, we know on that part we're safe.

But we will find out from the rest of the survey what things we need to do to improve- we're used to surveys- we're used to having areas where we can improve and we will continue to do that in the future.

(That was the end of Ott's skilled nursing report, but she jumped right into the issue of a new general obligation bond and looking at architects which the board lapped up like milk after a dry piece of bread)

(A month later, I sent over some questions to the CEO)

See below:
-----Original Message-----
From: Laura Hart [mailto:muymala@msn.com]
Sent: Tuesday, March 13, 2007 11:06 AM
To: Ott, Pamela
Subject: some questions...
Hello Pam:
I have a few SNF questions.
Are you taking new patients? [Ott, Pamela] No If not, why not?[Ott, Pamela] We are full like a tick!
Is Dr. Pormir being investigated as well; [Ott, Pamela] yes or has he been given a clean bill of health?[Ott, Pamela] there is information about the Director of SNF
Have you received any fines so far; [Ott, Pamela] No, to our knowledge, CMS has not been notified (DHS only makes recommendations to CMS) and what were they for?[Ott, Pamela]
Will you be fined for anything else in an ongoing manner?[Ott, Pamela] The way that the "fines" are designed, they go on until DHS comes back to find that everything in the plan of correction is in compliance. We were in compliance before DHS ever left our facility short of providing employee education which has taken place this week. Why were patients in the SNF given psychotropic medications without the permission of the family of the patients? [Ott, Pamela] Yes, 1 resident. 2 physicians evaluated the resident for psychotic behaviors (kicking, screaming, biting, refusing care) BUT - we did not have a psychiatrist evaluate. How many of these patients were involved?Who told Gwen to leave? [Ott, Pamela] No, when Gwen already knew that we were having a special Board meeting to deal with the behavior problems, when Carol Dene told her that DHS was on their way to do an investigation and that so far, their investigation had revealed that the biggest issue of immediate jeopardy was the DON, she promptly packed up her things and left the facility. Did she do it on her own? What is her last name?[Ott, Pamela] Hughes What sorts of documentation problems were you cited for? [Ott, Pamela] Care Plans that are individualized to the resident and reflect why we were giving particular medications and nurses notes taht again reflected why they were giving treatments/medications. (this is normal, nurses, given the choice of caring for patients and making sure that their charting is don will choose to ignore their paperwork every time, it is very frustrating!) What particularly didn't they write down?
Let me know when you get a chance. Thanks, Laura

(The employees were always, and probably still are, the ones that take the flack for everything done. Could it be that some short staffing problems lead to the lack of paperwork; or might it be that the missing paperwork didn't look good and stayed missing? I don't know. Could be both.)

He thinks it's funny: Do you DHS, Jerry Brown, CMS, DA?

Jerry Brown: it's never too late...

KVHD board meeting, June 2009:

Feeling safe and secure he will never have to face his responsibility for the disasters/failures/crimes of the Kern Valley Healthcare District, the district's employees and patients have been enduring for the last two plus years, board member, Brad Armstrong, reacted when I told him it was sick he was still a free man while a doctor and pharmacist pay his toll.

He laughed and smirked.

I asked him, "Do you think that's funny?"

I'm sure Dr. Pormir isn't laughing and neither are the families of the patients in the skilled nursing facility, or the former employees scapegoated and known always as "disgruntled."

While the perpetrators of the disasters sit at our KVHD board table each month, Armstrong, Bob Jamison and Chet Beedle, CFO, without conscience or an understanding of how many lives have been altered because of them. I'm going to make sure they know what their crimes have reaped.

Again, I repeat as I have written in personal correspondence with many of our elected officials, you let the leaders go, to continue the same indifference to laws and ethics while you took the "worker bees."

You want to kill the swarm you go after the queen and her mates. (Don't forget, former CEO of KVHD, Pam Ott, now infesting Sierra King District in Reedly, CA: Oh yeah, she's a witness for the state.)

Apparently the Department of Justice doesn't scare our Mr. Armstrong, I believe he thinks he is untouchable. He should probably take heed there are those out there that "know" what he did.

Bob Jamison has laughed off investigations crowing from his sqawk box at QAB media about the impotence of government. So, now he faces a new hurdle at the next board meeting and every meeting thereafter: having to listen to his own emails being read onto the hospital record.

And Chet Beedle with his funny abacus will never admit to the short staffing, the personal attacks on employees, the grandiose contracts, the short sighted bond refinance, so we are just going to have to help him out with the truth.

But once the state investigators looked away from KVHD, the element just reassembled, added new members, burrowed back in, becoming even more fearless.

At a special board meeting in March, I was asked to get a report for a TV station. When I entered the board room, the board counsel was giving me the synopsis over the phone, when Brad Armstrong stepped in front of me, clicked off the phone as the attorney was in mid sentence, and told me, "meeting adjourned." (Worthy to note, the chairman is the only one to say, meeting adjourned. He's not the chairman. I guess he's still living in the middle chair of his mind.)

I protested that I had not gotten the report. While I was protesting the cameraman from the TV station was getting hit with sprinklers as he tried to film in front of the hospital.

We went up to the bench at the entrance of the facility to do the interview, and suddenly, the sprinklers from the tree, sprayed us. We laughed and I explained to the startled cameraman that it was just the nonsense of stupid people. (He fixed the sprinkler by the way. Chet you owe him five bucks. Or maybe you would prefer he be your sprinkler consultant and you could contract for say, half a million?)

The healthcare district spent $60,000 on a public relations firm to try and change its damaged image.

They then really helped their marred image by turning the sprinklers on a cameraman from KGET, Channel 17 news, out of Bakersfield last March.

Opinion #7-13 Laura Hart:

Mr. Attorney General, if the government cannot serve the type of justice which produces healing by removing the malignant force, then it would be best to do nothing at all. You removed some healthy tissue but left most of the tumors behind. Not a good prognosis.

By ignoring the leaders in your indictments, much like leaving ruthless leaders from authoritarian regimes in power, you let them continue the same actions but with impunity.

Unfortunately, the message the state sent to the Kern Valley was that we are only a provocative headline for you sir and your public relations staff who are working on your next political campaign.

Dr. Pormir chided me two years ago that, "you, Laura, know nothing about politics."

Given our respective situations, related to the political machine, I'd say we're becoming frickin' experts.

Ocktoberfest KVHD board meeting: all beer and sausage

“…Because we have a lot of people in this community who need the assistance of a psychiatrist,” Tim McGlew with the quote of the night taken out of context, but even in context it’s still funny. Read on.

One week ago we had the Kern Valley Healthcare District Board monthly board meeting and I’m still reeling from what I heard that night. I wanted to make sure to cover this properly and have spent much time pulling quotes, as I will let them speak for themselves.

The issues which were at the forefront of the meeting were some I had identified almost a year ago, the cost of the skilled nursing facility, a risk assessment of the SNF, staffing, paying the revenue bond debt, and now a few others.

The new “bad debt” caused by the uninsured who don’t pay their bills and are recalcitrant about filling out forms to apply for charity programs where the hospital receives reimbursement.

And, the annual increases in Medi-Cal have been frozen by the state, thus taking away nearly a “half a million dollars” we put in the budget and thought we would have to spend. We never had the money, but we expected the increase, with obviously no contingency plan, like we always do.

Now we have to live with increases, but with no increase in reimbursement, according to our CEO, Tim McGlew, and verified, by our CFO, Chet Beedle.

Then there’s the fact that we have only enough cash on hand to run the hospital for five or six days if we’re lucky.




(And you, the audience thought it was just going to be about the pharmacy, didn’t you? We should be so lucky. )




No, Chief Financial Officer, Beedle, in no uncertain terms announced trouble paying the bond debt, and looking to the future, next August when we pay the big chunkaroo, 1.1 million, it will be amazing.

So, where do we start here. Well, there are some new beds being put in around the nursing facility, and Medicare won’t be paying for them. However, local gardeners will be volunteering their time to work and actually furnishing these aesthetic upgrades, flowerbeds, in three of the courtyards.


"I represent the KRV Garden group and our group is going to be doing a beautification of three of your courtyards and we are going to be calling them, healing gardens," Shirley Real explained to the board, while holding up a copy of the Kern River Courier talking about the media coverage on the group.

(Healing gardens, I like that whole concept. We already have the "healing murals" but that cost a bit more. Always interesting timing.)

Shirley Real told the audience about her informal garden "club's" project, which will bring in new plants, fire safe types, low water, and there will be a grand opening in March as spring is the time to see the project bloom.

(I know what you’re thinking who cares, give us the gory details. These gardeners are trying to do their part for the community, for the hospital and its residents, so they get a plug.)


And, of course, Alicia Audette, known for her very positive reports to the board on the activities of the hospital’s auxilliary group. The auxilliary runs a very profitable thrift store off the Lake Isabella strip.

Alicia Audette, showing her muscle as she reports high earnings at the thrift store.
"As usual, we are doing very well, our daily revenues have gone up."


The Hospital Foundation reported the Peddler’s Fair went well, and Mary David, Director of the Youth 2000 teen pregnancy program, propagated information regarding that program.

Chief Clinical Officer, Cynthia Burciaga, took to the podium, and an information waterfall spilled out. She gave us a lot of details regarding her work with the skilled nursing facility, such as staffing milestones, and we were introduced to our new Director of Nursing, Michael Goospy.

"He comes to us from Carlsbad, New Mexico, with a significant level of experience in the Skilled Nursing Facility areas as well as some acute care experience in critical care. He's been such a welcome to our healthcare community," Burciaga told the board audience.

"And he's jumped in looking at the policies and procedures, meeting with various personnel, becoming acquainted with each resident and their specific needs..." she added.

Goosby, who is taking over a critical position in the skilled unit, quietly received his applause, which he deserves considering the job and location thereof.

Burciaga then lead into the story about a recent look around by the Department of health services.

"We did have a visit from the state yesterday, we did good. And overall we're doing very well consistently. You know they come here and there, find the time, to just check up on things," she explained.

"We'd like to share with the staff and community that when the state comes to visit it's not a less than positive event. When the state comes to visit they share experience with us, they see current trends, just checking up on the various practices to make sure we are following those and other items...they come in and look at the staff they are very well pleased with our practices."

(And where was the state health department in 2006/2007 sharing their knowledge and practices? Now, they just drop in for a "visit")

Burciaga, who works sometimes personally in the nursing center when the need arises, said that staffing is going well, although the nurse's aides are opting to go to school to achieve the next nursing level, LVN, and some of the LVN's are going back to become RN's, so there is some shifting of staff going on.

The CCO said that the nursing facility is now meeting all its staffing requirements and has even exceeded them. "And our average patient care hours per day is 3.24 and so we stay above the 3.2 level."

Can we get our flu shots? If so, where and when?

Those questions currently cannot be answered in this story (get info soon), but Burciaga broached the subject talking about the precautions the hospital will be taking during the flu season, and with H1N1 on the loose. Gloves, masks and handwashing, as well as flu shots for staff and residents.

But where do we get our flu shots. According to Burciaga, there will be no "drive thru" clinic through the hospital, and patients are being urged to contact their doctors about the problem.

Currently, Rite Aide is out of flu shots but Sienna Wellness is hoping to have shots for their patients by November, as the shots are on order, even the swine flu vaccine.

(More on this topic, as I need to speak with Public Health as we have a high concentration of seniors who will likely need flu shots. And we need to know where to find them. Yeah, we might actually have to go to Bakersfield.)

A few technical problems didn't stop the chairwoman

As Kathryn Knight opened the meeting, the microphone apparently was borrowed from a local "jack in the box" as the crackling came out of the speakers after each word Knight spoke.

(I noticed a maintenance man there, he was more concerned with the cord to our video camera than he was about the distortion coming from the PA system. I'm sure he hasn't been cross trained yet, as is planned for the staff.)

(My time is running short here as the electricity is out because two drops of rain poured on the valley which always causes outages. I'm on my battery watching it drop while I write in the dark. So, we will see what happens, I've only got 35% to go...oh no.)

Secretary of the board, Victoria Alwin, asked for clarification on the consent agenda, as there was a question as to the pharmacist dosing Vancomycin, an aminoglycoside antibiotic which is known to be ototoxic and can cause permanent hearing loss.

I, myself, have taken Gentamycin, another aminoglycoside, and now I have no visual stability, balance, and it is permanent damage.

I'm glad that there has been discussion as to how to administer and dose these very strong and dangerous antibiotics. These types of antibiotics are used in cases of serious infections such as staph.

Two reporters narrowly missing each other at the meeting. "Don't look at me and I won't look at you," describes this close encounter of the lawsuit kind.

As Knight's microphone screeched and scratched, Dr. Robert Gross lent her his microphone, then needed it back later to ask Chet Beedle a few questions during the financial, or lack thereof for brand new reasons, report.

Chet chat, oh my what's that he said?

Beedle opened the report, "The Kern Valley Healthcare District had a very difficult month in the month of August, relative first to volume, the volume was down, under what it was the same month the previous year, in virtually every venue."

But not every venue, as Beedle surprisingly brought up a positive posting for the nursing center. "...for the first time in fours years the skilled nursing facility has made money."

Beedle said part of that was that the hospital has taken out most of the traveling nursing and registry, which sent staffing costs through the roof.

"The SNF can function, it needs, I've always said, it needs 70 patients a day and we almost had that at 69.15 and it needs no registry utilization and it had a small amount, but it was under its budget in registry utilization and it kept the salaries in line. Those three things together, you put them together, you will do well financially in the skilled nursing center."

(I think he left out the part where where we had millions in registry, consultant firms, and contractors, taking money by the bucketfull out the door to some other community. Maybe that has something to do with our current condition. So, why didn't we do this before?)

Chief Executive Officer, Tim McGlew, also talks about the closing the barn door after the horses got out, by doing a risk assessment in the nursing center, later in the story.

(I'm under 10% battery power, so we are both going to have to wait for Southern California Edison to get the power back on.)

It was a miracle

Well, we did it, we paid the bond reserve payment this year for both February and the month of August. Beedle initially reported at the beginning of the year that we would have to take money out of the reserve account which is part of the contract for insuring the debt, with Cal Mtg.

How we did it, was not explained, and the question was asked over and over again, "how can we make this payment without taking money from the resesrve, which Cal Mtg. doesn't like?"

The answer came a few months later, when Beedle said we did indeed have to take 155K out of the account.

But we paid our large million plus payment in August, with only a portion of the reserve.

"We made that payment which I think was a feat in itself," Beedle said.

"What that means is we had to dip into our cash, to make our semi-annual bond payment of 1.1 million dollars."

Cash, what cash?

The CFO explained that other hospitals on average, (he says he likes to compare our hospital with others around the state and nation, bringing us gems of comparative information.) have around 23 days the can operate with their cash on hand.

However, KVHD, has hit rock bottom at five to six days of viability without any money coming in.

"We could operate with the cash we had for six days...a year ago it was twenty days."

The economy and the uninsured: our newest excuses

I don't think anyone didn't see this economy coming down like a brick fireplace during a temblor, but it seems the hospital didn't quite plan for the situation.

Now the complaint is that more people are uninsured here in the valley, (I'd like to see the statistics on that for reference) and they utilize the emergency room services because they not only aren't insured, but they have no money to pay the sliding scale the hospital offers.

These people need to fill out "charity forms" for programs offered through the state so the hospital can get some sort of reimbursement. Otherwise, Beedle said, the services rendered would be part of the "bad debt" mounting at the hospital.

"They can have their bill reduced or written off."

Beedle talked about the amount of money this is costing the hospital, which should make you swoon: $300,000. Somehow, I'm not quite as impressed as I was when I added up the consultants fees and it came to "three million" dollars.

(It reminds me of the scene from Austin Powers when Dr. Evil asked for one million dollars in ransom)

I do, however, enjoy the new thriftiness being utilized in accounting at KVHD, but so much money was wasted over the last three years, and now Mr. Beedle talks about what can be done.

"Chet, I know you can't look at a crystal ball, but what do you think the future holds for us in the next six months, or in the future..." Dr. Robert Gross, DO, board member and hospitalist asked the CFO.


"What the hospital can do to deal with this economic climate, one of those things is looking at services which are non productive...one of those things is a staffing reduction. One of those things is other types of things that they do. For us, relatively speaking is the reduction in variable expense is limited. The reason I say that is because the number one, the largest share of variable expense is labor."

(That statement scared me a bit and I'm sure would do nothing for the morale of the employees.)

Dr. Gross then asked, "Do you expect that the number of uninsured patients coming to this hospital are going to continue to rise?

"I don't know if it's going to continue to rise, but it's not going to go down."

"And how long could this hospital absorb that?" Gross replied.

"That's an interesting question, that goes back to the statement I had before, if we don't increase the revenue in ten months...

Then CEO, Tim McGlew, wedged his way into the conversation.

"I think I'm going to jump in on that. The bottomline, obviously, we can't be in a position where we are standing still, we have got to find new sources of revenue, we got to look as Chet said before, things that are costly as like you know, we really need to make some decisions and we're going to talk about that later tonight." (the pharmacy)

McGlew expanded his explanation, into needing to start new programs such as wound care and pain management. He also talked about new specialists coming up to the valley.

"We can't just stay static we have to change the scope of things and find new choices," he said.

Beedle shared his hidden wisdom regarding asnwers to these pressing issues. "The real secret for us is volume." (Ssssshhhh)

I told Beedle I had read an article in the Bakersfield Californian, an AP story, regarding Medicare cuts. I asked how that would impact our nursing center.

The CFO explained that Medicaire does not cover most of the residents, and I remembered the coverage only lasted maybe 100 days for rehabilitation.

He said that the Medicare patients are usually utilizing "swing beds" which are paid by Medicare, paid well, and that isn't changing.

(Maybe that accounts for why Sierra Kings District decided to add swing beds there in the plan they concocted before filing for Bankruptcy.)

So, good money in swing beds from the feds, but cutting out other ancillary programs that help residents of nursing homes get proper attention.

What will we do about Cal Mtg. ?

Beedle used the phrase, "limp along," which means that something is going to take a hit, this time probably not the nursing center, as there might have been a learning experience there.

But Beedle wouldn't be considering taking on Cal Mtg. would he?

"The real issue is going to be, we're having difficulty funding our long term debt, I think we're going to make it for the first annual payment in February, I'm extremely concerned about the August payment that where the rubber is going to meet the road."

He went on to explain, without invoking Cal Mtg., what could potentially be done about this shortfall.

"Understand there's our half million in reserve there but we're talking about 1.2 million dollars. What happens if we don't? There's insurance that we bought when we did the bond, the will actually pay for it, so it will get paid. But there are all kinds of that go along with it."

Yes, there are many things that could happen if we didn't pay our friends at Cal Mtg. I'm sure you can read about it on the blog or go on the web and read the state plan for 2007: that should help you understand the situation we are in.

Beta Group: Risk management assessment of SNF

In his montly report, CEO, McGlew, happilly spoke of a "free" service given by the hospital's liability company which assesses risk potential and offers help in reducing the possible problematic outcomes.

(Isn't that great? Wish we would have done it before, but McGlew said Beta had just come up with this nursing center type survey. Gee, Beta, I guess its better to fight a dozen lawsuits than it is to survey the businesses you insure. I don't know maybe it works out for you.)

"The general findings from them was excellent, the team that was here was extremely complimentary of the staff and the quality service they provide. They did give us a list of suggestions to continue to make improvements, Cynthia is working with her team on that," McGlew explained.

McGlew updated on the radiology contract with Truxtun Radiology to do our digital media over the computer, as Dr. Eleanor Frazier, our on-site radiologist, retired last month.

Things seem to be going well, he said. And they will be looking for coverage for the night shift too. That contract will come to the board soon.

McGlew then announced the hiring of a psychiatrist for the nursing facility who is now being utilized at the Rural Health Clinic (I hope all who work there get a discount and use him) seeing patients, "because we have a lot of people in this community who need the assistance of a psychiatrist."

What is the fate of our "poor side of the lake" pharmacy?

McGlew made his reccomendations to the board that the pharmacy should be closed as it is losing money and not able to fulfill its obligations to the community.

The idea is to move out of the building and move the pharmacy into the hospital. (we could put it right in the hallway between the cafeteria and acute care) This way it would serve the residents, employees, and the patients.

However, Kathrynn Knight, was not as keen on the idea and asked questions about the accounting of the costs in the pharmacy. More questions need to be asked, and we will have the opportunity, as four board members voted to look at the situation prior to closing.

"The Drug Store" in Kernville, would take much of the brunt of the overflow if indeed Mesa Clinical Pharmacy is found to be unsalvagable.

The hospital would then have a building with no pharmacy license tied to it, and no stock, and they could sell, lease or even do something like another thrift store. Gosh, they do well.

We will go into the details on the blog as to the pharmacy, it's credit problems, and the lack of flu shots here in the valley.

Brad Armstrong, the poster boy for term limits, voted to take another look at the pharmacy rather than just cut it out of the picture.

He even asked the CFO if they had been doing any marketing of the pharmacy.

(Our motto: You'll get your medicine on time, if you pay for our shipment. We only do COD)

There are currently only three wholesalers who dominate the pharmaceutical industry and we have not made them happy by slow paying. But other pharmacists believe that Mesa Clinical is viable and could make money.

CCO, Burciaga, said in the event the pharmacy does close, the employees would be able to work at the hospital. Right now, the pharmacy staff is getting cuts to their hours, but staying on anyway.

Bob Jamison, the only "no" vote to take another look before closing the only pharmacy serving the southside, seemed to be unimpressed and rather bored last Wednesday.

Sorry, Bob, we didn't mean to wake you.

More to follow: "A Patient's Plea" , Youtube videos, and the final cut of the 2007 board meeting.

Next week: the countdown to court continues, why can't I get public info and answers, The Guardians, and "where they are now."

Attorney General's elder abuse hotline

I've had some interesting conversations over the last few days, and it comes down to this: what did you know about the DOJ investigation in the KVHD skilled nursing facility, dating Aug.1, 2006 to Jan.25, 2007?
(That is the time frame which was investigated. Right when Gwen Hughes arrives as DON and right after she left)

During these chats I kept hearing the same names over and over.

"We reported it to her and she did nothing."

"She pounded her fists at us during the meetings."

Now it's time to report what you know to the people in Sacramento who are out of touch with what really happened in our little valley. How could they not be, it's evident in their own case.

And let us not forget what Jerry Brown said about our hospital and community:

Brown Announces Arrests of Nursing Home Employees Who Drugged Patients for Staff's Convenience

BAKERSFIELD -Attorney General Edmund G. Brown Jr. today announced the arrests of a nurse, physician, and a pharmacist of a nursing home for "forcibly administering" psychotropic medications for their own convenience, rather than for their patients' therapeutic interests, actions that are alleged to have resulted in the deaths of three residents.

"These people maliciously violated the trust of their patients, by holding them down and forcibly administering psychotropic medications if they dared to question their care," Attorney General Brown said. "This is appalling behavior, which amounts to assault with a deadly weapon."

I'm trying to picture the PR folks writing this up. I am assuming Jerry Brown was standing somewhere waving his hands saying this is the worst I've ever, ever, ever, seen. You relied on the investigators information to say the things you are quoted as saying.

The young writer's picked up the message and created that little gem for Mr. Brown to live with. Was it true and correct to state that, I am sure it can be proven to be in error. You called them, "these people?" Okay.

We are the ones who know what happened. The evidence has built to such a degree that the mistakes of the DOJ case are self evident.

They have hostile witnesses from the hospital and seem to be basing their whole case on paperwork. Oh my, Dr. Locatell, the state expert, will give her version of the case based on possibly reliable, and most likely unreliable notations.

I know some people said they tried to talk to the investigators and tell them what was going on, but they weren't heard. So, it was not just us, but a deaf and dumb goverment entity that was immune to the warnings of employees, that helped lead to some bad situations.

(It's the worst I've ever seen, these government people; forcibly administering injustice, ignoring the Kern Valley Healthcare District witnesses of the truth for their own convenience! These DOJ people violated the trust of their voters to be heard.)

Now is your chance to set the record straight. Let them know what you know.

So, the state AG needs some help. They have suggested calling the enforcement department regarding elder abuse. (I won't get into my last conversation with the state unless I have to. I've told a few of you about it. Pretty sad.)

There are many of you who were there and know the truth. Help the poor AG get this right, so we can move on with the other problems at the hospital.

To report elder abuse or Medi-Cal fraud, call the Bureau of Medi-Cal Fraud and Elder Abuse's hotline at (800) 722-0432.

Scott Gerber or Christine Gasparac (916) 324-5500

Send A Written Complaint By Mail
California Department of Justice Bureau of Medi-Cal Fraud Elder Abuse P.O. Box 944255 Sacramento, CA 94244-2550

Call the Hotline
Phone Toll-free: (800) 722-0432 Attorney General's Bureau of Medi-Cal Fraud & Elder Abuse

Phone Toll-free: (800) 822-6222 Department of Health Services

http://ag.ca.gov/bmfea/reporting.php or go to this page and file a complaint via email.

Thanks for your help and your stories.

UPDATED: Here's your original report Department of Health Services and state board of nursing: lot's of questions about the nursing center

Nursing Home administrator, Tracy Brown, giving her report to the board at the July, KVHD board meeting.

Brown and her company have been managing the nursing facility since 2008. But Brown came in with Sycamore Asset Mgt. in 2007.

Something has come to my attention with documentation to go along with it, so I have many questions and comments to go with it.

I'm going to show you a document signed by two nurses who came to work on the morning shift at the KVHD skilled nursing facility on 11/23/08. (however, the signatures are removed for privacy reasons)

The document indicates they checked the patients and found they were wet: one patient had a rash and another a wound. Alarms were not turned on, were amongst the items they reported.

The CNA's said they turned in this report to the nurses in charge. They both signed and dated it. The say the report never went to Department of Health Services in a timely manner which was deemed "unsubstantiated" in another document by the hospital.

But this report was not investigated, another KVHD document shows, until 2/13/09 and the date shown as the time frame investigated is the not the month shown on the employee document. The employee referred to in the following document is blamed for not telling administrators about the above report until February.

The CNA said the date and information was incorrect in this report.

She refused to sign the document and

filed a grievance with the hospital.

HR manager, Debra Hoffman cites the problem that the proper reporting form was not filled out. And the incident was not followed up by the CNA's

(Click on documents to open and read)

In another document,

dated 2/23/09, the HRmanager, now terminates the employee.

But the report shown here indicates that the allegation of suspected abuse has been "unsubstantiated." That means the hospital investigated and decided there was no neglect.

So, this report was investigated, the document says the RN and LVN who the CNA's insist they gave their report to, were no longer at the district or available for comment.

The HR investigation then indicates the very allegations were unsubstantiated, yet the nurse has been fired for not reporting it properly. It seems by these documents they wanted them to report but then deny their findings.

I need to know from DHS if they received this report signed by two aides in February when the HR manager, CEO, and NHA supposedly found out this information.

New information update: Earlier it was reported that the second CNA who kept her job, for an extra couple of months before she was fired, was asked to and did fill out the SOC reporting form regarding the 11/08 report on Feb. 13, 2009, the day the other CNA was suspended. She believes she filled it out at approximately 7 PM on 2/13/09. So, we are assuming DHS and the hospital have some record of this incident.

Now why would they want her to fill out this form if the hospital's investigation lead to the conclusion that the two nurse's aides claims of neglect, wet beds, skin problems, and a wound were in error.

If it was just a KVHD investigation and not reported to DHS for a look, then would the SNF administrator be responsible to turn in this report now? Or was it turned in recently? (see above)

That's an awful big reporting loophole as the hospital is given discretion to investigate themselves, leaving DHS out of the decision process.


Rick Carter in March 20, 2009 report denying the employee re-employment.Carter is quite harsh.


Now the unusual part of all of this, which needs to be answered and quickly, is that the first nurse is fired, then the second nurse signing the report regarding what they found on the morning of November 23, 2008 is fired for something different but after the first CNA.

Now one nurse's license is under investigation with the state board of nursing for not reporting what KVHD called an "unsubstantiated" allegation. This has happened months after the termination and nothing is mentioned by HR or the NHA that this will happen in their documentation.

The nurses license complaint happened June 24,2009, just over a week ago. The complaint emanates out of KVHD, unknown source, just the hospital. I've put in a request for information from the hospital as to why this is happening.

That is now nine months since the incident where patients were left in unacceptable conditions in the SNF and the report was made to the chain of command, according to the employees.

And now a complaint for "not reporting" is made against the CNA's license four months after the employee has been terminated.

The other CNA on the report has been fired and her license is being investigated for something completely different. She is concerned though that by signing the SOC form on 2/13/09 that she may be up for a second complaint by KVHD regarding the matter, even though they asked her to do it. She said she doesn't trust them.

Her story is that she was asked the very same day 2/13/09 the other employee was fired, to sign off on the DHS report, SOC form, for the incident that the hospital said in its reports never occurred.

One of the CNA's said she has been attending board meetings and maintains that she and the other nurse made the report to their superiors in a timely fashion. She says she will not stop fighting until the record is set straight and she gets her good name back. There were harsh remarks in these reports, but then there was a trivial write up for making a "smart" comment. (I guess I wouldn't last two minutes in the SNF)

Reports have surfaced in the skilled nursing facility of similar incidents, and some are claiming retributive actions. I will follow up.

Since questions have been coming in regarding the contract with the nursing home administrator, since I put it up on the blog, I will be requesting more documentation to answer people's questions. (hopefully information will no longer be blocked from the public)

Department of Health Services where's my paperwork?

I'll follow this post with a look at what we know now about the current administrator of the nursing center, Tracy Brown, and the controversy surrounding her arrival with the former contractor, Sycamore Asset Management.

Brown, who recently resigned her contract as the nursing home administrator, will continue to work until the end of August, as her contract has a 90 day clause.

In discussions with Brown, the SNF administrator said when asked about the $240,000 contract with the hospital, she said she turned down a $750,000 job to stay in the Kern Valley because she cares deeply about the residents.

Brown's contract pays for housing while she is in the area working.

The administrator who is contracted to work 40 or more hours a week, plus being on call for the facility, told me after she resigned she was asked by Board member, Brad Armstrong, and the Administrative assistant, Heidi Sage, why she resigned. Brown said she was surprised by the questions. Hmm.

What was Brad and Heidi's adventure into the SNF business about?

There will definitely be more on this story as there are too many lingering questions...



Another KVHD personnel policy
shows the Director of Nursing reporting
instances of actual or alleged abuse.





And then in the state
laws shown below are another
set of reporting instructions.




state laws

Give us all a break KVHD: that's not an investigation, this is an investigation...

KVHD, former CEO, Rick Carter states in documents from February of 2009, that a report of neglect in the skilled nursing facility, was "unsubstantiated." But the KVHD investigation proves not to be so substantial:

On 11/23/08 two CNA's report to work at the KVHD skilled nursing facility and and say they find residents wet, skin rashes, a wound, and alarms not on that morning.

After making rounds they wrote up a handwritten report and gave it to the RN and LVN in charge of the SNF overnight. They both say they wrote a handwritten report, signed and dated it.

The RN and LVN are traveling nurses, who the two aides, say they gave their report to that morning.

Both CNA's who filed this report have been fired. Both have had complaints filed with the state board of nursing after their terminations.

Hospital records state that the nurses who were in charge of the SNF at the time of the report, could not be found to add anything to the hospital's own little investigation...

I just got off the phone with them.

I forgot to ask them if their licenses were under investigation too.

It took no time at all to find them and the hospital cannot say without looking ridiculous, that they couldn't have done it themselves.

I imagine the hospital has the excuse the employees had left and therefore could not be investigated by the hospital. But they would've been witnesses not the subject of the investigation.

(See stories below, "employees fighting back")

CE, OH BOY! Here we go...

I guess the news is out, KVHD has selected a new CEO. Details are great, if you like gossip. However, what I have confirmed is that there has been an offer given to a certain CEO type, and this person is on the work schedule for June 15.
The rest is left to our imaginations.
I would hope we get introduced to our new leader at the next board meeting on Wed. June, 3. Apparently, everyone wants to know who our new board configuration considers a qualified CEO. We've seen some doozies in the last few years, lets see what has changed.
Could I politely ask that the board meetings be moved to 6 pm from 5:30 pm? I think more people would attend if they had time to eat and deal with their children before the meeting.
Heard that the Skilled Nursing Facility had its annual Center for Medicaid Services survey. Heard that the "crack" (-head, -pot, -smoking; your choice) investigators from department of health services held the exit survey which was attended by a board member, a CEFO, quality control, CEO sidekick, and a few others.
No substandard care claims were found with no substantial deficiencies.
The final report will be available soon.
Who do we thank for this favorable news? I can tell you who we won't thank soon.
Also, just wondering why no one from KVHD Human Resources didn't attend the graduation for the CNA's at Cerro Coso College?
After so many excuses for not having staff or having staff but not the right staff, or whatever it's been, there was no one from the hiring aspect of the hospital at the graduation.
Hello? I understand Tracy Brown attended along with staff from Medical Records, but as far as I know, Human Resources must have been busy doing something else other than finding the invaluable CNA's.

There are many things I want to talk about before the next meeting. However, I maybe going in to "pick your part" (In Bakersfield) to have a few parts removed next week. But if I have to, I will be at that meeting in a wheelchair. Unfortunately, at the last meeting, because of medication side effects, I chose not to unroll my agenda that night.
But I'm almost ready...see you there and on the blog.