Sun City Hospital’s Woes Risk Funding

By Douglas E. Beeman, The Press-Enterprise, Riverside, Calif.

Sep. 29–Menifee Valley Medical Center was nearly dropped from the federal Medicare program twice this year amid allegations of patient abuse and delays of more than 30 hours in getting emergency-room patients into intensive-care beds.

The Sun City hospital still could be kicked out of the federal health-insurance program for the aged and disabled in November. It flunked a third inspection in May, although hospital officials say they will submit a plan this week that should resolve the problems and avert any loss of the hospital’s Medicare contract.

Geoff Lang, interim chief executive of Valley Health System, the Hemet-based hospital district that owns Menifee Valley Medical Center, said the new leaders in place at the hospital would not allow the kinds of problems that inspectors found earlier this year.

“I think the citizens of the Menifee area can feel comfortable getting high-quality care at the medical center,” Lang said in a telephone interview last week.

Lang took over in late April and led the district until this week, when a permanent chief executive started work.

Losing its Medicare contract would be a fatal blow to the 84-bed Sun City hospital. Medicare accounted for 71 percent of the hospital’s revenue in the first three months of this year, according to the most recent state hospital data.

Ron Ho, a supervisor at the federal Centers for Medicare and Medicaid Services in San Francisco, said it is unusual for one hospital to have so many serious problems in one year.

Ho added that it appears the most serious problems involving long waits and patient abuse have now been corrected, although the hospital remains under scrutiny.

“There’s no endangerment to patients right now,” he said.

Menifee Valley hospital’s problems began surfacing in mid-February, when hospital regulators found that some emergency-room patients waited 30 hours — sometimes longer — for an intensive-care bed to open, according to inspection records obtained by The Press-Enterprise under the federal Freedom of Information Act.

In one case, regulators reported, the hospital reserved an intensive-care bed for a patient about to undergo elective surgery while other patients needing transfer to the intensive-care unit lingered in the emergency room. After regulators inquired, the hospital’s then-administrator canceled the surgery so that an emergency-room patient could occupy the open bed, federal documents show.

Although Riverside County health officials limit the number of hours that a hospital’s emergency room can divert ambulances elsewhere, an overwhelmed hospital still can transfer current patients to other facilities that have more space, said Michael Osur, a county public-health administrator. Under state law, Osur said, hospitals are not supposed to keep patients in the emergency room for more than 24 hours.

At the end of the inspection on Feb. 14 and 15, state regulators acting on Medicare’s behalf declared the waits posed an immediate jeopardy to patients and began steps to terminate the hospital’s Medicare contract.

The hospital avoided being kicked out of the Medicare program when it promised in early March to hire more nursing staff and to send patients to other hospitals when it was too swamped, according to federal inspection documents.

But by late March, the hospital was once again in trouble with hospital regulators.

An older female patient complained that the younger male nurse assistant had bathed her, including in her genital area, despite her protests that she did not want to be bathed, federal records show.

The woman’s family told hospital officials the patient felt “abused and humiliated” that a young person of the opposite sex would bathe her private areas, according to the inspection report.

Inspectors visited the hospital March 22 and 23. When they examined the personnel file for that male nurse assistant, they found a history of problems over two years but no indication that the assistant had ever been given more than a reprimand.

Inspectors faulted the hospital for failing to suspend a nurse assistant who repeatedly cursed at and mistreated patients, showed up for work under the influence of alcohol, and left patients saturated in urine.

In one case, the aide was accused of telling a 3- or 4-year- old child receiving stitches to “shut up,” according to a federal inspection report.

After the inspection, the aide was terminated, the hospital said in its plan of correction submitted to Medicare officials.

Menifee Valley Medical Center’s administrator, Kim Eastman, also left, the hospital said in its correction plan. Lang declined to comment on the reasons for Eastman’s departure. Corey Seale, who is Moreno Valley Community Hospital’s administrator, has been acting administrator at Menifee Valley since Eastman left in early April.

Eastman was Menifee Valley’s top administrator for about 2 1/2 years, according to district records. She could not be reached for comment, despite three phone calls and a letter requesting an interview left at her home.

In its correction plan, the hospital promised to train its staff on policies governing patient rights and how to handle patient complaints. The hospital promised to immediately suspend any employee accused of abusing a patient and to terminate the employee if the allegations are confirmed.

Inspectors returned to Menifee Valley in early May to check on the hospital’s progress. They found still other problems that prompted them to warn the hospital Aug. 26 that it could be terminated from the Medicare program if corrections were not made by Nov. 26, said Lang and hospital spokeswoman Karen Roberts.

Lang, who wrapped up his duties as interim chief executive last week, declined to provide details of the latest inspection. He said the hospital already has corrected “90-some percent of all the things they pointed out.” He said the district is submitting its plan of correction to state and federal regulators this week.

Lang is being replaced by Jim Maki, who took over Monday as the district’s permanent chief executive.

Valley Health System day-to-day operations are managed by Valley Health Care Management Services LLC, a company created jointly by the district and its business partner, Hemet surgeon Dr. Kali P. Chaudhuri. That company is paid $696,161 a month and employs the district’s chief executive, all of the district’s hospital administrators and other managers.

Chaudhuri referred a phone call seeking comment to his attorney, William Thomas.

In a statement, Thomas said: “Valley Health Care Management Services LLC has taken what it believes to be appropriate steps to respond to comments by the Medicare authorities regarding the operation of the Menifee Valley Medical Center.”

Thomas’ statement added that the company “is confident that best practices will continue to be successfully implemented” under Maki, the district’s new chief executive, “who has given this project his highest priority.”

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