Report threatened Tenet/SVH with its most severe sanction – termination of any funding for the care of patients under Medicare and Medicaid, calling for corrective action plan to restore safety
In June, the Joint Commission issued findings that Tenet failed to meet care standards set forth in its corrective action plan as documented in complaint filed by MNA
CMS findings validate hundreds of claims made by RNs over the last 18 months about unsafe care conditions and harm to patients caused by policies of embattled hospital CEO and CNO
Nurses also report illegal firing of SVH nurse and local union leader for comments she made on podcast about the patient safety crisis, file suitin Superior Court under Healthcare Whistleblower Statute
In the wake of six official complaints by nurses at St. Vincent Hospital to state and federal regulators over the course of 2024-25, and several hundred documented cases by nurses of situations that compromised the health and safety of patients under their care, the Department of Public Health in conjunction with the Centers for Medicare and Medicaid Services completed an unannounced investigation of the hospital earlier this year that has validated and substantiated ALL of the nurses' concerns. The investigation found that St. Vincent Hospital and its administration exposed “all patients at the hospital” to “immediate jeopardy” for serious harm.The investigation documented at least three patient deaths related to lack of needed RN staffing, the lack of monitoring for patients that necessitated immediate intervention by a team of staff to prevent their demise, and the lack of staff supplies and protocols that contributed to more than 200 patients suffering debilitating, preventable pressure ulcers.Through a request under the Freedom of Information Act, the MNA obtained a copy of the full report and will make it available to the media upon request to David Schildmeier atdschildmeier@mnarn.org.
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The deficiencies identified in the report were so severe and widespread that the agencies threatened Tenet with termination of CMS funding for all services for patients covered under Medicare and Medicaid, which represent more than 70 percent of the patients served by the facility. The termination of participation in the CMS program is among the most severe penalties the regulator can administer to a provider.
The report and the DPH threat to terminate participation in the Medicare/Medicaid program was issued to the hospital in early February, which was followed by an announcement of the resignation of the hospital's embattled CEO Carolyn Jackson, who was to leave on Feb. 14th. Jackson's controversial Chief Nursing Officer, Denise Kvapil, who the MNA believes is the architect of the dangerous staffing practices and failed protocols that imperiled all patients admitted to the hospital, was also let go on the same day.
“While we continue to be both saddened and sickened by the suffering our patients suffered at the hands of these failed and disgraced administrators of St. Vincent Hospital, we felt wholly vindicated in the findings of the recent DPH report, as it validates every single claim we have made over these last two years in our effort to hold Tenet accountable for their failure to value our dedicated staff and to protect the patients we have given our career's to serve,” said Marlena Pellegrino, longtime nurse at the hospital and co-chair of the nurses local bargaining unit with the Massachusetts Nurses Association (MNA).
Reporters who wish to receive a copy of both Whistleblower complaints should contact David Schildmeier atdschildmeier@mnarn.org.
In Response to Care Deficiencies, DPH Threatens Tenet with Termination of CMS Contract for Medicare/Medicaid Patients
As result of the investigation, and all the deficiencies identified in the report, the document includes a letter to the CEO of Tenet/St. Vincent Hospital with the following order:
Within ten calendar days of receipt of this letter you must submit an acceptable Plan of Correction (the POC) for each deficiency cited in the Statement of Deficiencies (the SOD).The Facility is currently on a 90-day termination track, with a termination date of March 30, 2025,resulting from EMTALA survey: OM4Q11 and a CoP survey: S08J11, with IJ removed for Emergency Services in which notification was sent by the Centers for Medicare and Medicaid Services (the CMS) on December 30, 2024.All deficiencies cited must be corrected no later than March 22, 2025.
The “termination track” referenced in the letter refers to the threat by CMS of the termination of the hospital's contract with CMS to be reimbursed for the care of patients covered under Medicare and Medicaid. The report includes specific corrective actions required to prevent termination, and steps the SVH administration promised to take to prevent further incidents of harm to patients.
MNA Documents Tenet's Failure to Follow Corrective Action Plan Resulting in Joint Commission Finding of Tenet's Failure to Meet Promised Changes
The nurses have reviewed the corrective plan contained in the report and found that a number of those remedies have not been implemented. On May 12, the MNA submitted a follow-up complaint to the DPH/CMS, as well as the Joint Commission (the body that oversees accreditation of acute care hospitals) detailing Tenet's failure to ensure there is compliance with the DPH/CMS order for change to prevent patients from being placed in immediate jeopardy going forward, writing:
In many or most cases, St. Vincent Hospital (SVH) management has not effectuated the corrective actions submitted to state/ federal regulatory agencies after multiple days of DPH/CMS investigation identified safety concerns. SVH management continues to fail to protect the safety and well-being of patients in their care.
On June 25th, the Joint Commission responded to the MNA complaint and after its investigation concurred that the hospital had failed to meet its obligations under the corrective action plan, “which will require the organization to demonstrate evidence of compliance to be compliant with applicable The Joint Commission standards and CMS Conditions.”
Reporters who wish to receive a copy of the MNA's letter detailing Tenet's failure to implement promised corrective actions, as well as the communication from the Joint Commission to MNA in response to the complaint should contact David Schildmeier atdschildmeier@mnarn.org.
SVH Nurses' Effort to Voice Patient Safety Concerns Finally Vindicated
Under the leadership of Jackson, and her chief lieutenant Kvapil, the nurses at St. Vincent Hospital were subjected to an unrelenting assault on their ability to provide the care they knew their patients deserved, yet the nurses were equally unrelenting in their effort to document and report what they and their patients were experiencing to all responsible state and federal agencies In December 2023, January, March, April, May and December of 2024, the SVH nurses and MNAfiled a number of official complaints with the Department of Public Health Division of Healthcare Quality, Joint Commission (which accredits acute care hospitals), the Center for Medicare and Medicaid Services and the Mass. Board of Registrationin Nursing in response to a growing and dire crisis in the safety of care for patients admitted to the Worcester-based facility. In September, the nurses also filed a complaint against Tenet-owned Framingham Union Hospital citing similar deficiencies in care.
In late December theBoston Globe ran a frontpage story about the last of those complaints, and reported on two patient deaths identified in the complaint, which was verified by the patients' family members and the nurses who filed the reports with DPH. The story also highlighted the nurses' call for a meeting with DPH Commissioner Robbie Goldstein, so they could directly share what they and their patients were experiencing. That meeting was held in early January.The Globe story on the Goldstein meetingprovided more information voiced by nurses about the untenable conditions at the hospital, with the Globe citing the Commissioner's characterization of what he heard including, “the stories and insights highlighted by these frontline caregivers were honest and heartfelt. Their perspectives are invaluable, as nurses are so often the first to identify potential risks and problems.”
Tenet characterized the nurses concerns as “unfounded” and a “publicity stunt,” two claims proven to be truly unfounded given the findings of the DPH/CMS investigation.
Nurses Had Hoped for New Opportunity for Meaningful Change with Departure of Jackson et al.
After the departure of CEO Jackson and CNO Kvapil, and the installation of a new CEO for St. Vincent and other Tenet hospitals in Massachusetts, along with the hiring of a new head of human resources, and local labor relations chief, the MNA nurses were hopeful that Tenet was indeed turning a new leaf. It appeared that might be the case, as nurses and the new management team began efforts to build a more productive relationship. But the initial shine of the new relationship was tarnished with the decision by officials in Dallas to target Carla LeBlanc and the realization by the nurses that Tenet has failed to make the corrective actions it promised the DPH and CMS to ensure the safety of all patients and to avoid having their CMS contract terminated.
“We are always ready and willing to work in good faith with this or any administration that acts in good faith with us to ensure the safety of our patients, but once again, Tenet is showing its all too true colors and we, as we have always done, will not hesitate to hold them accountable,” Pellegrino concluded.
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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 26,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and lobbying the Legislature and regulatory agencies on healthcare issues affecting nurses and the public.
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