Leapfrog just published their Fall 2017 Hospital Safety Grades Report. The nonprofit group is committed to improving quality, safety, and transparency in the U.S. health system. Their grades are often cited in major media outlets including the New York Times. Of 2,632 hospitals rated, just 174 received failing or near filing grades. We call these the “killer hospitals.” Six of those killer hospitals are located in Texas.
Fortunately, none of the “F” graded hospitals were located in Texas. The state still had six that received a grade of D, however. The grades are based on government data and surveys. Several of the hospitals failed to turn over or disclose some of the requested data. That worries us that could mean their problems may be worse than reported.
No hospital can expect a perfect grade. We have more respect, however, with failing hospitals that at least cooperate and acknowledge their faults. Until a hospital takes ownership of their safety issues, the health and safety of patients is likely to remain in jeopardy.
Preventable medical mistakes are the third leading cause of death in the U.S. Many people who seek hospital treatment die because of that treatment. Experts put that number at 700 deaths. Per day. Serious injuries caused by hospital neglect and malpractice occur on average 2,740 per day. Serious injuries include brain injuries from preventable falls and paralysis.
Does that sound scary? It is. While complications from medications and surgery are inevitable, the above figures represent preventable deaths and injuries.
So why do we publish this list?
First a disclaimer. We are not hospital malpractice lawyers (although we have partnered on bedsore and infant death cases). If you or a loved one suffered a serious life-threatening preventable injury or if a loved one died because of hospital neglect, call us. We may be able to find you the right lawyer.
The first reason we published this list is to educate readers. If you are having a life-threatening emergency in Kerrville, Texas, chances are paramedics are taking you to the D rated Peterson Regional Medical Center. You don’t have a choice. If you need elective surgery, however, you might be better served driving the extra 35 miles to the A rated Hill Country Memorial.
We also published this killer hospitals list because we are whistleblower lawyers. Hospitals that cut corners on patient care often violate Medicare and Medicaid rules. Violating good sanitary standards or understaffing often also means violations of Medicare rules. By becoming a whistleblower, we can step in and help correct the problems that hospitals won’t.
In the early days, most hospitals were non-profits. Today many have become revenue generating machines. Suddenly, the emphasis has become profits over patients. Even in some of the so-called “non-profits,” the top staff and administrators earn million dollar salaries. To us, they have become just like a for profit hospital.
Texas Killer Hospitals
Here is the list of D rated hospitals as determined by Leapfrog for the fall of 2017:
- Peterson Regional Hospital (Kerrville TX)
- Southwest General Hospital (San Antonio)
- Navarro Regional Hospital (Corsicana TX)
- St. Joseph Medical Center (Houston TX)
- Paris Regional Medical Center (Paris TX)
- East Texas Medical Center Tyler (Tyler TX)
Are these hospitals violating the False Claims Act or committing Medicare or Medicaid fraud? We don’t know. Any facility that makes it to our list of “killer hospitals” certainly gets our attention.
Peterson Regional Hospital
According to Leapfrog, The Peterson Regional Hospital has significant problems with infection rates, dangerous objects left in patients, patient falls, basic hygiene, dangerous bed sores and qualified ICU and nursing staff.
These ratings don’t mean that the nurses and doctors are bad. In our experience, the poor ratings often mean that the hospital is understaffed or using less than qualified people.
We often see whistleblower cases where a facility forces a LVN to act in a role that requires an RN. That kind of staffing issue is not fair for patients or the staff.
If the hospital is billing Medicare or Medicaid for unqualified people, there probably are False Claims Act violations present. More on that below. The important thing to remember is that False Claims Act violations can pay huge cash whistleblower awards.
The Leapfrog ratings noted a concern for patient falls. Those problems may have been going for quite some time.
Court records reveal that on March 15, 2010, a patient in his 90’s was brought to Peterson Regional Hospital after a fall. A CT scan showed no head injury. The patient, Kenneth Mayhew, was lucky.
Hospital staff administered morphine and held him for observation.
An hour later, Mayhew fell. The court records say he was unsupervised. Hospitals and nursing homes are required to assess patients for fall risks. Those that are at risk shouldn’t be unsupervised. While that might put some burden on hospitals resources, they have a duty to protect patients in their care. Why was a patient in his 90’s who had already fallen and on powerful morphine left unsupervised?
Court records say that after the second fall, a second CT scan showed a brain injury. Mr. Mayhew died shortly after the second fall.
As noted in a court opinion,
“[Morphine and Ativan] can be given in carefully selected patients, but, given the potential frailties of elderly patients such as Mr. Mayhew, the standard of care when administering such drugs to an elderly patient like Mr. Mayhew requires additional monitoring by hospital staff, e.g. a nurse or sitter. There was no evidence of this in this case. There was no documentation of the need for additional monitoring by either the physician or nurse. In fact, the patient was left alone after these medications were given.
“Dr. Tan also opined on the causal relationship between the failure to provide additional monitoring and the resulting fall that ultimately led to Mayhew’s death by stating, ‘[a]s a deviation from the standard of care, there is evidence to suggest the inopportune death of Mr. Mayhew was the result of not providing a secure and safe environment for him.’”
We don’t know the case was finally decided but do know that the trial court and Texas Court of Appeals refused to dismiss the case. (Hospital malpractice cases often settle if the hospitals are unable to get the case tossed on a technicality. Unfortunately, those settlements are often sealed meaning we can’t discuss them with the public.)
[If you work or worked at the Peterson Regional Medical Center and have information about fraud or kickbacks, give us a call at 202-800-9791 or online.]
Southwest General Hospital
Southwest is another hospital that only earned a D rating from Leapfrog. According to them, the hospital had multiple problems with infections, bed sores and patient falls. Remember, we believe that both bed sores and patient falls are almost always preventable.
What makes Southwest General Hospital especially noteworthy is that it had one of the worst ratings in the nation for dangerous objects left in the patient’s body.
A review of court records reveals lawsuits against Southwest. As lawyers, we know that not every lawsuit is valid. What caught our attention, however, were the employee reviews on glassdoor.com.
One nurse commented that there was one RN on a floor with 14 patients. The nurse said there simply wasn’t enough staff or time to properly care for the unit during a shift. Another RN summed up working at Southwest General like this, “Your license on the line.” That same nurse also said that the facility was under staffed and “management only care about productivity and bottom line.”
A rating by 160 patients had a whopping 119 of those patients giving the hospital just 1 star (out of a possible 5). That alone is enough to put Southwest General on our killer hospitals list!
This summer, the owners of Southwest General Hospital announced they were being acquired by Steward Health Care. The merger between the two hospital owners will create one of the largest for-profit hospital companies in the United States. Will things get better or worse for the hospitals in the new merged company. We are eagerly awaiting the next ratings.
[If you work or worked for at the Southwest General Hospital and have information about fraud or kickbacks, give us a call at 202-800-9791 or online.]
Navarro Regional Hospital
Navarro Regional Hospital is a small rural but full-service hospital. It has 51 doctors and 162 beds. According to Leapfrog, it also has problems with collapsed lungs and patient falls. What especially concerned us is the large number of categories where the hospital didn’t provide information. As noted before, we would much rather see a hospital take ownership of its shortcomings than hide information from the public. In our experience, there is a reason people hide information.
According to a Texas Court of Appeals decision, Navarro Regional Hospital failed to shake a medical malpractice claims against it filed by the family of Charles Donell Washington.
In 2010, Donell was admitted to the emergency room of Navarro after complaining of difficulty breathing and dizziness. Although his condition was stable, he was in serious enough shape that he was brought to the ICU. The next day his condition worsened. In the middle of the night, his heart rate “dropped suddenly.” Donell wasn’t getting enough oxygen.
Minutes later, the ICU called a Code Blue. Two doctors responded and attempted to intubate Mr. Washington. They were not successful. When seconds count, minutes passed by. Donell wasn’t getting enough air. He couldn’t breathe.
Donell’s family sued and claimed that the ICU didn’t have the necessary “difficult airway” equipment that should have been on hand in the ICU.
Forty-five minutes after the Code Blue was called, another physician was able to establish an airway. By that point, it was too late. Donell’s brain had went for too long without oxygen. He suffered permanent brain damage.
The Washington family claimed in their lawsuit that the hospital “failed to have the difficult airway equipment readily available, and failed to have and/or enforce adequate policies related to such equipment. These failures resulted in Donell needlessly suffering severe, permanent brain damage.”
Once again, we see this as a case of profits before patients. Navarro Regional Hospital attempted to get the lawsuit dismissed but failed. Both the trial court and Court of Appeals ruled the case should go forward.
[If you work or worked at the Navarro Regional Hospital and have information about fraud or kickbacks, give us a call at 202-800-9791 or online.]
St. Joseph Medical Center
St. Joseph Medical Center in Houston is today owned by the same for profit company that owns Southwest General Hospital. That means at least two facilities on our Texas killer hospitals list.
Leapfrog claims St. Joseph is plagued with infection problems, patient falls, bed sores, and death from serious but preventable complications.
Because it is a trauma center, many of the patients that wind up there have no choice. They were brought there by ambulance even though Houston has several hospital choices. The hospital’s website talks about numerous “top awards for quality and safety” but Leapfrog certainly paints a different picture.
The employee reviews were a mixed bag. Because it is such a large hospital, we were not surprised. Our favorite review, however, simply said “Run!”
Big hospitals tend to have bigger problems and St. Joseph Medical Center is no exception. With 792 beds and 800 physicians, the hospital is big. Any hospital that size is going to have lawsuits. What surprised us, however, was the astounding number of Medicare violations found at the facility. Since May of 2013, the hospital has been cited 40 times by Medicare and Medicaid. We wonder how many other violations simply haven’t been discovered yet.
As early as 2013, Medicare was worried about its infection control policy. A follow up site visit in 2013 found the hospital was not properly identifying hospital beds that needed to be cleaned after a patient was discharged. In 2015, Medicare found hospital staff did not remove gloves and wash/sanitize hands after direct contact with contaminated items and patients. Yet another inspection found problems with the process to disinfect operating rooms.
Fast forward to 2017 and Leapfrog finds significant problems with various infections.
Tragically, in 2016 Medicare cited St. Joseph Medical Center for improperly transferring a patient complaining of alcohol withdrawal. The patient was found dead in a hospital lobby restroom three hours after his discharge.
[If you work or worked for St. Joseph Medical Center in Houston and have information about fraud or kickbacks, give us a call at 202-800-9791 or online.]
Paris Regional Medical Center
The Paris Regional Medical Center received a D grade from Leapfrog for infections, collapsed lung issues and death from treatable complications.
Like most hospitals, Paris Regional has also seen its fair share of litigation. One case that especially concerned us is a case that arises under a law called the Emergency Medical Treatment and Active Labor Act (EMTALA). That laws says emergency rooms can’t turn away patients with life-threatening illness or injuries.
Why would any hospital turn away a patient? Money. Certain hospitals in Texas have a notorious reputation for turning away critical care patients who have no insurance. At 3:40 am on January 30th, 2006, Wanda Dean showed up at the emergency room of Paris Regional Medical Center. She complained of shortness of breath, pain in her arms and chest pain. You don’t need to be a doctor to know those are classic signs of heart attack.
The ER staff ran both an EKG and did a chest X-ray which were abnormal. There was one big problem that morning, however. Wanda Dean had no health insurance.
At 4:50 am, two physicians decided to admit Wanda for cardiac evaluation. Her diagnosis was congestive heart failure.
Several hours later, an internist ignored the prior orders for cardiac evaluation and the diagnosis for congestive heart failure. He ordered uninsured Wanda discharged and instead prescribed asthma medication.
Wanda left the hospital. When she returned a day later she was in full cardiac arrest. Efforts to resuscitate her were futile. She was pronounced dead. The cause of death? A heart attack.
Ironically, Paris Regional Medical Center’s website at the time had this to say about cardiac emergencies and heart attacks:
“Heart attack is one of the leading causes of death in the United States. Doctors agree that these grim statistics do not have to be. For many people, there is a window of time, sometimes called the “golden hour,” when a heart attack victim can be saved if proper treatment is given quickly. In fact, when treated immediately and professionally in a facility that is equipped to diagnose and intervene with balloon angioplasty and clot-dissolving drugs, a heart attack may be stopped in its tracks and lives can be saved.
Paris Regional Medical Center Health System is the only Heart Center in the area equipped to perform the life-saving balloon angioplasty procedure, and houses the most advanced cardiac catheterization lab in the area. Performing more than 20,000 procedures since the cath lab opened in 1991, the 24-hour heart team members are all Advanced Cardiac Life Support (ACLS) certified.”
Wanda apparently did present herself during the golden hour but the hospital’s Advanced Cardia Life Support certified doctors failed to “stop her heart attack in its tracks.” Instead they shuffled her out the door.
EMTALA violations are not necessarily whistleblower cases but they can be. Hospitals that receive Medicare and Medicaid funds are supposed to follow all state and federal healthcare laws. That includes EMTALA. Throwing poor and uninsured people out the door because they have no money is not only cold and callous, it is also illegal.
Once again, profits over patients.
[If you have knowledge of EMTALA violations, turning away uninsured critical care patients or work or worked for at the Paris Regional Medical Center and have information about fraud or kickbacks, give us a call at 202-800-9791 or online.]
East Texas Medical Center – Tyler
Our last entry on our Texas Killer Hospitals list is the East Texas Medical Center in Tyler. They are on our list because Leapfrog gives them a D for patient safety. Once again, they found problems with infections, not enough qualified nursing staff, patient falls and deaths from preventable conditions.
In all the hospitals thus far, we alluded to possible violations of the False Claims Act. There is no “possible” or indirect link here. In January 2017, the Department of Justice intervened in a whistleblower lawsuit filed against East Texas Medical Center’s parent company, East Texas Medical Center Regional Healthcare System, Inc. They are one of east Texas’ biggest healthcare companies.
The case was originally filed in 2014 by a man working for Paramedics Plus. The employee, Stephen Dean, was no ordinary employee, he was the COO for Paramedics Plus which happened to be owned by East Texas Medical Center’s parent.
Despite being the number two person at the EMS subsidiary, Dean had a conscience and knew East Texas was paying kickbacks. Federal law prohibits kickbacks in healthcare. Congress believes that medical decisions should be driven by medical necessity and the best interest of the patient. It should never be based on who pays the biggest bribes.
In announcing the government’s intervention in the case, the acting East Texas U.S. Attorney said, “The law prohibits paying kickbacks, such as those alleged in this lawsuit, in order to gain access to Medicare and Medicaid funds. Kickback schemes are anti-competitive, undermine the integrity of our nation’s health care programs, and wrongly prioritize profits over patient care.”
The defendants in the case have filed a record 16 motions to dismiss. They did want jurors to hear the facts. Thankfully, all their efforts have failed. It appears the case will finally proceed, this time with the full weight of the United States government backing our hero, Stephen Dean. (We remind everyone that the case isn’t over and that means no one should be presumed guilty of any wrongdoing.)
[If you work or worked for the East Texas Medical Center Regional Healthcare System and have information about fraud or kickbacks, give us a call at 202-800-9791 or online. Interested in learning more about kickbacks? Visit our Anti-Kickback Statute and Stark Law whistleblower page.]
Whistleblowers and Killer Hospitals
We represent whistleblowers anywhere in the United States. We chose Texas to begin our killer hospital list but that is simply because the author of this post, Brian Mahany, lives in the Lone Star state.
We believe there is a strong tie between medical malpractice, hospital neglect, poor safety ratings and Medicare fraud. Under federal and state law, Medicare and Medicaid fraud often violates the False Claims Act. Under this law, whistleblowers with inside information about Medicare or Medicaid fraud can earn an award for their information. (Texas has its own false claims act law that pays awards for information about fraud involving state funded Medicaid, TexCare and the state funded Children’s Health Insurance Program (CHIP)).
Medicare auditors can’t even begin to catch most fraud. Doctors, nurses, administrators and billing specialists have the best information. And Congress passed the False Claims Act to help provide incentives to those folks willing to step forward.
Each year thousands of people call the government’s toll free fraud line. Calling that number doesn’t earn you an award, however. Worse, special agents and auditors working for the Department of Health and Human Services can only audit a fraction of 1% of healthcare providers each year. The best way to put an end to dangerous and corrupt healthcare practices is by filing a False Claims Act complaint. Federal law allows these cases to be prosecuted privately. In our experience, they also go to the top of the pile. If you want to stop healthcare fraud, consider filing a whistleblower complaint and let us do the work.
Both the state and federal whistleblower laws also have strong anti-retaliation provisions that can even pay for your employment lawyer and pay double damages.
If you have knowledge about EMTALA violations, Medicare fraud, illegal kickbacks or similar activity, call us. We have helped our whistleblower clients collect over $100 million in awards. For more information, contact attorney Brian Mahany online, by email at or by phone (414) 704-6731 (direct). You can also visit our Medicare fraud whistleblower page for general information including how the whistleblower process works.
We also consider infant death and bed sore cases, contact us online for an immediate response from an experienced lawyer. If we can’t help you with the malpractice case, we can certainly steer you in the right direction.
Whistleblowers are the new American heroes. They represent the best of America’s healthcare workers; individuals who know the difference between right and wrong and are willing to help stop the greed and corruption. We are proud to help healthcare workers put an end to the dangerous game of “profits before patients.” We also help our healthcare clients earn the maximum whistleblower awards allowed by law.
MahanyLaw – America’s Medicaid and Medicare Fraud Lawyers