U-T: Scripps Mercy Cited In State Probe; 4 Fired

U-T: Scripps Mercy Cited In State Probe; 4 Fired
Investigators Say Workers Took Gifts, Steered Patients Into Certain Nursing Homes
Janet Lavelle, U-T San Diego
March 7, 2012

SAN DIEGO -- Scripps Mercy Hospital has fired four case managers and overhauled operations after state investigators found the employees broke state and federal laws by taking gifts from a nursing home owner and by steering patients into certain homes instead of giving them a choice when they left the hospital.

The California Department of Public Health launched an investigation in mid-November and two state Department of Justice investigators also participated.

Health department officials issued a deficiency report detailing the violations and last week approved a Plan of Correction that Scripps Mercy filed in response.
The state Department of Justice has filed no charges and “there is nothing we’re actively doing with this,” said Lynda Gledhill, press secretary for state Attorney General Kamala Harris.
Officials at the five-hospital Scripps Health system released a lengthy statement Tuesday, which said in part, “Scripps does not condone this type of behavior by employees. We work to ensure patients have a voice in their care. We regret this happened and have taken steps to prevent it from happening again.”
Those steps included demoting one supervisor and reorganizing the case management leadership, tightening auditing and conflict-of-interest procedures, and holding employee training classes.
Scripps spokeswoman Janice Collins said, “We started implementing a lot of the changes in January.”
Scripps Mercy, which employs 15 case managers, started its own investigation in October after getting a complaint from a patient who hadn’t been given a choice in nursing homes, Collins said.
State law requires hospitals to give a patient being transferred to a skilled nursing facility a list of options, without offering a recommendation, and then honor the patient’s choice.
In November, state and hospital investigators looked at medical records for 108 patients referred to nursing homes between May and October 2011. Interviews with patients and their families were compared with medical records and discrepancies were found involving five case managers who gave patients few or no choices among nursing facilities but documented that they had.
The five case managers told investigators they had gotten a free dinner boat cruise from one nursing home owner, and one case manager, who also received a $50 gift card, said “an established relationship” with that operator influenced her, according to the state report. One case manager also failed to disclose that her son worked at the nursing home, a violation of state conflict-of-interest laws.
The report didn’t name any nursing home facilities or operators. State Department of Public Health officials could not say Tuesday whether any nursing home has been cited as part of the investigation, department spokesman Ralph Montano said.