Tuesday, September 26, 2006

Northeast Essent...2/8

Greetings from the Northeast (specifically, Ayer, Massachusetts)

We are alive but not well! Recently discovered your blog and couldn’t believe what was before my eyes. The same management style has been felt by all current and former employees here at Neshoba Valley Medical Center. Let’s start by setting you straight on former CEO Andrei Soran. Andrei was a “puppet” for Hud and his “buds” and only had one thing in mind. The almighty dollar! Andrei and his senior “MIS-MANAGEMENT” team were and still are incompetent when it comes to their ability to provide quality care to the residents of these communities.

The same tactics of suspension and job termination are issued to quality care givers who speak to advocate for safer working conditions. Essent healthcare is unwilling and unable to provide a quality workplace and a standard of care which is the acceptable standard throughout the nation. It’s healthcare on the cheap.

NVMC is a 57 bed hospital which has never been at capacity and struggles week to week to keep 20 patients on the floor. The 6 bed Intensive Care Unit closes every other week due to lack of patients or no staff. Word is out in these communities to drive a few extra miles to Emerson Hospital, Leominster Hospital or the Lowell Hospitals to have a chance at a good outcome. One patient made a $1000 donation to a local ambulance service to bring him to a facility other than Nashoba Valley Medical Center.

The new CEO Steve Roach (previously the CFO) is a 33 year old bean counter who spends his time photographing employees as they drive up to the back door to punch in. These photographs are distributed to department managers with threats of written warnings and termination. All managers are required to park in a designated area of the parking lot “FOR MANAGERS ONLY.” The security department is often requested to run plates to be sure rules are being followed. The latest is PARKING TICKETS to any staff violating Essent’s parking rules. While all this is taking place patients have empty O2 tanks, antibiotic doses are consistently left over from failure to be given, PACS is down for 3 days, Human Resource Manager functioning as Nursing Supervisor on 11 to 7 shift, patients being boarded in the Emergency Room overnight due to lack of staff, hospitalists are no where to be found after 8 pm , 3 physicians resigned from the medical staff due to the poor quality of care. The “red sox” program for denoting risk to fall patients is a miserable failure. A visiting family found a patient lying on the floor yelling help with her RED SOX on as they came off an elevator.

If you visit the NVMC job postings you’ll see that in 2006 over 100 positions have been open. In the last year the CEO, Risk Manager, CNO, PT Manager, Pharmacy Director, and IT Director have all moved on. Essent’s philosophy of hiring new grads is in full swing up here also. However, it has come back to bite them in the butt. The Radiology Department is currently under investigation by the Department of Public Health for having an unlicensed and unregistered technologist working since May 2006. She has failed the registry 3 times. Essent is facing fines for each day she worked unlicensed. Administration had full knowledge of this and chose to ignore it.

The Board of Registration in Medicine is also in town. There have been 4 physicians on staff at Nashoba Valley Medical Center under investigation by the state for numerous violations. I can assure you it was not due to Esssent’s administration that investigations took place. It was ethical employees and patients who had to go out on a limb to protect the public. Essent’s policy was COVER IT UP. It became a police state in the hospital. If you were caught talking about the situation you were disciplined.

The bottom line is residents of the Nashoba Valley expect and deserve to have access to high quality healthcare. It is time for Essent healthcare to put Nashoba Valley Medical Center “FOR SALE” and give these communities a chance to receive the quality medical care they deserve.

So long from Ayer, MA “Where Excellence is (Non) Essential”

Essent is gold--fool's gold. Note to all the bean counters: Only one out of five hospitals has not piped up....frank


Anonymous said...

Wow. And here I thought we Texans didn't have anything in common with Yankees. Has anyone thought of contacting 60Minutes. This is their kind of story isn't it?

Anonymous said...

It would appear that Hud is keeping up with the blog. New posts garner an 8:00 AM email.

I talk to a lot of pissed off nurses, techs, and physicians on a daily basis. Most are afraid to become part of the solution, thereby becoming part of the problem. If management actually cared to make a long-term improvement in each of the communities that they are located in (not a part of,) they'd realize that lean management is not a top-down process, but a bottom-up one...so is anger.

Well behaved women rarely make history.

Anonymous said...

IT management seems to be a high turnover area for Essent. And wasn't this the place that the downsized employees from MVMC were offered jobs?

Wasn't Soran your poster child for Essent, Frank?

Got me there, but encouragement of innovation is a top-down factor. Essent as a rule doesn't promote that. Their style is more head-office micro-management.

I had thought that the eBay-style overtime bidding fell into an innovative area. Come to think of it, I haven't caught anything new or exciting from where he went. From poster child to milk carton.

To quote a commenter, "Yesterday's sunshine doesn't warm your butt today"....frank

Anonymous said...

Wow!!! A leopard can't change his spots! Nothing good this way comes. I'm sure glad to have moved on and not be dependent on Essent for healthcare, or Paris for my financial future! I feel sorry for the good people that are dependent on this community. Good luck to all of you!

Anonymous said...

Thank you so much for your post. Please keep us updated.

Frank, thank you so much for the site. Please hang in there and keep it going.

To Hud, I just wish you would give it up. Arcon was a bust, Essent is a bust. Enjoy life; go play golf.

Anonymous said...

The cover-up issue sounds like what the boys from Nashville were trying to blame CHS for...better clean out your own closet, first, guys.

fac_p said...

It has been about a year since Greg and Austin came on board, wonder when they drop their papers?

Not that their tenure has been auspicious: Greene Co., Weatherford, and Muskogee--oh well, one for three....but then wasn't that deal already in the making...yesterday's sunshine....

Anonymous said...

Speaking of Muskogee, how are the negotiations going? And which one of the other E$$ent faciities have not spoken up?

Anonymous said...

The posting from Ayer is wrong in its specifics and – most importantly – wrong in its perspective. I won’t address every specific error, but here’s a sampling:

-- The blogger says our Radiology Department is “currently under investigation by the Department of Public Health…” First, there is no investigation by the state of our hospital and, second, it’s not the Department of Public Health that oversees Radiology in Massachusetts anyway.
No, it’s the Department of Health and Human Services. Easy to confuse.

-- The blogger says “Essent is facing fines…” for the alleged radiology issue. No issue. No fine. Just not true.
In checking, apparently they are, for having a non-registered tech working in a hospital. JACHO violation?

-- The blogger says “there have been four physicians on staff at Nashoba Valley under investigation by the state for numerous violations…” But these doctors are also on staff at other hospitals, including high profile Boston hospitals. More importantly, any problem these docs may face is not related to their work at our hospital, but to other unrelated issues.
Considering the total number of physicians at this location, the percentage is rather significant.

-- The blogger makes a big deal about parking. Parking is tight, it’s true. We insist employees and administration leave plenty of room for our patients and their families to find a place to park. They come first. Most employees appreciate this.
No, the issue was with the CEO, and his obsession.

The list of errors goes on, but it misses the real point: Essent Healthcare, our nurses, employees and physicians have turned around a dying hospital.

-- When Essent purchased Nashoba Valley Medical Center, it was losing $4 million a year. Today it’s making $4 million a year.

-- When Essent purchased Nashoba, it had 335 employees. Today it has 368 employees.
Is that all FTEs, or are we padding with PTEs and PRNs?

-- Essent has invested more than $11 million in the facility for new equipment since it bought the hospital, including all new digital radiology equipment (with significant downtime, as in several of the Essent group) and much more.

-- Essent is building a $50 million replacement hospital here. The architects have already begun work on the hospital and construction on our new medical office building will begin in a week or so.

It’s easy to complain, particularly when your facts are wrong. But turning around a broken hospital is hard work. It means systems and people have to change. It means the status quo was a failure and must be replaced.
Certainly there are changes to be made, but treatment of staff is a significant factor. Essent has been noted as a micro-management organization, with little local autonomy.

It’s fine to dislike your boss or to have issues with administration. But it’s truly disappointing someone would try so hard to harm the hospital hundreds of people have all worked so hard to save.
This is an issue with administration, and quality of care. Making it into a profitable enterprise is one thing, leaving the staff and patients adrift is another. I was waiting for a reply from the emailer, but figured timeliness was a priority, so the comments are mine. Most of these smaller hospitals need an infusion of cash--updates are expensive--and that's what they go shopping for--deep pockets. Accounting and management practices of not-for-profits aren't as tight as a for-profit. Most of the turn-arounds are due to attention to details, but in Essent's case, a loss of humanity comes with it....frank

fac_p said...

A minor (to them, not me) glitch in the indexing held up publishing misc. changes, comments, and a post. Nothing was showing on the public side. I had to place a number of posts back into draft and then return them to published. Hopefully the issues are taken care of....frank

Anonymous said...

Making a sizable profit is in no way a measurement of excellence in patient care (which one would think MUST be the number one objective of any healthcare facility). Could be that the bottom line has improved under Essent "management" but at what impact to the caring staff, the good physicians and the area residents who want and deserve something better.
I also want to express an opinion that the information on this posting is much more likely to be factual than not. Think about it. You could never make this stuff up in a million years.

Anonymous said...

“Me thinks you doth protest too much!!” The “posting from Ayer” is spot on baby. You’re obviously one of Hud’s corporate muppets. He has his hand so far up your wazoo it’s affecting your ability to separate the truth from the rhetoric that’s spewed out at HQ. Even Frank can see it and he’s probably an entire time zone away! Let’s look at this more thoroughly shall we?

Radiology Technologist Mass licenses are issued by the Department of Public Health. Perhaps you should visit the radiology waiting room. The techs licenses are displayed on the wall and at the top of each one reads the Department of Public Health.
Hmmmmm. As far as them being interested in an unregistered and unlicensed tech I have no doubt they would be. Maybe you could explain why she is no longer an employee if you didn’t feel she was in violation of the laws of the commonwealth. She could still be working like she has been since May. JCAHO would have a field day with this one. The fines are just a matter of time my dear.

As for the physicians, let’s proceed to www.massmedboard.org and into the physician profiles. Now, type in the chief of Cardiology at NVMC Dr. Adam Wheeler Cerel. Am I hallucinating or does it say that his infractions occurred at NVMC. If you or anyone out there is really interested in some late night reading, ask for his practice restrictions from which you can read between the lines. Beware it is verrrrrryyyyy scarrrrey!! (and it’s all public information) No matter how you try to deflect the focus away from the hospital medical staff, you can’t get away from the common denominator. All four of them were staff at NVMC. I don’t believe the blogger said anything about all of them committing their crimes at NVMC although 2 did. Also, since we are on the subject of deflecting, why was it that the general staff and patients had to do the work of reporting? Could it be that for years the chiefs of the medical staff were so overwhelmed by all of the incident reports on him that they couldn’t take on the mammoth task of fixing the problem? Was it that administration had no balls and didn’t want to lose their “gravy maker?” You would rather subject the staff to persecution by him which shows how little you care about your employees. Just the fact that he is still practicing at NVMC shows how little you care about quality healthcare. Emerson escorted him out and won’t let him back in their doors!

The parking for patients is not an issue. After all there are so few. Only the blue hairs who can’t take the drive to Lahey or navigate the Concord rotary to go to Emerson continue to be loyal. The others just wave on their way past “the Center.” Heard that management is considering attaching monetary fines to the parking tickets they issue. Perhaps they are hoping to generate more revenue than their inpatient billing gives them.

A dying hospital it may have been, however the quality of care was never the reason. The issue was that Beth Isreal sucked the life out of it by taking patients into Boston and never meeting the needs out here of technology and billing. Yes, Essent did sink money into “the Center” but at quite a cost. The patients of this community used to love this hospital. They enjoyed the fact that they could get great care from people they knew and who knew them. Now it’s all agencies, new grads and new staff who see very quickly that this is not where anyone who is of quality, or has a standard of care anywhere near normal would want to be. The old employees left, the new people left and even the new new people leave. “The Center” may be having some black marks in their account ledgers but it is most likely due to the loss of some big salaries, (and some little ones) throughout the year. People are being fired right left and center over here. Talk about robbing Peter to pay Paul!! They didn’t save a dying hospital, they just rolled it over to stab it on the other side. There is nothing I would like more than to see this hospital survive and be the place it had the potential to be. It maybe too late especially if things continue on in the same style.

New equipment? I think the blog has addressed this issue a number of times. The PACS system is a piece of s—t. Just ask any licensed and registered radiographer or radiologist. As for the new medical office bldg and or hospital…haven’t seen any surveyors on “the Center” grounds yet. You all have been spouting this for 2 years now. A patient even asked Andrei before he left for other pastures if it would ever happen and he was emphatic that it would not! It’s what they tell the natives to keep them from storming the castle.

You don’t get it honey!!! The people who write in this blog are not trying to harm the hospitals. They are trying to get you Hudettes to get a clue. They are trying to get you to see how your management style is killing every hospital you touch. Have you ever heard of the old saying “if it ain’t broken, don’t fix it!” All your silly schemes and foolish notions about innovative this and cutting edge that, only make the staff at the small hospitals roll their eyes and wonder what idiots they are working for. This office building is supposed to be temporary then turned into a pool when the new hospital is built. Have you ever heard of such a concept?

One question.. have you made the red socks no skid yet? By the way.. Andrei’s innovative program of having a famous hospital spokesperson started the “red sox” program with Rico Petrocelli. Andrei is now the CEO at Metrowest in Framingham MA and apparently not skipped a beat. Rico is out and Doug Flutie is in.

The blogger who had the suggestion of going golfing instead had it right. Perhaps you should all join Hud. FORE!!

Anonymous said...

Wow 6:03 PM ... Deja vous! This is the E$$ent formula. Just replace the hospital name (x) in the post with the name of each new E$$ent aquisition... and voila!... you can predict the future! The magic of Hudd.

Anonymous said...

This last comment is so similar to the evolving situation in Paris it is scary! The exit of experienced RNs and Techs of all disciplines has been unbelievable. We have had a mass exodus of the entire radiology staff of M.D.s only to be replaced by travelers (two of which have been drunk on the job); anesthesia is supplemented by four traveler CRNAs and two campuses are serviced by only 3 anesthesiologists. We too have been promised a new hospital.

Essent has invested money in the facilities true; but they are fixing up patient care areas cosmetics while all the time sub rosa (whether by design or incompetence), the quality of that care has deteriorated. The women’s and Babies Hospital doesn’t even have an ICU! Anyone knows that an ARDS patient on PEEP can easily be transferred to across town by ambulance! Ha! Nurses are invoking Safe Harbor declarations for the first time in the history of the north campus. They are then accused of "overreacting" and are afraid of retribution.

It seems that Essent is so much like other phonies: Give me form but don’t task me with safety or performance. I think the most surprising thing to me personally has been the sell out of long time nurses (who know better) but because they have been made chief or department head still go along with what they know is clearly not safe or in the patients best interests. Of course this has happened in the M.D. Staff leadership also. I guess the intoxicating effect of being included on innumerable meetings and given the false impression of really having a say in the hospitals governance is the explanation. But one would think that the third or fourth time that they see that their input is ignored, they would have some deeper character commitments that would win out.

The final story has yet to be written on the once great hospitals that Paris once had. It would be wrong to blame Essent for the shells that we have now. Essent is here, I think, for one reason: to put together a chain of turned around "hospitals” that look good financially, but are in reality not much good to the community. (In which they once were once regarded as meeting most of the medical needs of the community….)

They may be sellable to the “big Boys" but not to the people who live there. How unbelievably sad it has been to witness this death of our once great medical center, shame on you who know better but don’t speak up! You and yours will have to use the hospital that you have participated in creating; either by eager participation or by blinking at what you know is wrong. As for me and mine, we are heading to Dallas.

Anonymous said...

Unfortunately, the quality of patient care has deteriorated since E$$ent purchased Deaconess-Nashoba Hospital. Many long time employees have left and the feeling of family which was clearly evident amongst staff is gone. It’s all about MONEY.

A high number of NVMC physicians have been under investigation by The Board of Medicine in 2005 (4 to be exact.) One of these physicians, cardiologist Dr. Terrence Hack was recently reprimanded and fined by the Commonwealth. The other three physicians entered into “Voluntary Agreement Not to Practice” with the state which indicates HIGH PROFILE CASE. Two of these physicians have a Resigned License Status. Under Board regulations, a physician who is under investigation or named in a complaint by the Board may chose to submit a resignation and terminate the investigation. Resignations are an irreversible and final disciplinary action.

The last physician, cardiologist Dr. Adam Cerel continues to be in “OPEN INVESTIGATION” status and his day before the judge and jury awaits him. Complaints were filed in 2004 according to docket numbers placed on his “Voluntary Agreement Not to Practice” which is a public document.

Hopefully, state regulatory boards are going to set a precedent with this case and hold Former CEO Andrei Soran, present CEO Steve Roach and the Medical Executive Committee (who oversee quality control) accountable for failure to report a licensee.

The public has a right to know that everyone at a healthcare institution, from the top down, has an ethical responsibility to put patient, physician and healthcare worker safety as a priority and failure to do so has consequences. Stay Tuned!!!

Anonymous said...

to the first post made (9:09)you gave me an idea i went to dateline nbc and wrote an email telling them that they needed to investigate essent corp. and told them to visit this site. it may not do any good, who even knows if they really read those emails but i figured whats a few minutes out of my life to hopefully get an investigation open that saves another.

Anonymous said...

Wow is right! Ditto the post. Throw Southwest Regional Medical Center's hat in the ring too. I couldn't have said it better myself. What a bunch of predictable dumb a$$es!

Anonymous said...

At 1:52 AM Anonymous said: "The women’s and Babies Hospital doesn’t even have an ICU!" There hasn't been an ICU on North Campus since 2002, a Christus decision. "Nurses are invoking Safe Harbor declarations for the first time in the history of the north campus." There have been Safe Harbors filed on North Campus in the past, again under Christus.

Yep, although one might as well say "under Monte." As to Safe Harbor declarations, I would venture to say that there are more now than under Christus.... No one said it was all E$$ent's fault, but they deserve their share of the blame....

Anonymous said...

If you notice on the Mass Physicians link, Dr. Adam Cerel doesn't even list Emerson Hospital any more--of course, if you drop down, he was suspended for a month last year. He was given, at about the same time, a four month "other" diciplinary action from NV.

Anonymous said...

Dr. Adam Cerel's profile on the Mass Physicians link doesn't list Emerson Hospital under hospital affiliations because he does not have priveleges at this facility. Emerson Hospital never let him back after his February 2005 suspension due to their HIGH STANDARD OF HEALTHCARE. On the other hand, The Nashoba Valley Medical Center February 2005 discipline is listed as "OTHER" so they didn't have to reveal what they actually did to him. "COWARDS" Dr.Cerel didn't even stay out the full 4 months as indicated under this hospital discipline. He was back in May 2005, one month early. It's all about the "GOOD OLD BOYS CLUB" and we all know E$$ent Healthcare will do anything to make a buck.

Anonymous said...

It's not just coincidence that Cerel's discipline by Emerson happend when it did. He was under agreement not to practice medicine when he showed up at that facility where he was sending his patients for cardiac myoview testing. According to sources that were present, security was needed to assist him from the building. He was heard to mutter on his way out "Don't tell anybody that I was here." The agreement that was signed by him two days before, evidently didn't mean anything to him. Not surprised, Nashoba has been letting him get away with murder for his entire carreer there. He gets away with it at NVMC because he is the biggest referrer. When you order 25+ myoviews a week (whether they are necessary or not) that's hard for a struggling hospital to give up. In order to protect the integrity of their facility Emerson didn't want anything to do with a substandard physician. But as we all know this means nothing to ESSENT. All they care about is the cash! What they don't get is that when Cerel's investigation is all said and done, the publicity for the hospital may just be the final nail in Essents coffin. When people are finally able to find out what the investigation was about they will never trust a facility that was willing to put them at so much risk all for the sake of a dollar. It's amazing that Dr. Marukus just entered into a voluntary agreement not to pracitce and NVMC removed him from the staff only 1 business day later. Then again, he wasn't a big referrer so what do they care. NVMC was forced to discipline Cerel somehow once the Board of Medicine started knocking on their door with subpoenas in hand. As former CEO Andrei' Soran was famous for saying he wasn't going to do anything about Adam Cerel until he absolutely had to. Evidently Steve Roach, the new CEO, has the same philosophy. This was too little too late. Will the new office building encorporate a satalite office of the Board of Registration in Medicine? Will anybody be surprised at who's next on the Boards list? Stay tuned for the answers to these burning questions and more. 2007 may just hold all the answers.

Anonymous said...

I am one of those employees of the old .."The Nashoba Community Hospital" I worked there for 18 years, I watched it go from "The Nashoba Community Hospital" to "Deaconess-Nashoba Hospital" to "Beth Isreal/Deaconess Nashoba Hospital" which was part of the failing "Caregroup" alliance. Then finally I lasted one year into the "NVMC", until I could not take the philosophy of the money=everything....patients/employess mean nothing. I too moved onto greenier pastures. There was a very smart guy I used to work with there, who use to quote Andrei and his cloanies as saying "You mean nothing to me!!"
When Essent first took over their first hospital forums was laced with comments as "We are going to do this, and that..if you do not like it leave...we will not have unhappy employess here" I watched as a once great friendly hospital that I pretty much grew up in ...turn into a mis-managed shell of a hospital. I went back there to work only per diem, the only reason I did that was to see old friends....then those friends also started to "see the light" Now if I would ever to go back there to work a shift...,I would only know about 10-15% of the employees. I'll finish off by saying I seen the hospital go thru all sorts of changes from a place I was proud to work at.....to a place that I'm ashamed to have worked (under NVMC).
I respect the employees working there...just not the system.

Anonymous said...

I am one of those "Nashoba Community Hospital" employess who have moved on. I could go on and on about my experiences with Essent. I am going to keep it short. I've seen this hospital change names 3-4 times. I stayed for about one year into the NVMC reign of terror. Andei and his string pulling Tennessee fools came in and in their first open forum with the employees mention that ...they were going to do this and that..and "if you did not like it, you can leave to another job" Andei mentioned he would not have any unhappy employees working for him. I wonder what his philosophy is down at Metrowest now that the "puppet masters" aren't pulling strings. One bright guy I use to work with use to kid around and quote Andrei's favorate line "You mean nothing to me". I worked there for 18 years before I left, and pretty much grew up there as a professional. I watched a once great, friendly, family hospital spiral down to a hospital that puts the all mightly dollar before patients and employees. They can't expect to get go quality employees in there when their Human Resource Department is sub-par at most. I went back for a per diem shift two years ago and I got to tell you, after 18 years I only knew about 10% of the employees there. I respect the employees there, but not the system they work for. As I said I could go on and on (18 years worth). The Essent disaster is only worth so many words.

Anonymous said...

Sorry for the double posting, didn't think the first one went thru.

Anonymous said...

RE Nashoba Valley Med Ctr Ayer, Ma-As an ex employee of over 10 years I Can tell you that Essent Corp is going to Hell in a handbasket and that the reason is corporate greed , and all at the patients expense. Trying to be brief but there are so many issues I have personally witnessed. One of which was a technician who was assaulted by an administrative dept. head and nothing was done although there were 4 witnesses to this (I was one) after a meeting in head of HR?PR Spin Doctor Wanda's office ( I have seen many a good caregiver enter that office never to be seen again) we were urged to deny we saw anything, that poor kid!
Yes!!! Doctors aren't the only ones being investigated and yes there are rad tech's unlicensed( they are cheaper to hire)servicing patients, more another day bye.