The Department of Health and Senior Services found several deficiencies with Meadowlands Hospital and Medical Center in Secaucus during an investigation conducted on July 6 and 7 in response to health advocate complaints.
Union leaders and a public-interest law group have called for the state to assign an independent health care quality monitor to oversee operations and to ensure that the deficiencies found during the investigation are corrected.
The hospital was sold to a for-profit company last year.
“The report stands on its own.” – Jeanne Otersen
In response, Tom Gregorio, the CEO of the hospital, said, “MHMC works daily 24/7 to meet the expectations of the Department of Health, the federal government and the community we serve. The union’s tactics will not derail the mission of our organization or our vision for creating the premier hospital in a county that has suffered for years of substandard care.”
Jeanne Otersen, a spokesperson for Health Professionals and Allied Employees, a nurses and health care workers’ union, said, “The report stands on its own. We think they did a very thorough review of the hospital and concerns that were raised.”
Staffing and services
The hospital employs 720 people, has 230 beds, and sees between 60 and 70 emergency room visits per day. Staffing has increased overall and specifically in the operating room, which has gone from 1,800 yearly procedures to 6,000, according CEO Gregorio.
Chief Nurse Felicia Karsos defended the practices of the operating room. The OR reports to Karsos, who has 27 years of experience.
“Nobody cuts those corners – you don’t sacrifice,” she said. She added that with double the staff in the OR and increased volume, nurses are required to turn over rooms quickly to accommodate 10 to 15 procedures a day, as compared to two per day in the past under the previous owners.
In determining patient-to-nurse ratio, Karsos said their system wasn’t explicit enough but that they do use objective patient criteria.
Karsos said that the hospital relies on part-timers, per-diem staff, or an outside agency whenever in need for increased support. But she said this is the case with any hospital. She said at the time of the investigation and to this day, the hospital is still undergoing hiring, training, and staffing changes to “right-size and put bodies where we actually need them.”
Gregorio also indicated that Secaucus residents are satisfied with the services provided by the hospital such as an ambulance service worth $700,000 at no cost to the town.
The state requires that all hospitals provide, on a regular and continuing basis, out-patient and preventive services. But the state said that the hospital does not have a pediatric clinic or a written agreement or contract with an outside source to provide pediatric services.
But Gregorio said that the hospital does have a contract with Riverside Pediatrics across the street, which was put in writing after the visit, and that the hospital has not seen a decline in pediatric coverage.
Calling for a state monitor
HPAE and Newark-based New Jersey Appleseed Public Interest Law Center called for a state monitor last year, months before the nonprofit LibertyHealth System sold the hospital to MHA. They followed up with recent complaints this summer.
“With the growing number of for-profit hospitals, the state needs to bring increased scrutiny. We see an ongoing tension between the profit motive and the in-patient care,” said Otersen.
She gave Salem Hospital in Oregon as a precedent, saying the hospital is now for-profit and the state is monitoring their Charity Care.
“[The state] has the authority to do it…we think the situation calls for it,” Otersen added.
Gregorio said that MHMC has provided over $18 million in charitable care and expects that number to increase.
Several hospitals in Hudson County that have suffered from financial problems have been sold recently to for-profit companies, or are in the process of being sold. Those companies have taken steps to turn them around financially, but some complain that this means cutting certain services (see related story in last weekend’s Jersey City Reporter at hudsonreporter.com).
“There really is no difference from a regulatory perspective,” said Gregorio in regard to for-profit versus nonprofit operations. “The hospital has to maintain the same level of compliance.”
Ongoing complaints from health advocates
HPAE met with DHSS in June and later issued a letter identifying a number of conditions that they believed had not been met by the hospital. NJ Appleseed followed up with their own letter Aug. 2 that poor practices had created a “threatening and hostile work environment for staff and an unsafe and hostile medical environment for patients.”
Gregorio said that the HPAE union has taken issue with the fact that hospital staff are being asked to work at greater capacity than they were accustomed to and that they are using the media and their relationship with NJ Appleseed to create propaganda and disseminate “blatant lies.”
“We took over a hospital that was dying where folks were not incentivized to work and now all this volume is coming in,” said Gregorio. “There are requirements and we want folks to work to the levels that they are expected to work.”
Karsos said corrective action has been taken since the state visit in July and that the hospital is preparing a report outlining the plan to address the deficiencies.
The DHSS said that the hospital has 10 days to respond to the outcome of the investigation once it is made public. There was no indication as to whether DHSS will assign an independent monitor.
Adriana Rambay Fernández may be reached at firstname.lastname@example.org.