09/17/08 — Cherry Hospital chief talks about its future

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Cherry Hospital chief talks about its future

By Phyllis Moore
Published in News on September 17, 2008 1:41 PM

Cherry Hospital will survive its latest struggles and be recertified to receive federal funding, its director said Tuesday.

News-Argus/Steve Herring

Dr. Jack St. Clair, the director of Cherry Hospital, speaks at a meeting of the Wayne County Board of Comm-issioners on Tuesday. St. Clair said the recent spate of troubles at the hospital will eventually be solved.

Dr. Jack St. Clair, hospital director, addressed the county commissioners at their Tuesday meeting, clarifying some of the recent issues faced by Cherry. Afterward, he offered more comments in an interview with the News-Argus.

County Manager Lee Smith called the visit "an attempt to dispel rumors (and) keep things under control."

For the past year, Cherry has been at the center of controversy -- from its near-removal of federal funding in September 2007 to its recent decertification, resulting in the loss of an estimated $800,000 a month in Medicare and Medicaid reimbursements.

In the midst of that, a 50-year-old patient died, allegedly left unattended for an estimated 22 hours in a dayroom. The ward, containing 23 beds, was later shut down and several staff members reassigned. Before completion of that investigation, two other incidents surfaced -- one patient-on-patient and the other staff-on-patient -- with two staff members arrested and charged in one of the cases.

St. Clair has remained quiet in recent weeks, with the state's Department of Health and Human Services fielding all calls and inquiries from media.

That silence was broken Tuesday when the hospital director was invited to speak to the commission, primarily to give an update. He expressed appreciation for "the outpouring of support" received from the public and gave a glimpse into the recent challenges faced by the hospital.

"There's no one more regretful of the series of untoward events that we've experienced at Cherry Hospital in recent days than the many dedicated individuals that often put themselves in harm's way every day to come to work at Cherry Hospital, working with a very difficult population," he said. "Many of the people we serve are volatile and unpredictable."

The actions of a few, he added, do not reflect the character, the work ethic or the social values of the vast majority of those who work at the hospital.

St. Clair recalled the series of events leading up to the recent loss of federal funds -- starting with the arrival of surveyors in August to investigate a complaint about patient safety.

"After about three or four days with us, they indicated that they were going to put our facility in something called immediate jeopardy," he said. Cherry officials were given 23 days to put together a plan of correction.

He was optimistic at the time, crediting his staff with devising a good plan.

"That was satisfactory to the surveyors" when they returned the last week of August, St. Clair said. "And while they didn't have any issue, they did discover two other incidents that did cause some concern ... about the degree of patient safety."

Negotiations then broke down, resulting in the hospital's decertification by the federal Centers for Medicare and Medicaid, based in Atlanta.

Since the announcement, rumors have swirled around the county, St. Clair said.

"The impression that has been given by many is that we were indeed going to close the hospital," he said.

Untrue, he said. In fact, previous construction plans for a new hospital are proceeding on schedule -- with plans to break ground in June 2009 and, on a 26-month construction cycle, projecting a late 2011 opening.

Only a few questions were raised by commissioners.

Commissioner John Bell asked whether the federal loss of funds placed clients in any jeopardy.

"When facilities are decertified as we have been, we are no longer eligible for reimbursement through Medicaid and Medicare for services that we provide for our consumers, our patients," he said. "We have typically generated about $800,000 a month in revenue from Medicaid and Medicare services.

"That void that's created because we can no longer bill for those services, will have to be filled in with state dollars."

Commissioner Efton Sager asked how long it might be until the hospital is recertified.

That depends on one variable, St. Clair said, referencing the management consultant firm hired by the state to be on site and work closely with management and staff to develop and implement a corrective action plan. Compass Group Inc. of Cincinnati is under contract to report findings to DHHS Secretary Dempsey Benton by Sept. 25, he said.

"We're not sure what all's going to be contained in those recommendations, but we do think more than likely there will be some recommendations made around additional resources, training that we'll need at the hospital, placing more emphasis on therapeutic intervention and less on physical control of the environment," he said.

Hopefully, he said, it will take markedly less time than it did to resolve a similar situation at the state's mental hospital in Morganton, which took a year.

"At this point, what can we do as commissioners to assist in whatever needs to be done?" Commissioner J.D. Evans said.

"Keep praying," St. Clair said. "This hospital has been an active part of the Wayne County community for about 148 years and there are a lot of people from this community who work at Cherry Hospital, a lot of good people. We just continue to be thankful for all the thoughts and prayers and the support that we have gotten from the community. That means a lot to us."

St. Clair has been at the helm of Cherry for two and one-half years, he said.

"I know that changing a large organization is not an easy thing to do and it takes time," he said after his commission presentation.

"Part of that culture out there that I was talking about will require additional staff training and more therapeutic ways to do intervention with the patients that we serve."

St. Clair said he is limited in what he can say about the Cherry situation, except to reiterate his confidence in what will happen.

"Like I'm confident that we will come through this and that we will be recertified by the CMS," he said. "I am confident. There's nothing out there that we can't turn around."

Regarding the arrival of the team from Compass, St. Clair was also optimistic.

"I felt that their attitude was very helpful," he said. "I did not perceive them as having ready-made answers when they walked in the door. And they left giving us the clear impression that they're here to help and that's the right partnership that we all want.

"I do think it's time -- there are some positives that we need to look at and not dwell on the negative stuff."