Henry Mayo Hospital on the Edge of Viability

Henry Mayo Newhall Memorial Hospital (HMNMH) is a nonprofit, 501(c)3 facility required to follow governing documents for recognition of compliance, and for allowing legal accreditation. When found not to be compliant, the hospital faces sanctions that must be rectified in a timely fashion. Such has been the recent case of persistent communication problems between the Administration and Medical Executive Committee (MEC). This problem has now come full circle in a convoluted epic of power and brinksmanship, creating potential liability and putting our hospital in its greatest jeopardy since bankruptcy.
The Joint Commission (TJC) is a government agency delegated with the responsibility of assuring hospitals throughout the United States maintain consistent standards of patient care. To comply with a recent TJC sanction reciting communication problems, the hospital Administration and MEC jointly agreed to hire a Mediator who would mitigate the conflict and write a report to TJC, thus removing the hospital sanction.
Within weeks, HMNMH oddly announced creation of a new position and hiring of a hospital administrator called Chief Medical Officer (CMO), and to the surprise of the medical staff and MEC, it was the Mediator! Still with me?
Day-to-day hospital operation and function rely on committees under the auspices of the MEC, Administration, and Board of Directors. Committee members follow rules related to HIPAA and Peer Review to maintain patient confidentiality according to By-Laws, Rules & Regulations, and Hospital-Wide Policy and Procedures. The CMO position, duties, and responsibilities, are not mentioned nor defined in these HMNMH governing documents.
The hospital has demanded the CMO be allowed to sit in hospital committee meetings and peruse patient charts. The MEC has objected and feel this is a breach of HIPAA and Peer Review confidentiality. With that, every committee the CMO has attempted to attend has resulted in this objection and cancellation of the meeting, stalling hospital function and compromising patient care.
It is ironic the person hired as Mediator to improve communication has now become the source of “discommunication.”
Because I attend many HMNMH committees, I discussed this matter with my malpractice insurance Risk Management attorney. My attorney agreed that indeed, because the position of Chief Medical Officer is not defined by the hospital governing documents, physicians, Administrators, and the hospital are at risk should there be HIPAA/Peer Review litigation brought against the hospital. Additionally, governmental agencies such as TJC might sanction the hospital and jeopardize accreditation. Hospital attorneys might not agree, but I wonder what is their legal precedence?
The position of Chief Medical Officer is not new in a hospital setting, but ground work must be laid in governing hospital documents in order for the position to legally exist. This has not been done and hence the hospital may be judged to be libel.
Ultimately, the Board of Directors are responsible for this legal matter, as they voted to create the CMO position. Viability of our community hospital is at stake, so I truly hope communication is better between the Board of Directors and hospital attorneys than between Administration and the MEC.
Gene Dorio, M.D.- Commentary
Gene Dorio, M.D., is a local physician. His commentary represents his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.

Guest Commentary: Dissecting Henry Mayo Newhall Memorial Hospital

The West Ranch Beacon’s mantra “Sometimes controversial, always thought provoking” can describe Henry Mayo Newhall Memorial Hospital. Most emergency and critical medical care in the Santa Clarita Valley is rendered there, yet most have no understanding of how our hospital functions.
I have been on the Medical Staff at Henry Mayo 23 years, and have a private practice specializing in geriatric medicine. As an educator, I cohost “The Senior Hour” on KHTS, wrote a column in The Signal “Profiles in Medicine”, and have had a television show entitled “House Call for Seniors” on Channel 20. For those who read this blog and are involved in City Council politics, you know that I fought to keep our Transitional Care Unit (TCU) open for our elderly, and questioned the recent hospital expansion through their Master Plan. As a primary care physician for seniors in this community, I consider myself to be on the frontline in healthcare, and therefore hope I can briefly present to you…without the medical jargon…how Henry Mayo functions.
The hospital is established as a nonprofit 501(c)3 which means it doesn’t have to pay taxes, but because of this status, is obligated to follow certain legal guidelines. Federal and state legislation maintains constant vigil over patient care to protect the public. Periodic unannounced inspections by The Joint Commission, California Health Department, and other agencies must be passed for the hospital to remain “accredited.”
Having practiced at Henry Mayo for over two decades, there have been tremendous strides in technology adapted by our hospital. It is much easier for physicians to now give state-of-the-art medical care to those critically ill patients. There is no doubt also that my colleagues and I have the best trained nurses, pharmacist, laboratory, x-ray, and other personnel (many of whom also live in this community) working with us at Henry Mayo Hospital.
The Medical Staff are physicians, most in private practice, some in groups, and others solo, like myself. We are bound and guided by “Rules & Regulations” and “Bylaws” that must be adhered to. There are some groups that have contracts with the hospital to give specialized care to patients such as emergency, trauma, anesthesia, radiology, dialysis, and pathology. Most of the physicians though are not contracted, nor are they paid or employed by the hospital. Payments for hospitalized patients are made to us from Medicare, MediCal, and third party payers (Anthem Blue Cross, Aetna, Blue Shield, etc.). The Medical Staff duly elects members to a Medical Executive Committee (MEC) that represents physicians as a part of the governing body.
There are three interactive governing bodies at Henry Mayo…somewhat similar to the Executive, Legislative, and Judicial branches of our government where there are checks and balances: The above mentioned MEC; the Administration; and final decision maker Board of Directors.
The Administration hierarchy is headed by Chief Executive Officer, Roger Seaver. Immediately under him are the Chief Financial Officer, Bob Hudson, Chief Operational Officer, John Schlief, and Chief Nursing Officer, Larry Kidd, RN. There are a myriad of department heads all of whom must follow highly regulated policies and procedures again laid down by federal and state agencies.
Finally, the Board of Directors are volunteer members who live or work in this community. They are the ones that must juggle all the financial and medical information to come up with the best decisions for the hospital and the residents of the Santa Clarita Valley.
Some physicians serve on the Board of Directors, some Board of Directors serve on Administration Committees, while some Administrators come to the MEC meetings. All the governing bodies therefore have links to enhance communication.
Painting this picture of functionality makes it seem all the necessary ingredients are in place for our well-oiled hospital to run smoothly. But do the Executive, Legislative, and Judicial branches of our government run smoothly?
Mistakes have been made, but we are legally mandated to rectify these mistakes and learn from them.
Differences arise from personality, financial, and political conflicts with a recent surge in dysfunction between the MEC and Administration. Divisive issues and divisive rhetoric are emblematic of this ongoing drama. The Joint Commission sanctioned Henry Mayo for this lack of communication, and the hospital has been given a deadline to rectify this problem or it will jeopardize our accreditation.
Fortunately, this problem does not have any direct effect on patient care…yet. As I shrug my shoulders and raise my hands into the air, I think Henry Mayo’s mantra should really be: “Sometimes thought provoking, always controversial.
Gene Dorio, M.D., -Commentary
Gene Dorio, M.D., is a local physician. His commentary represents his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.

Good experience; no problems with pain management

I had surgery for uterine cancer a few months ago at Henry Mayo, and I have absolutely no complaints about the care I received. I had no problems with pain management; the nursing staff responded very quickly to my calls. Problems can occur at any hospital: Cedars-Sinai, UCLA Medical Center, St. Joseph’s Hospital are all well-regarded, and yet all have had their share of bad publicity for alleged medical errors and poor patient care. I am sorry your experience at Henry Mayo Newhall Hospital was a traumatic one for you and your family. In my personal experience, with my own medical care and with that of other members of my family, Henry Mayo Newhall Memorial Hospital rates very highly in professionalism, compassion, and patient care.

The hospital could not handle premature birth

(From Larry) My grandfather was in there after a bout with pneumonia. He was also suffering from dementia.
He ended up being placed in transitional care at the hospital. I was horrified when I went by to see him and he was feeding himself. While this is not a problem for most people, he could barely lift his hands. He had food all over himself. I talked to the nursing supervisor about this and was told they were short staffed and would do their best.
The next day, the same thing happened. We ended up having to hire our own nurse to go over there to feed him.
When he left, he was bed-ridden since the pneumonia had left him so weak. We found he was covered in bed sores and had raw areas on his skin. It was so bad that we documented it and my grandmother filed complaints with the state.
My sons were also born here. One of them was premature. The hospital could not handle this. They had to bring in specialists from Northridge Hospital for the delivery and transport. These guys knew their stuff and saved my sons life.
Unless I am dying, I drive to Holy Cross.
My grandfather was in there after a bout with pneumonia. He was also suffering from dementia.
He ended up being placed in transitional care at the hospital. I was horrified when I went by to see him and he was feeding himself. While this is not a problem for most people, he could barely lift his hands. He had food all over himself. I talked to the nursing supervisor about this and was told they were short staffed and would do their best.
The next day, the same thing happened. We ended up having to hire our own nurse to go over there to feed him.
When he left, he was bed-ridden since the pneumonia had left him so weak. We found he was covered in bed sores and had raw areas on his skin. It was so bad that we documented it and my grandmother filed complaints with the state.
My sons were also born here. One of them was premature. The hospital could not handle this. They had to bring in specialists from Northridge Hospital for the delivery and transport. These guys knew their stuff and saved my sons life.
Unless I am dying, I drive to Holy Cross.

AWESOME OR AWFUL HOSPITAL??

Hello, I am a long time resident of the SCV. I have enjoyed the new advertising campaign for Valencia….AWESOMETOWN. The advertisers are correct that the SCV is AWESOME. The sad thing is that the local Henry Mayo Newhall Memorial Hospital is the furthest possible from AWESOME. We need an awesome hospital not a hospital that patients are afraid to go to for care. As an example of how bad the care is, my daughter was born there last month and there was an emergency caused by the nurses that almost killed my daughter. The baby had to be transferred to another hospital. The therapist lost a tube in my daughter’s lung. The other hospital had to go in and remove the tube lost in my daughter’s lung. Henry Mayo is really an….AWFULHOSPITAL!!!! I am sure if you can go to another hospital you will be better treated. Why doesn’t the administrator respond to my daughter’s complication? No call has been made to me to ask how the baby is or even apologize!!!! I think I will in the future call the hospital “AWFULHOSPITAL” or Henry Hold the Mayo. I invite SCV citizens to click the link to a Rant and Rave about the local hospital. Maybe there are patients that are happy with the care and they should respond. The local newspaper has more letters to the editor that are highlighting the bad care than those highlighting good care. Please respond and let’s get this hospital’s problems aired out. I am hoping the hospital will respond to each and every one of the replies to this website. Let’s hope we can change the “AWFULHOSPITAL” to an “AWESOMEHOSPTAL.”

Henry Mayo Part 1: The ER, stock up on “Ammo and Water!”

This is a reprint of an October, 2008, commentary from the West Ranch Beacon news site. I have written about the hospital issue a few times before but now it is different having spent the better part of three days there with my wife Nancy. On Friday she fell down the last three steps of the stairs in our house and got a compound fracture of her lower left leg. A compound fracture is when the bone breaks and is sticking through the skin.

Fortunately, I had taken the day off from work and was at home. I was downstairs and my wife was coming down from the upstairs of the house having just retrieved a piece of paper that she was reading when she slipped. I heard her yell out as she crashed to the floor, and when I came around to the stairway she was on the floor and her left foot was oriented about 90 % from where it normally should have been. It was ugly!

I called 911 right away and the paramedics from Station 124 were at the house within 5 or 6 minutes as was an ambulance that followed a few minutes later. The paramedics were fantastic, and they put a splint on Nancy’s leg and foot to stabilize it and gave her some much needed pain relief as she was starting to go into shock. Several firefighters got her easily onto a stretcher and into the ambulance for the ride to Henry Mayo Newhall Memorial Hospital. I followed suit in my own car on their recommendation.

We could not have been happier with the response and the professionalism of the paramedics and firefighters from Los Angeles County Fire Station 124. Our community is lucky to have that station and equally lucky to have such wonderful firefighter personal staffing it in our community.

The ambulance took off from the house and I followed as long as I could but finally lost them at a red light that I had to stop at by the The Old Road and Stevenson Ranch Parkway. By the time I got to the hospital Nancy was already in the Emergency Room (ER) getting care.

I have not been to Henry Mayo Newhall Memorial Hospital in quite a while except for a tour that Roger E. Seaver, the President and CEO of the facility, gave me last year.

Both of my children were born at a hospital in Tarzana by choice even though we have lived in SCV for decades. We have avoided Henry Mayo whenever possible because of the bad reputation, real or imagined that the hospital has had over the years. Let’s face we have all heard stories or comments that the place is a “butcher shop” or a “sh@# hole”. Certainly Mr. Seaver has been doing an admirable job of trying to turn that perception around.

But nonetheless, we have made it a point to seek our medical care down in the valley south of Santa Clarita. Due to the serious nature of my wife’s injury we had to go to the Henry Mayo ER for immediate care. Believe me, if it was a simple broken bone I would have driven her down to St. Joseph’s or Tarzana in a heartbeat.

Now, I have to tell you that when I pulled around to the ER entrance there was little to no parking in that area. But I finally found a parking space not too far away and made my way over to an entrance which I quickly realized was under construction. I was directed to another entrance further away from the ambulance entrance. It was the waiting room and a hospital employee was in there and reluctantly opened a security door to let me through to the ER. By the way, he never asked for ID or a name, just let me through.

I will tell you upfront that the hospital personal that we encountered for the most part were great. The ER nurses and doctors that tended to my wife were fantastic in every sense of the word. They were professional, knowledgeable and did not hesitate to answer all of our questions.

There were some other hospital employees that wondered over to see my wife’s broken leg because it was “grotesque”, “it’s not Halloween yet”, “yikes, that’s nasty”, and so on. One orderly even took a photo with his cell phone camera because he likes to “collect” such pictures. That was downright unprofessional and weird!

The ER was clearly not big enough to handle a community the size of SCV. Add to that people using the ER for primary care and you quickly see a large problem. There was a woman in the bed next to my wife who was there because she had a headache/wasn’t feeling well and she arrived by ambulance. An ambulance!! She decided to leave on her own while we were still there.

If the ER was a microcosm of health care in the US we are doomed! This was reinforced by one of the ER nurses who said if there ever was a catastrophe in Santa Clarita we would all be screwed. She leaned over and said to both us, in a hushed whisper; “that we should make sure we are stocked up with plenty of “ammo and water”. (Seriously, you can’t make this stuff up!!)

Have you ever seen a ball of rubber bands? That is what I equate Henry Mayo Hospital to because it was a small community hospital that has been adding on space for years in order to try and stay up with the growth of the area.

There are two things wrong with this; 1) the hospital always appears to be behind the growth curve and playing catch up and 2) there is no real plan for what the community actually needs to sustain itself in the future. In other words, we have a hodge-podge of a hospital complex and a current plan to add more buildings and office space just like adding more rubber bands to the ball.

The current hospital complex is just not big enough to handle the current and expected population growth of the Santa Clarita Valley. This is why I felt like a gerbil running through a maze of tubes in a Habi-trail to get to where my wife was in the emergency room from the waiting room area.

What we need is a regional hospital that is on a larger piece of property more centrally or conveniently located in the Santa Clarita Valley. Now that may not jive with the current hospital owners or the hospital developer or City Council members that have received financial support form any of those participants, but that is what our community needs.

And everyone can sit around fighting and frittering away time to add a few more office buildings to an already to small, poorly located community hospital or we can be bold and come up with a vision of what our Valley really needs now and in the future. Instead of saying “we can’t” because of this or that, how about we start asking “how can we” and start down the road of actually accomplishing something for the good of all the residents that call the Santa Clarita Valley home.

Stay tuned for part II of our experience at the local “small community hospital” including the lack of security.

Dave Bossert- Commentary

Dave Bossert is a community volunteer who serves on a number of boards and councils. His commentaries represent his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.

Henry Mayo Part II: Surgery at a “Small Community Hospital”

This was originally published in November, 2008 as part of a four commentary series chronicling my and my wife’s experiences at Henry Mayo Newhall Memorial Hospital. It is an accurate account of a four day stay at the hospital which started in the emergency room, nearly five hours of surgery and then 3 days recovery in a hospital room. This part two in a series of commentaries, the number of commentaries is yet to be determined, on our experiences with Henry Mayo Newhall Memorial Hospital. Part I was titled “The ER: Ammo and Water!” which covered the accident, paramedics, and emergency room treatment.

After my wife, Nancy, received immediate care for her injury, which included twisting her foot back into place in the emergency room (ER), we waited a while until a room was assigned to her. During that wait there was an influx of Sheriff Deputies into the ER with at least three prisoners from the local jail. Yes, it was a rough and tumble crowd!

What I don’t understand is why they just don’t have a permanent ER at the jail. Doesn’t it make more sense to treat most jailhouse injuries at the jail? The inmates that came into the Henry Mayo ER didn’t look all that bad. I would think cuts, bruises, etc. could be handled at the jail; you know, throw an old x-ray machine in a room, some lab equipment, a Swingline stapler, some band-aids and sewing thread and you’re pretty much set up. Right!?

Fortunately Nancy got a room shortly after the inmates arrived and we left the ER rather quickly. Once again we traversed the rat’s maze of corridors to an elevated that initially didn’t want to work once we got in and the doors closed. After a few tries of the buttons and opening the doors a couple of times it finally decided to work and take us up to the second floor.

We exited the elevated and proceeded down a long hallway to basically an elevated, enclosed hallway that connected what is the main hospital to a newer, add on pavilion. I’m thinking the architect was a guy named Rube Goldberg! Again, this gets back to my assertion that the hospital is just a ball of rubber bands with a hodge-podge of add on buildings.

The room was just inside the pavilion at the end of the, no doubt expensive, elevated hallway. We waited in the room for a couple of hours until it was time to go to pre-op. My sister brought our two daughters so they could visit with their mother before the surgery.

At about 6:15 PM on Friday, several orderlies showed up to take Nancy to the pre-op area just outside the surgical suits on the second floor on the opposite side of the pricey, yet stark elevated hallway. They put us in a small private room.

Here is the shocking thing. Someone we have known, not a family member, wondered into the post-op area with out anyone stopping them. Let’s forget for a moment that it is more or less inappropriate, inconsiderate, rude, and rather brazen for this person to invade our privacy, especially since my wife was drugged up on morphine and other medications. Somebody just freely walked in off the street and into the pre-op area! That’s just not right and is one example of the lax security at Henry Mayo.

Add to this the fact that I asked an employee the next day to use his security card to open a doorway to a stairwell and you have the makings of an eventual bad situation. That’s right; I was to lazy to walk all the way around to the proper entrance and this employee just happened to be walking by at the right moment. Never asked who I was or if I had ID; how hard would it have been to say no you have to go around to the entrance. Instead he swiped his security card to unlock a door to a stairwell.

If you go to other hospitals, for instance Tarzana, you have to check in and get a visitors badge. They don’t allow anybody to enter their facility and roam around. Is Henry Mayo that bad off that they can’t have some semblance of a security process or is the hodge-podge of buildings just that porous, with so many ways in and out, to cover effectively?

I don’t know; all I know is that it was effortless to breeze in and out of Henry Mayo Newhall Memorial Hospital. Let’s just pray that some thug doesn’t wonder in off the street and starts robbing people or worse.

But hey, the phrase that we kept hearing from various care givers is that we were at a “small community hospital”. Again, I have nothing but praise for the Doctors, Nurses and caregivers we encountered but we do not live in a small community like it was 25 or so years ago.

We live in a growing suburban community on the fringes of a major metropolitan area and we all deserve to have a medical center that can fully serve our community; one where the skilled caregivers at Henry Mayo can fully utilize their talents with a modern up-to-date facility. It needs to be a medical facility that can handle the current and future population of SCV in an effective, efficient manner.

Part 3 will detail some interesting issues at Henry Mayo ranging from pain management problems to faulty communication.

Dave Bossert- Commentary

Dave Bossert is a community volunteer who serves on a number of boards and councils. His commentaries represent his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.