After whistleblowers speak out about Community Hospital local patients are called on to help uncover the truth.
It's hard to keep up with Community Hospital. It opens. It closes. It partially opens. The past several years have been a costly roller coaster. Now Community Hospital's operator is in the process of shutting down its Emergency Room and its ICU. The operators idea is to swap out medical care services for what it calls a mental wellness "hub". City Council will soon vote on the matter following closed doors meetings with Molina and partners.
A mental health campus sounds like a good idea on the surface. Long Beach certainly needs more mental health services.
Jan 4 2O21 Community Hospital "reopens" with several indications that it was not truly operative.
The problem is that Community Hospital's operators are beginning to sound more and more like the Queen Mary's operators. Far too generous contractual terms granted by the city. Promised repairs that never happen. Employees blowing the whistle on shockingly poor conditions and management inside the hospital. Even some Council members appearing to cozy up with operators. The list goes on.
In search of answers, here is what we’ve learned from local Long Beach residents who were treated at Community Hospital during its Emergency Room's brief reopening.
Joe And His Wife
When Joe’s fever took a dangerous spike, his wife called 911 and he was rushed to Community Hospital by paramedic. Joe’s wife is a nurse at a local hospital in Long Beach. The couple wasn’t long at the hospital before Joe’s wife refused to leave his bedside. Joe called it a “bad experience” as he recalled his wife having to instruct nurses how to properly “hang an IV and give medication.”
Joe's wife was even more alarmed when she observed that her husband wasn’t wearing a wrist band with a barcode. A standard technology used at her hospital in order to carefully track when a patient was administered medication.
Routinely, the couple heard physicians and nurses alike complain that they only had a paper system. In fact, when Joe was discharged into the care of his primary care physician his doctor wanted to review the medical records from Community Hospital. Initially, they had trouble even finding them. Once found they were only available by fax machine. They were handwritten and as illegible as they were incomplete.
Joe was fortunate that the two days and two nights he was hospitalized, he enjoyed the benefit of both a loving wife and a skilled nurse wrapped in one.
Cheryl And Her Son
Cheryl’s son was lucky too. Having recently lost her husband to cancer, Cheryl was no stranger to keeping notes on doctors’ visits. They came in handy when her husband would visit a new specialist or a new hospital.
What Cheryl didn’t expect is that the skillset she had honed caring for her husband would be especially helpful when her son was admitted to Community Hospital.
Cheryl’s son may have been one of the fist Long Beach resident’s to be treated at Community Hospital’s re-opened emergency room. His first visit occurred the second week of May. Later this summer he was transported to Community Hospital again but by ambulance because there were no beds available at either Long Beach Memorial or Los Alamitos. Cheryl remembers she and her son being the only patients there in fact.
Even given a low patient to doctor ratio, she remembers a very long wait.
Still, given that other hospitals in the area had an even longer wait she and her son were grateful. For Cheryl, Community Hospital held precious family memories. Her last moments with her Mother were spent in Community Hospital before she passed away.
A Long Beach native, Cheryl’s family moved to Long Beach in 1906. A year after her family’s arrival, 13 physicians would launched Long Beach’s first hospital; the future Memorial Medical Center.
While Joe’s wife knew better than to leave him alone at Community Hospital, Cheryl recalls hospital staff saying that her son “would have been better off at another hospital that was fully staffed.” In fact, the reason her son ended up hospitalized a second day at Community was because he needed a GI specialist.
The specialist never came.
Her son ended up in Los Alamitos Hospital where he contracted COVID-19 during his stay. His COVID-19 treatment ended at Long Beach Memorial. Cheryl remembers her son being discharged from Long Beach Memorial with a packet full of medical records. Cheryl doesn’t remember Community Hospital giving she and her son much more than a list of the belongings he was admitted into the hospital with. When the pair left Community Hospital she recalls saying to her son, “that’s all ya’ got?”
The disparity was glaring.
With the hospital closing again, Cheryl worries how her son will gather his medical records from Community Hospital.
By the end of the the Thanksgiving weekend Community Hospital closed it's Emergency Room again. The operator blames low demand and costly repairs. Staff say that the hospital’s brief reopening was a sham and that without the tools necessary to run an intensive care or emergency room there is no way the operator was every serious about staying open.
Community Hospital at the beginning of 2O21
after reports it had re-opened.
To make matters worse, if it’s true that Community Hospital didn’t have standard medical equipment, it would mean that neighbors treated there during the pandemic didn’t get the level of care they deserved.
The quality of care our neighbors received didn’t go unnoticed by Community Hospital staff. They too expressed disappointment as they detailed working conditions inside the facility.
According to hospital whistle blowers, who spoke under condition of anonymity, the failure of Community Hospital has far more to do with inadequate staffing, below standard medical technology and a lull in COVID 19 related billing.
There was even a time when the ICU ceiling caved in last summer.
No Medical Billing System
According to staff, there is “no Medical billing system” at Community Hospital. The result has been a backlog in the hospital’s ability to collect Medicare and Medi-Cal dollars.
If true, this would mean that Community Hospital likely had little means of seeking reimbursement since billing for Medicare and Medi-Cal are known to require extensive billing services.
We reached out to Community Hospital's spokesperson, Brandon Dowling regarding the staff's multiple claims. After many days, he did not respond.
In 2016, Medicare and Medicaid accounted for nearly 60 percent of health care revenues reported by the five largest U.S. commercial health insurance companies (UnitedHealthCare, Anthem, Aetna, Cigna, Humana).
Damaged ceiling inside Community Hospital's ICU
this summer after hospital re-opening
No Electronic Medical Record System
Staff say that they feel like they are in the “Stone Age” and report that there is no Electronic Medical Record System either. Billing systems are linked to Electronic Medical Records. So it stands to reason that Community Hospital couldn’t do much billing in the modern world without pairing billing with an Electronic Medical Records system.
According to the Harvard Business Journal, by 2016 up to “96% of hospitals and 86% of physician offices have adopted” Electronic Medical Records. This would place Community Hospital in the vast minority of providers across the nation and several years behind current industry standards.
Without an Electronic Medical Record system in place, records are illegible and incomplete. It’s also burdensome for specialists to update a patient’s file for a general practitioner. “Aside from interrupting continuity of care for patients, the chance for medical error is greater,” one staff member told us.
Doctors also can’t access records outside of the office. Making it impossible to monitor hospital patients from home overnight.
One Doctor we interviewed was surprised to hear that a hospital with an ER and an ICU failed to have an Electronic Medical Records system. “COVID cases and even ICU care are so complicated, I don't understand how it’s possible in modern times to provide quality of care to patients without Electronic Medical Records,” noted Dr. Patel.
No Pyxis
Even medications are difficult for staff to access at Community Hospital. “We don’t even have Pyxis,” one staff member declared. Having no idea what Pyxis was I did my homework.
Pyxis is an automated medication dispensing system. It kinda looks like fancy school lockers. You may have seen it used before by a nurse when they press buttons on a machine and pull meds from a draw that opens. Its main function is to help clinicians safely and efficiently dispense the right medications, for the right patients, at the right time. Pyxis is also helpful in keeping narcotics out of the wrong hands.
Supporting area hospitals was one of the benefits touted by Mayor Garcia upon the hospital’s partial reopening in January. But it’s hard to offer much support without modern tools.
To the average person whether a hospital uses Electronic Medical Records may seem like a business preference. But for frontline medical teams these are basic modern medical tools that help keep patients safe and guarantee continuity of care in a complex medical system.
But establishing whether or not Community Hospital did or did not have Electronic Medical Records is also a key building block into understanding more alarming accusations being raised by staff inside Community Hospital.
Staff say that providing medical service at Community Hospital was hamstrung by the lack of industry standard technology and that the lull in government funded COVID-19 dollars is the true driving force behind Community Hospital’s closure after less than a year of opening.
November 25, 2O2O Long Beach Mayor Garcia Shutdown restaurant dining due to shortage of hospital beds for COVID 19 patients while a local hospital with over a hundred beds served as Hollywood film location.
“The Hospital made tons of money just on administering COVID 19 swabs and those services were easily billed without electronic record or billing systems because of Federal funding,” explained one staff member. Now that pandemic rates have decreased and a good number of Long Beach residents have had at least one jab in the arm, “fast money” - as one staff person put it - isn’t as plentiful.
Community Hospital’s operator says, however, the closure has to do with unaffordable repairs and low demand.
We’d like to believe the operator. It’s rather unimaginable that an operator with a decades long history of providing health care to Long Beach families would take advantage of the acute care needs of the most elderly portion of our city in order to benefit from readily accessible emergency COVID dollars. Staff, however, point to the lack of standard medical technologies as circumstantial evidence that the operator never sincerely intended to open a successful hospital.
“You can bill during a pandemic emergency without an Electronic Medical Record system but it’s impossible to run an ICU without one,” one staff member reflected.
What’s Next for Community Hospital?
Community Hospital is operated by Pacific 6. A partnership founded by Long Beach magnate John Molina. Aside from Community Hospital, according to their website, Molina has considerable holdings across the city including the Long Beach Post, Long Beach Business Journal and Downtown assets such as The Breakers Hotel and The Ocean Center.
Molina has requested that the City enter new contract terms with Pacific 6 that would allow the partners to pivot into helping meet mental healthcare in Long Beach. Molina’s proposed alternative use would require City Council’s approval. Those conversations took place behind closed doors and out of public view.
If November 9th’s City Council meeting was any indication, it appears that Council members are already signaling they may welcome Molina’s request to rebrand Community Hospital as a mental health and “wellness hub”.
Perhaps coincidentally, days after Community Hospital announced its plans to “rebrand” as a mental health hub, Vice May Rex Richardson led a Power Point presentation directing the City Manager to explore a city wide mental health system. Molina’s newly sought after contract terms, if approved, would fit rather neatly into what Vice Mayor Richardson calls:
“a more robust infrastructure for mental health services in collaboration and alignment with local mental health providers in Long Beach.”
What the council member calls "Collaboration" and "alignment" may also give the appearance of collusion. During Vice Mayor Richardson’s presentation to City Council he used a colored graph to show how much our city needed better mental health care.
Graph presented by Vice Mayor Rex Richardson at City Council meeting November 9 2O21
The Vice Mayor's graph was strikingly identical to a graph used 5 days earlier in an article favoring Molina’s new mental health campus. Molina and partners own the newspaper that published the identical graph. The graph's caption in the newspaper clearly states that it comes from a City Council agenda item. But the timing of the article - along with the fact that the newspaper is owned by the very person seeking new contract terms during closed door sessions with City Council members - may raise red flags.
Is this what Vice Mayor Richardson meant by "collaboration and alignment with local mental health providers in Long Beach"?
Graph published on November 5, 2O21 in news paper owned by Community Hospital operator.
Whether the news article followed by the Vice Mayor's PowerPoint presentation was orchestrated or merely coincidental underlines the trouble when the political donor, the news paper owner and the hospital operator seeking City Council approval on a new contract are all the same person or business entity.
Molina was among Vice Mayor Rex Richardson's most generous donors according to a recent campaign filing. Richardson’s campaign boasted in July that the total funds raised were “the highest amount raised within the first six months of any city campaign in Long Beach history.”
Who’s Telling The Truth?
Both the City and Molina say that there just isn’t the demand for medical services. According to the City, “Despite all the effort to reestablish and operate the hospital, the operator has informed the City that it is not feasible and there is not sufficient demand for services, even during a pandemic.”
At odds with the City’s claim is how demand for medical services is so low locally while the operator’s own spokesperson complains of a “national shortage” of nurses as another reason for the hospital's closure.
Which is it? No demand or no nurses.
Reasonably, a hospital without basic modern technologies that protect patients can hardly expect much demand for its local medical services. Especially when patients like Joe and his wife are telling their friends and family, “whatever you do don’t go to community hospital.”
The operator says that events such as construction cost and low demand were unforeseen.
If, however, what whistleblowers report is true it’s unclear how an operator with decades of experience in health care would not foresee the importance of Electronic Medical Records. Hopefully this time reports such as these won't be ignored as they were in the case of the Queen Mary.
We may never know the truth about Community Hospital. But given the millions of tax dollars and preferential contract terms already given to Molina and his partners, it seems fair that the City Auditor might add Community Hospital to her growing list of City owned and privately operated assets that require audit.
The present need for an audit is especially urgent since elected officials are currently meeting with Molina behind closed doors rather than under the watchful eye of the public.
In any case, the real losers here are local families. Despite Cheryl and her son’s experience, she’s still hopeful Community will be the beacon of hope it had been to her family for generations. A place to celebrate a new birth or to say goodbye to a loved one, one last time.
But when the hospital operator is a local magnate, longtime friend and donor of the Mayor and happens to own the two most prominent and influential papers in the City, it’s hard for working families to get a fair shake.
Still, all residents want is the hospital they were promised and the peace of mind that their family is getting good care. Cheryl, told me as much when she expressed how pleased it made her when Community Hospital reopened its doors only several months ago.
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