DECH’s future in limbo
health care

DECH’s future in limbo


Hospital loses status as Medicare provider
By Eric Russell
BDN Staff
Harvey

MACHIAS, Maine — In the last few years, Down East Community Hospital has faced financial uncertainty, the departure of longtime physicians and dueling rhetoric in the community about the hospital’s management team and board of trustees.

While weathering those difficulties, the hospital last year came under investigation for violating federal licensing requirements and putting patients in jeopardy.

Those investigations escalated to their most serious point this week.

The Centers for Medicare and Medicaid Services, the federal licensing authority for hospitals, has informed DECH that as of July 10 the hospital will no longer be able to accept Medicare reimbursements.

“After a careful review of the facts, [CMS] has determined that Down East Community Hospital no longer meets the requirements for participation as a Medicare provider,” read a letter from CMS to hospital President and CEO Wayne Dodwell that was obtained by the Bangor Daily News.

For DECH, a critical access hospital that serves a rural and aging population, losing the ability to collect Medicare reimbursements is a crippling proposition. A state takeover is being considered.

In its letter, CMS outlined four areas of noncompliance: emergency services, organizational structure, provision of services, and periodic evaluation and review. However, unlike in the past, CMS will not allow the hospital to submit a plan of correction, according to the agency’s regional spokeswoman Roseanne Pawelec, putting the hospital’s future in limbo.

“Having said that, CMS is also in very close communication with the state Department of Health and Human Services, and we’ll continue to talk about what to do next,” Pawelec said.

DHHS Commissioner Brenda Harvey said Friday that the situation involving the Machias hospital is fluid for the moment, but she stressed that all parties are doing what they can to ensure the hospital remains open.

“We have a short period of time to develop a plan to assure that the citizens of Washington County are provided with good care and that the hospital is functioning,” Harvey said. “But it’s important for people to know that we are doing everything to keep that hospital in the community.”

One of the options for the hospital’s future is placing it into a receivership. Under that scenario, Harvey said, the state would assume temporary management of DECH and appoint someone to manage the facility.

“First, we have to talk with the hospital and their lawyer and make sure we understand what their intent is,” Harvey said. “We’re also talking with the [Maine] Attorney General’s Office about our options.”

Ultimately, the decision could be made in court, she said.

DECH released a statement Friday that said the following:

“Efforts are ongoing to assure DECH’s continued participation in the Medicare program. The hospital has been working closely with CMS and DHHS to ensure the continuity of care for its patients and the community.”

Quorum Health Services, a national firm that provides management services to numerous hospitals, including DECH, offered a little more information in a statement from spokeswoman Susan Hassell.

“Over the last 18 months, the DECH board has developed a clear preference in how they desire to manage the hospital, particularly in relation to regulatory compliance,” the statement read. “In some instances, their preference differs from our company’s approach to hospital management. More recently, the board has made numerous decisions inconsistent with [Quorum] recommendations. For example, the board refused to allow [Quorum] consultants and other experts to be involved in surveys by state and federal investigators and rejected changes in hospital leadership strongly proposed by [Quorum].”

Walter Plaut, chairman of the hospital’s board of trustees, did not return a call for comment Friday.

Down East Community Hospital has faced increased scrutiny since the high-profile death of Reid Emery in January 2008. Emery was a DECH patient who checked out of the hospital against doctors’ wishes on a cold, snowy evening. The Eastport man, heavily drugged from his stay at the hospital, was found dead the next day in a snowbank near the hospital.

Emery’s death prompted the first federal survey into policies and procedures at the hospital. DECH submitted a plan of correction to address deficiencies cited. Later in 2008, state and federal authorities were back at the hospital conducting an investigation into new deficiencies. Once again, DECH implemented changes.

Earlier this year, another investigation was launched, this one more serious. DECH was on a conditional license for several weeks related to numerous failures in emergency room procedures.

Even before Emery’s death and the subsequent investigations, numerous physicians and other staff members at DECH were either fired or quit over clashes with management. Before that, the hospital climbed out of a significant financial hole. Quorum Health Services took over management of the hospital in 2002 when DECH was in serious financial trouble. It picked Dodwell to lead. The president and CEO reversed the hospital’s financial outlook, but recent incidents, including the CMS investigations, have overshadowed that success.

Sen. Kevin Raye, R-Perry, has been following the DECH issues for some time and said he was informed of the recent CMS decision late Thursday evening.

“Nurses and other employees have made it clear that serious problems exist at the hospital, and today marks the beginning of the healing process for the institution, its dedicated employees and the community,” Raye said in a statement.

“The important thing to convey is that this doesn’t meant the hospital will close,” he added.

Rep. David Burns, R-Whiting, said that as far as he’s concerned, the hospital had ample opportunity to rectify its problems and failed to do so.

“I’m very willing to do anything to correct these problems and keep [the hospital] going,” he said.

erussell@bangordailynews.net

990-8167

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Comments
27 comments on this item

The saga at DECH is apparently at the critical point where meaningful changes must be made. Some of us have watched and grieved for several years now. All of the unfortunate mishandling has escalated to a point where the fallout is obvious. The lights are on, now. Something of substance must be done, and that is a good thing. I sincerely hope that the state, EMHS, or some other entity is able to make some permanent corrections, especially in the administration of this beautiful little hospital. Hopefully we will see it become, once again, the place it was meant to be for the people of Washington County and neighboring New Brunswick.

carol1: "neighboring New Brunswick". Why is Dech serving Canada? I thought their Health Care was so Wonderful!!!!! For all of you that think DECH sucks wait until Obama and the dems pass a nationalized health care program...than every Hospital will have the same problems.

Wayne Dodwell Please leave!

DECH serving Canada because with their nationalized health care system, they can't get the health care they need so they come the the USA. Just think when OBAMA gets his way we won't have anywhere to go when they start telling you Sorry we don't cover that, or oh you are to old to have that life save operation done. These days are coming unless people call write e-mail to Sen. Collins, Snowe, Reps Michuad Although with Michuad he will just do what his Democrat leaders tell him to do anyway. Just like his vote on Cap and Trade yesterday. Look foreward to having your Energy cost going up very high soon and more jobs being lost from Maine. And when they do send a thank you card to Michuad!

Zatwoodz and Bobsmith:

Get a life, you sound like you're programmed by those right wing talk shows. We live in a poor area and Obama's plan will benefit all of us. Think for yourself and not what "Rush" tells you to think. Solving our health care problems will benefit many people in our poor county.

The problems with this hospital start and end with the board. Walter Plaut as chairman??? What a joke. This guy can operate a wheel barrow, and that's it. He has no comment on this disaster? What a leader he is.

Clean house and pay EMHC to operate it and they'd probably do alright. I don't know what it would take - how much money - to get EMHC to come in, but having the state run it is another way to bring in more incompetents. They have enough of those there now.

It isn't the buildings or personnel that make this place a death machine; it's the board of dunces and the management that requires the fastest trip possible out of town to avoid the death curse. I think the hospital can be a great operation if it has quality, experienced people to operate it. I hope a solution can be found before it get's closed down.

If this action will aid in the neccessary removal of Wayne Dodwell, then I welcome it!!! Wayne Dodwell, please leave....!!!!!!!!!!!!!!!!!!!!!!!!!!

It is too bad that a situation which could use cohesive community action and support to improve conditions at DECH instead is mired in some really hateful politics. Name calling? junior high rhetoric? come-on people we can do better.

BTW LubecKDeck Walter Plaut (in my opinion a multi-talented individual) saved my father's life in 1998 without using a wheelbarrow. I understand that apart form his position on the DECH board, he is also a highly trained EMT, a college graduate a former teacher and a member of the Whiting VOLUNTEER fire department. What may I inquire have you done for your community lately?

As far as DHCS serving New Brunswick,(Canada) it happens to be the closest hospital to Campobello Island which has no hospital. The Island Ambulance also serves US citizens and backs up service for Lubec Trescott and Whiting!

Wayne isn't the only one who needs to be let go in that place they need to CLEAN house other "certain" managers! There is one there in particular that is a waste of space who got this job in the first place baffles me (more or less grandfathered their way in) this manager can't spell if their life depended on it (emails that they send out has at least three or more mistakes in them just for starters on an all the time basis) this person is very sneaky and loved to send emails to the higher up manager and would tell flat out lies etc about other staff members. We have to laugh because this so called supervisor was thought they was sooooooooooooo smart (we ALWAYS knew what was going on little did that f***tard know) lmao ask yourself who the h*** is stupid enough to use their pet's name for a password!?! Hope some of the lies and stuff she wrote doesnt' come back to bite her on the a**

My point and opinion here is they need to clean house and start over on "just about all" of the management there. Start fresh its the only way to do it. Don't keep managers there that are only out to get you and cause problems for people and talk behind your back. There Are people there that do catch on to this and are always ONE step ahead of them... Why doesn't the state take a survey/interview of how the employees feel about the managers there? I feel that would be a wonderful idea...

It is due time to shut this band aid station down. The level of incompetence and malpractice is beyond belief at Dech. No other hospital in the state of Maine has had so much scandal and incompetence. It is not just the management it is the whole medical culture at DECH. They are pathetic.

Zatwoodz and Bobsmith are 100% correct. kciskicin, you are a freaking moron!? If you think healthcare is bad and expensive now, wait until it's "FREE" and "Government-run"!!!! Us hard-working, law abiding, tax-paying citizens will be paying for ObamaCare while you welfware loving libtards will be living off the state and feds for years upon years to come. I am FREE and an AMERICA and I will be DAMNED if Government is going to tell me what I can and CAN NOT have for healthcare treatments!

To Eric Russell: Wayne Dodwell is NOT the first Qurom provided CEO. His predecessor, Phlio Hall, was also Quroum, as was HIS predecessor, Ric Hanley...

That should read Philo Hall, not Phlio Hall.

According to the facebook site, Down East Community, Wayne Dodwell has been fired.

Knigtcross, in a way your points contradict each other and reinforce what others have been saying. There is a "bad" culture there. That is what happens when you fire and/or let other good personnel walk away. That is the responsibility of the CEO, among others, to keep a professional atmosphere. Once the staff loses confidence in the facility, the best professionals are going to leave, and those left behind are going to bicker and back stab as they jockey for vacated spots.

I think this new board of trustees should choose a level above which everybody is out. I know that is harsh and even unfair, but this board of trustees needs to assemble a competent management team to redevelop the atmosphere to attract and retain competent professionals. This is going to be a very challenging task, at the very least. A house will burn down very quickly, but rebuilding will take time. This going to require a lot of change at a lot of levels and will need patience. But with enough time, skill and money, this hospital can be saved. For the sake of the emergencies in your lives, you need this facility.

I don't like to see anyone hurt, even Wayne Dodwell. Yet, if WillBee is right about Dodwell being terminated, I'd have to call it poetic justice. So, so many people have been fired or forced out since Dodwell arrived Downeast. (I'm one). Perhaps some of it was justified, but most of it was not. So, for his own healing and the healing of the rest of us, perhaps Dodwell needs to know and see how it feels to be rejected completely. Maybe he'll find a way to make a statement to at least tell the scores of wounded employees and ex-employees that he was wrong and he is sorry. Maybe he won't. But he ought to. That would be a good starting point for ALL of us. I think Raysgirl has a good point, too. Perhaps EVERYONE should get a pink slip and at the same time be given the opportunity to re-apply. . . . and some neutral team appointed by DHHS could look at QUALIFICATIONS and staff up again.

RE:Jonesportdevil

YOUR POST "We have to laugh because this so called supervisor was thought they was sooooooooooooo smart (we ALWAYS knew what was going on little did that f***tard know) lmao ask yourself who the h*** is stupid enough to use their pet's name for a password!?! Hope some of the lies and stuff she wrote doesnt' come back to bite her on the a**

I think you should really consider the ramification of your post. Is hacking legal?...Guessing that your super used her pet's name as a PASSWORD???Oh-oh

The trustees at DECH had ample opportunity to hear the staff (the ones who dared to speak) and the towns people. They had the opportunity to hear Quorum. They had the opportunity to hear the perspective of some excellent physicians. They had the opportunity to hear what CMS had to say -- and JCAH-O. But the voices were to little avail for years. The majority of the trustees bought into the wrong side on this one. Even some of the physicians lined up with the wrong side. The ones who stood for reason and ethics were fired or forced out. Even volunteers were dumped. Many excellent, experienced professionals moved away or had to commute to work elsewhere. This is a tragedy beyond belief.

To me the bottom line is the old adage, "where there is smoke, there is fire". There was a lot of smoke, folks, and too many people turned a blind eye to it. That's the sad fact.

All that I hear from the Republicans is whining, moaning and complaining about Obama spending money, ruining the health care system, blah blah blah... I am sorry but the hero and savior GWB didn't do a damn thing to help this country. Obama may not necessarily be our answer either, but I am taking a wait and see approach instead of drink the Limbaugh kool aid. Conservatives had eight years and royally screwed things up.

There is a problem with the health care system in this country. I think a blend of private and public medicine is the solution. Just last week, I spoke to a Canadian colleague about his opinion of health care in Canada. While he said that something like a knee operation may take 6 to 9 months to schedule, you DO have the option to pay for expedited service. Overall, he is very pleased with their system (as are most others whom I spoke to in the past) For those of us not covered by ANY insurance in the states (I have coverage again after a three year lapse), I'd rather wait 6 to 9 months for a surgery then NOT have any surgery at all.

Everyone needs to make money but the medical profession needs to stop thinking like a corporation , and get back to the basics of helping people starting with DECH.

downeastdave: I agree. I heard something on the news last night from a head doctor at a hospital in England. He said, on the whole, he would choose their healthcare system over what we currently have here in the U.S. He did not sugar-coat, though, and admitted things are not perfect with the healthcare in the U.K. He said he thinks President Obama can come up with something novel that combines the best of different healthcare systems.

Oh, the naysayers. It will keep on....but do not believe it will get them very far. You can sort of read between the lines sometimes and it almost seems visceral, and more than just a disagreement on the part of some Republicans with Obama's policies. See a comment above....these "God' comments,etc. So pathetic. I think sometimes it is their way of trying to be insulting .....seems almost like a desperate ploy. I like our President but sure have never seen him as some kind of flawless human being (far from it!) I just cannot believe it sometimes!! (some of those comments.)

Do you really want to reduce the cost of health care? Has anyone look at the cost of malpractice insurance of late? Has anyone looked at the cost of a "medical" step stool or patient exam stool is? Why do these items cost so much? Because we are a suit happy nation. Want a quick buck? Sue someone and the insurance company just might settle out of court to make the claim "go away". Ever look at the wording on a McDonald's or Dunkin’s cup of coffee says? Caution: This container may contain hot liquid"! How about the cap on a Batman costume? "This cap not meant for flying"! If you want to rein in cost, limit the frivolous lawsuit.

So, do I understand from the article that Ouorum recommended certain procedures that the Board choose to not do? WHAT DOES THIS MEAN? And did I read that Quorum recommended certain leadership changes which were also ignored or discarded? WHAT LEADERSHIP CHANGES?

And yes, lets get the GOD references out of this discussion. This very serious situation requires thoughtful discussion....get our president, Rush L., and again, god off the table. Lets see if these Ouorum statements can be reported on. I am very curious what that is all about.

Ha! The Quorum statements mean they see the end of the road and are tossing Dodwell and the board over the side to save their own much tarnished reputation. YET, Quorum did send 'consultants', well paid syncophants with fine sets of teeth to 'help'. They even had a 'crisis communications expert' which translates to a paid liar and cheerleading coach.

It is all falling apart now and I am pleased with it. Perhaps it can be rebuilt. They have hurt so many people, most of them people who stood up and said, 'wait, this is wrong!'.

To downeastdave, chersully2000, & others who think socialized medicine will be great: You state that in Canada "you DO have the option to pay for expedited service". Only if you are wealthy can you afford most procedures these days and there aren't many of those people in Washington County! I am not a Republican but even I see the reading on the wall. We have already been screwed by Obama and daily it just keeps getting worse. In four months he spent more money than ALL the Presidents in the Country together have ever spent! And they are already telling us those that already have health insurance can expect to have added on to their costs, the costs for "free" health care. Maybe it is all of you who should start reading or listening to the news that isn't in love with the dude. Try going to Congress's website and start reading the bills they are passing without reading to see what your future holds, it is VERY SCAREY!

And if you think about it, we already have free healthcare for those that don't have it. All they have to do is go to an ER and they get what they need instantly and rarely pay the bill.

My Mother received a letter just this week from Medicare telling her they will no longer provide vitural colonscopies which according to her Doctor is the only kind she can have unless she has a death wish. The procedure that my father had 3 years ago (a dead asending colon removed) saved his life. It won't be offered to people with the new health care plan because he was 87 when he had it. YET here he is, alive and very well, feeling like he's 60 again.

Regarding DECH: I'm glad they have been here. They saved my husband from having his foot amputated; they saved his life from a heart attack, and they saved my daughter's and my life when she was born. For all their faults, it sure has been great to have them within a two mile radius because none of us would be alive today if they hadn't been. So when they close, you'd better hope you and your family won't need immediate care.

mainelifer: Glad to hear of your husband's good experience at DECH. I do not think it is all black and white. It seems many have complaints about the place, and others have positive things to say, as you do. Let's hope they work things out and come out of it stronger than ever.

You Obama people are idiots headed for slaughter taking the country down with ya's.

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