Ray Mariano to St. Vincent Hospital: Get it right this time for the patients

I thought they had settled this. After a 301-day nurses strike, I thought that the St. Vincent Hospital administration and its nurses had agreed to staffing that would make the hospital safe. When they signed an agreement on Jan. 3, 2022, I thought that issues of patient safety were behind them.

Unfortunately, according to some nurses at the hospital, that’s not the case.

Too many patients

Over a six-month period, starting July 1, 2023, nurses at the hospital filed more than 600 complaints citing serious deficiencies and increasingly dangerous conditions at the hospital — most relating directly to insufficient staffing. After getting nowhere with hospital administration, the nurses union filed complaints with several state and federal regulatory agencies.

For most of us, going through the complaints and trying to understand the value of things like cardiac telemetry boxes and the number of nurses assigned to a particular unit can be hard to evaluate. But one of the nurses described their concerns in straightforward language.

At a January press conference announcing that their complaints had been sent to state and federal agencies, Marlena Pellegrino, RN, a nurse at the hospital with 37 years of experience, spelled out the problems using words all of us can understand. She said that “on too many days and too many shifts, too many patients were being left unattended and unmonitored. Too many patients were not receiving their medications on time or at all.”

I admit that I cringed when she said that “too many patients were left to lie for hours soiled in their own urine and feces.” She reported that far too many patients are suffering falls and that too many are placed at risk for preventable bedsores and infections. Then she asserted that “tragically, some are dying from want of care from one of our nurses.”

According to the MNA, there have been nights in the emergency department when only four nurses were responsible for more than 100 patients, including critically ill patients, in need of monitoring for a stroke or heart failure, who were waiting for a bed in the ICU and behavioral health patients, some at risk of suicide or who were potentially violent.

These are incredibly serious charges.

The nurses filed complaints with the Department of Public Health Division of Healthcare Quality, the Joint Commission, the Centers for Medicare and Medicaid Services and the Mass. Board of Registration in Nursing. The Joint Commission, which accredits acute care hospitals, conducted an onsite review in February and found the hospital “to be noncompliant with applicable Centers for Medicaid and Medicare Services (CMS) Conditions.” Ultimately, that could put the hospital’s accreditation in jeopardy.

Additionally, Joint Commission investigators from the Department of Public Health are also investigating complaints involving incidents of patient harm.

Since their initial press conference in January, nurses have filed more than 100 additional reports alleging unsafe conditions, bringing the total to more than 700 — every one of them is a cry for help for patients who rely on nurses for care.

St. Vincent administration response

So how does the hospital administration respond to these serious concerns? Well, I called the hospital’s CEO, Carolyn Jackson, for her side of the story. Guess who never returned my call?

But I do know that Jackson’s initial reaction to the complaints was to start firing some of the nurses who complained. First, she fired Marie Ritacco, a nurse with more than 40 years of experience serving the patients at St. Vincent. It’s no coincidence that Ritacco was a vocal leader during the nurses strike and that she handled contract grievances for nurses in the months after the strike ended.

An independent arbitrator wasn’t fooled and ruled that the firing was unjustified and “an act of punishment and thinly veiled retaliation.” The hospital was ordered to reinstate Ritacco.

That didn’t slow Jackson down. Last month, after the nurses filed their complaints with the Board of Registration in Nursing and other agencies, three nurses in the emergency department involved with filing the complaint were fired. Then six more nurses, including the co-chair of the nurse’s bargaining unit, were suspended without pay. They all had objected to unsafe conditions for their patients. Ultimately, the hospital terminated the six nurses who had been suspended.

Tenet’s record

I don’t really have a problem with “for-profit” health care. Just like any other company, Tenet Healthcare, St. Vincent’s parent company, has a right to make a profit. But I do have a problem with the way that Tenet has made its money.

In 2020, Tenet and an affiliated hospital agreed to pay $1.41 million “to resolve allegations that they violated the False Claims Act by knowingly charging Medicare for implanting unnecessary cardiac monitors.”

In 2016, Tenet and two of its subsidiaries were forced to pay $513 million “to resolve criminal charges and civil claims related to a scheme to defraud the United States and (for paying) kickbacks in exchange for patient referrals.”

Consumer Watchdog published a story titled “Profile of a Repeat Offender: Tenet Healthcare Corporation.” According to the story, Tenet pleaded guilty “to federal conspiracy charges for paying kickbacks and bribes to doctors.” It paid $375 million to settle the charges.

But all of that is small potatoes. According to online reports, Tenet posted a gross profit of $16.9 billion in 2023 with an operating income of $2.4 billion. Not bad for a company with such a dubious record.

So Tenet keeps making billions while nurses struggle to reach patients who need their care. And the company cash register couldn’t be happier.

Email Raymond V. Mariano at rmariano.telegram@gmail.com. He served four terms as mayor of Worcester and previously served on the City Council and School Committee. He grew up in Great Brook Valley and holds degrees from Worcester State College and Clark University. He was most recently executive director of the Worcester Housing Authority. His column appears weekly in the Sunday Telegram. His endorsements do not necessarily reflect the position of the Telegram & Gazette.

This article originally appeared on Telegram & Gazette: Ray Mariano on allegedly unsafe conditions at St. Vincent Hospital