Parkview Vows to Pursue Lawsuit Against Doctors: State Records Show Hospital Faced Noncompliance

Thursday Jan 04, 2007

http://www.theforecaster.net/story.php?storyid=9118&ftype=search

By: Steve Mistler
Source: The Forecaster
Thursday, January 4, 2007
Page: 1

BRUNSWICK – ParkviewAdventistMedicalCenter officials are vowing to pursue a lawsuit against three departing doctors while refuting allegations of declining care and financial hardship.

While the decision to seek damages estimated to exceed $1 million against the three doctors seemingly puts Parkview back on the offensive, the hospital may find itself fending off more attacks from doctors’ attorneys, who maintain their clients are among numerous health care professionals leaving the 55-bed facility due to deficient services and quality of care.

The issue was raised during a Dec. 27 Superior Court hearing in Portland, where Parkview sought a temporary restraining order against Drs. Gregory Gimbel, Dr. Melissa Streeter and Dr. Jonathan Commons. The basis of the injunction – and the lawsuit – was that the three obstetricians broke the non-compete provisions of their existing contracts.

The provision would prevent the doctors from practicing at any hospital within 25 miles of Parkview for the next two years. Gimbel and Streeter were set to begin practicing at Mid Coast Hospital on Tuesday. Commons was moving his practice to Lewiston.

Judge Thomas Delahanty II denied the injunction, ruling that it would have an adverse effect on the doctors’ patients, including 64 women in their third trimesters of pregnancy.

During the hearing, Gimbel and Streeter’s attorney, Terrence Garmey, argued that his clients’ decision to leave Parkview was partially due to the hospital’s loss of national accreditation through the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a third-party nonprofit that evaluates and accredits nearly 80 percent of the country’s health-care facilities. Garmey also asserted that declining care, understaffing and outdated facilities inspired not only his clients’ departure, but that of Chest Medicine Associates and Bowdoin Medical Group.

The hospital refuted Garmey’s claim. “This is absolutely not true,” Ted Lewis, Parkview chief operating officer, said in a Dec. 29 press conference at the hospital. “Parkview chose through a significant study to leave the JCAHO organization.”

JCAHO spokeswoman Charlene Hill last week confirmed Parkview’s withdrawal decision came last May. She also added that Parkview was “in full compliance and in good standing prior to its decision.” Lewis maintained Parkview no longer saw value in a JCAHO survey that had become “bureaucratic and very difficult.” and that also cost the hospital $40,000 per year. He said 13 of Maine’s 33 hospitals don’t undergo JCAHO accreditation.

“Nobody would argue with the goal of JCAHO,” he said. “But in states like Maine, we are reviewed extensively through the state.”

But Parkview has had its problems with the state process, too.

On June 15, the state’s Division of Licensing and Regulatory Service received a State of Deficiencies report from a Medicare survey team highlighting scores of standards not met by Parkview. Some standards relate to obstetrics care. At least one – allowing certified nursing assistants (CNA) to perform duties outside of their scope of practice and inadequate registered nurse supervision of 24-hour nursing services – was severe enough to knock the hospital out of compliance and put it in danger of losing state licensing.

“Some of these were very serious violations,” said Cathy Cobb, director of the Division of Licensing and Regulatory Services. “There are some violations that are simply deficiencies and there are some that rise to the level of not meeting participation and licensing.”

Parkview responded with a Plan of Correction on June 27. An unannounced follow-up survey on Aug. 11 found the hospital in full compliance.

As for the claim that Chest Medicine Associates and Bowdoin Medical Group left Parkview due to inadequate staffing and care deficiencies, Garmey provided an affidavit from George Hunter, vice president of administration and human resources at Mid Coast Hospital. Hunter provided copies of two letters from Bowdoin Medical Group and Chest Medicine.

In a Dec. 12 letter to the Department of Health and Human Services, signed by Dr. Paul LaPrad, Chest Medicine said it resigned from Parkview due to an inability to “provide quality care at the institution.” It also read, “the environment was troubled by inadequate support of qualified 24-hour services in the intensive care unit.”

Bowdoin Medical Group, meanwhile, submitted a letter on Dec. 6 to Cobb stating similar concerns with the ICU, as well as episodes of “untimely attention to detail,” “delayed reporting of critical laboratory data” and actions from Emergency Department staff that “raised grounds for our uneasiness.”

Both letters were written in support of Mid Coast Hospital’s recent Certificate of Need application and planned expansion.

Neither organization would comment on the letters.

“I can tell you that the hospital had no desire or didn’t initiate their departure,” Lewis said. “Bowdoin Medical Group left in the spring, and we never once heard that quality had anything to do with their decision. Chest Medicine cited concerns regarding technology and systems in our ICU, we took those concerns seriously and we’re very proud of the improvements we’ve made there.”

Lewis also disputed claims that Parkview was in financial trouble. While he said Medicaid owed the hospital $1.4 million for 2004, he said Parkview made a profit of $640,000 last year and was $500,000 in the black to date. That surplus, he said, was “plowed back into patient care and new technology.”

Steve Mistler can be reached at 373-9060 ext. 123 or at smistler@theforecaster.net.

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