Regulators reopen investigation into Saint Vincent Hospital, amid union complaints & whistleblower lawsuit
Photo | Matt Wright
Nurses from the Massachusetts Nurses Association went on the longest-ever nurses strike in the state's history in 2021. The Massachusetts Department of Public Health launched its latest investigation into the hospital in June.
The Massachusetts Department of Public Health has relaunched its investigation into patient safety at Saint Vincent Hospital in Worcester, after the union representing nurses complained the for-profit hospital was no longer following the corrective plan stemming from the original investigation.
Additionally, the hospital now is embroiled in a whistleblower lawsuit filed on behalf of Carla LeBlanc, a former Saint Vincent nurse who was fired on May 1, over comments she made on a podcast about dire patient conditions.
DPH and the Centers for Medicare & Medicaid Services launched a joint, unannounced investigation into Saint Vincent in January following numerous complaints filed by the Massachusetts Nurses Association, the labor union representing nurses at Saint Vincent’s, claiming unsafe working and staffing conditions.
The investigation determined the hospital was not in substantial compliance with requirements of quality assessment and performance improvement program; and nursing services, according to the agencies’ report from Feb. 12.
Identified patients throughout the investigation were put in immediate jeopardy: a term defined by CMS as a situation in which noncompliance by providers, suppliers, or laboratories put patients at risk for serious injury, serious harm, serious impairment, or death, according to CMS’s website.
The report found Saint Vincent failed to ensure an adequate amount of licensed registered nurses were providing care to meet patient needs, drawing a connection between this shortage and three patient deaths.
“Due to a lack of nursing staff and ancillary nursing staff, hospital nurses were given multiple tasks resulting in patients not receiving monitoring as ordered nor necessary care,” said the report.
DPH and CMS found a number of nursing services were out of compliance in a sample of 21 patients, including instances when patients were not monitored during in-facility care and transportation, staff failure to comply with nurse-to-nurse hand-off requirements, and failure to report incidences per hospital policy.
Many of the deficiencies cited in the report were executed under the supervision of the hospital’s former Chief Nursing Officer Denise Kvapil. Kvapil left the position in February, according to her LinkedIn profile. Saint Vincent’s former CEO Carolyn Jackson also made her swift exit that same month.
Saint Vincent responded to DPH/CMS’ report by outlining a plan of correction, and a follow-up, on-site investigation on March 11 found all deficiencies related to the investigation had been corrected, according to a DPH report filed on the same day. The investigation was then closed.
MNA union is now vehemently contesting this determination, claiming in a May 11 letter to the Massachusetts Executive Office of Health and Human Services that Saint Vincent’s management has failed to effectively implement its plan of correction.
The letter lists a sampling of 35 violations that had been submitted to the MNA, and some to DPH, detailing incidents of insufficient staffing leading to inadequate care and patient injury.
Examples included:
- Feb. 2: Patients requiring continuous cardiac monitoring were unmonitored due to lack of available telemetry boxes.
- Feb. 8: One RN and one float RN were responsible for 15 infants and three special-care newborns.
- Feb. 23: A fall-risk patient did not receive required continuous one-on-one monitoring, leading the patient to fall and sustain a closed head injury.
- March 22: No telemetry tech or RN monitored telemetry
- April 5: Twenty-one patients were left in the waiting room without an RN as none were assigned to the triage/waiting room that night.
- April 27: A newly graduated RN was taken away from orientation early and given procedures to perform that she had not been oriented to, including blood transfusions.
When reached for comment, a spokeswoman for Tenet Healthcare, the Dallas-based owner of Saint Vincent, declined to address the specific allegations but pointed out U.S. News & World Report ranked the hospital as the 11th best in the state and second best in Worcester.
“These patient safety concerns have persisted because SVH management's response and stated plans of corrective action submitted to CMS were inadequate or only implemented for a brief period following DPH/ CMS investigators being onsite,” Mary Susan Howlett, MNA staff member, wrote in the letter to EOHH. “Patient safety continues to be at risk and nurses are placed in precarious circumstances on a regular basis.”
Howlett finished her letter by imploring DPH and CMS to return to Saint Vincent’s to observe what she referred to as ongoing violations and sheer disregard by management.
After receiving the letter, DPH launched a new investigation into Saint Vincent in June, but DPH officials could not provide additional information until the investigation was complete.
“We greatly appreciate that the DPH is continuing to investigate care conditions at St. Vincent Hospital and hope that they will hold Tenet accountable for addressing the staffing and other issues that have contributed to the unnecessary pain, suffering, and even deaths patients have suffered as a result of their callous practices over the last 18 months,” David Schildmeier, MNA’s director of public communications, said in an email to WBJ.
MNA finds it hard to believe that the hospital continues to fail to appropriately address the issues found in the DPH/CMS’ initial report, he said.
“Given this situation, as well as the conditions experienced by nurses at other Tenet facilities in Massachusetts (MetroWest Medical Center's Framingham Union Hospital and Leonard Morse Hospital in Natick), we believe the DPH should assign regular monitors to all the facilities to ensure Tenet adheres to appropriate patient care standards,” said Schildmeier.
The whistleblower lawsuit filed Aug. 1 in Worcester County Superior Court stems from the firing of LeBlanc. LeBlanc’s termination came three months after she appeared on the Worcester-based “Outdoor Cats Podcast ” on Feb. 6 after Jackson left the hospital’s leading position.
“At this point, I'm not confident that things will be changing for the better. You know, I've learned over the last few years that I can never be confident that this company is going to do the right thing. But … in my opinion, I don't think that necessarily Carolyn Jackson's the biggest problem in that building. And the CNO is for me, the riskiest for patients in the community. It's her directives,” LeBlanc said on the podcast.
Saint Vincent gave LeBlanc’s comments on the “Outdoor Cats Podcast” as the sole reason for her termination.
“During an interview on a podcast, you made disloyal, reckless, and maliciously untrue statements attacking the Hospital and its services. As a result, the hospital has determined that there exists just cause to terminate your employment effective immediately,” said LeBlanc’s termination letter.
The lawsuit looks to acquire damages from Tenet Healthcare and Saint Vincent with interest, reinstatement of her former position with full benefits and seniority rights, litigation costs, and a permanent injunction to restrain continued violations, according to court documents.
“As a nurse and a union leader, I have a professional and ethical responsibility to advocate for my patients and to do whatever is necessary to protect them from harm,” LeBlanc said in a Monday press release from the MNA. “While frustrated and angered by Tenet’s corporate decision to terminate my employment, I intend to fight this decision in my continued effort to stand up for what is right and just, not only for me, but more importantly, for all nurses who choose to stand up and speak out against unsafe working conditions that threaten the safety of the patients we have given a solemn oath to serve.”
Mica Kanner-Mascolo is a staff writer at Worcester Business Journal, who primarily covers the healthcare and diversity, equity, and inclusion industries.
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