Kaweah Health’s state-of-the-art emergency department is sitting vacant and unused as the medical center awaits approval from state regulators, who have raised concerns about the hospital’s ability to adequately staff the $35 million expansion, CEO Gary Herbst said.
Kaweah Health unveiled its emergency department expansion in an April media tour. Hospital leaders at the time said they expected to begin treating patients at the new facility by the end of the month.
Three months later, the new wing of the ED remains empty. Herbst believes the delay is connected to two incidents of drug thefts by emergency staff, which Herbst announced publicly in a July 9 blog post.
Nationwide nursing shortages driven by the coronavirus pandemic will also see the size of the ED reduced once certified, Herbst said.
The California Department of Public Health raised concerns about supervision and staffing levels at the hospital’s existing emergency department following two instances of drug thefts that happened over the past year, according to Herbst.
CPDH declined to comment on the potential expansion, citing department policy.
The first instance involved a medical scribe who stole Propofol, a powerful anesthetic and sedative, from a dead patient’s IV pole. The scribe was later found dead in the emergency department’s bathroom after overdosing on the medication, Herbst said.
The medication is the same that killed Michael Jackson in 2009.
The second incident involved a longtime anesthesiologist director who was ordering inflated doses of fentanyl for patients and stealing the excess medication for personal use. Fentanyl is a potent synthetic opioid subject to strict controls and regulations. The physician is on medical leave and not currently practicing.
He resigned his post as part of the group of doctors practicing at Kaweah, Herbst said.
Neither incident compromised patient safety, according to the hospital’s own investigation, Herbst said.
The hospital self-reported both incidents to the Centers for Medicare and Medicaid Services, triggering a federal investigation that revealed the hospital was not following its own policies and practices.
“The cumulative effects of these systemic failures had the potential to negatively impact the safety and quality of care, treatment, and services of the patients, staff, and the public,” the CMS report concluded.
Herbst called the results of the investigation “deeply disappointing.”
The hospital submitted a plan of correction that was accepted by state and federal regulators on July 9. Changes include restricting staff who have access to patients’ rooms when alone and keeping all syringes behind lock and key.
State inspectors recently completed a “validation survey” to determine whether the hospital is properly implementing its plans, but their report is not yet available, Herbst said.
If the inspection is favorable, the ED could open by mid-August, Herbst said.
According to Herbst, the state’s other objection to the ED expansion is a lack of nurses available to staff it.
The new wing of the ED would bring the hospital’s total number of emergency beds to 73.
In order to comply with staffing requirements, however, the hospital will likely have to temporarily close two older wings of the ED. The number of beds would then be 57.
“Certainly, our desire and our goal is to get full staffing of those 73 beds. But until we get there, we can’t legally and safely open all 73 beds,” Herbst said.
Herbst said opening the new wing is a priority because it will increase comfort for guests and improve workflow for emergency staff.
When the hospital planned the $35 million expansion, long before the coronavirus pandemic, Herbst said there was a glut of nurses.
Now, hospitals across the country are grappling with a shortage of nurses as many leave the profession because of the stresses of the pandemic. The emergence of the Delta variant has strained hospitals in the midwest, so the hospital’s usual supply of traveling nurses has also dried up, Herbst said.
The timing has been a challenge for the hospital. Many patients delayed necessary procedures during the pandemic and are now flocking to the hospital in large numbers for critical treatments.
The hospital is above 90% occupancy, Herbst said, an unheard-of number for this time of year.
Joshua Yeager covers water, agriculture, parks and housing for the Visalia Times-Delta and Tulare Advance-Register newspapers. Follow him on Twitter @VTD_Joshy. Get alerts and keep up on all things Tulare County for as little as $1 a month. Subscribe today.