Philadelphia Inquirer

Fri, Jan. 23, 2004

MCP staff says Tenet ignoring order to stay open

Staffers testified administrators diverted patients to other hospitals.
They were ordered to consult with medical staff first.

By Josh Goldstein
Inquirer Staff Writer

 

The battle over the closing of MCP Hospital returned to court yesterday at a hearing over whether Tenet Healthcare Corp. has violated a Philadelphia judge's orders temporarily barring it from taking action to shutter the hospital.

With testimony from three of the East Falls hospital's doctors and a nurse, lawyers representing the Association to Save MCP tried to show that Tenet was reneging on its agreement - and Judge Matthew D. Carrafiello's orders - to keep the hospital fully functioning.

"It's been like a ghost town," testified white-coated Philip S. Mead, medical director of the MCP emergency department and president of the hospital's medical staff.

Last year, Tenet announced its plan to stop taking new patients at MCP at the end of February and fully close the 153-year-old hospital by March 31. Tenet said MCP was losing $5 million a month.

Mead said that the hospital had "been on divert" status - sending ambulances to other hospitals - at least 30 to 40 times since Carrafiello ordered Tenet not to take actions to close the hospital more quickly.

"No ambulances are coming," he said. "I have not been consulted once... . You should not have administrators making decisions about public health."

Tenet's witnesses and attorneys argued that the hospital had lost more than 90 nurses since Dec. 30 and was only diverting patients to other hospitals when it was unable to guarantee it could adequately staff its inpatient beds.

Rebecca Horvath, the director of quality management at MCP for the last nine years, testified that "patient safety" was the only consideration.

In his cross-examination of Mead, Tenet attorney Robert Nicholas cited an affidavit from Tenet that showed the number of patients at the hospital had been as high as 95 since Dec. 30 and was consistently higher than the 70 patients in the facility on Jan. 8, when the judge ordered Tenet "not to take any action to implement the closure."

The Save MCP group has asked Carrafiello to fine Santa Barbara, Calif.-based Tenet - the nation's second-largest hospital company - $1 million a day for restricting access to the emergency room or for using that area to hold patients who should be admitted.

Yesterday, Horvath admitted that she had not consulted with a doctor "every time" the hospital was placed on divert status.

The lack of patients clearly frustrated emergency-room head David K. Wagner, who testified that he called MCP's chief executive officer and told him: "We need a deck of cards because you won't let us have any patients."

At the time, only two patients were in an emergency room that could handle 23 people, but MCP was on divert status, Wagner said.

At the end of the more than two-hour hearing, Carrafiello ordered MCP administrators to comply with the hospital's written policy to consult the medical staff before diverting patients.

Echoing Mead, Carrafiello said the decision to divert "should not be made by administrators."

And the judge further ordered that the requests of administrators, the doctors' responses, and the ultimate decision be fully documented.

At that point, those packed in the overflowing courtroom in City Hall burst into applause.

Tenet spokesman Jeff Jubelier said: "We must abide by that policy."

The judge asked that both sides submit additional testimony by affidavit or deposition, saying that he would hold a conference on the matter in one week.