Company's 'town hall meetings' did not solve staffing problems, DaVita patient s

Company's 'town hall meetings' did not solve staffing problems, DaVita patient says

By JESSICA SAVAGE
The Lufkin Daily News

Sunday, May 25, 2008

Several "town hall" meetings held at DaVita's Lufkin Dialysis Center 18 months ago did not address health issues or solve staffing problems about which several patients and their family members had complained, said a patient who requested the meetings.

"Had they fixed the problem two years ago, I don't think it would have come to this now," said Lapika Moffett, a patient advocate who has since transferred to a DaVita center in Dallas, where she said her treatment is "excellent."
Joel Andrews/The Lufkin Daily News
(ENLARGE)
DaVita Lufkin Dialysis closed its doors April 28 after contacting state health officials and the local police department about a recent spike in patient deaths.

Michael Chee, a spokesman for DaVita, said, "We held a number of patient town hall meetings at the Lufkin (center) around November 2006. These meetings were held to introduce patients to our new location on South John Redditt Drive and to provide a forum whereby patients could provide feedback about amenities and other topics."

Moffett said she requested the meetings after having concerns, along with other patients, about the health care at the Lufkin facility. She said there were so many unanswered concerns that she suggested that the center's administration host a meeting to open dialogue with patients.

"Patient's were so concerned with what was going on, and nobody would tell them," she said.

Moffett described a variety of patients' concerns, including staff administering incorrect treatments and a staff shortage.

"At one point in time, they were very shorthanded. They had workers working more than 16 hours," she said. "When you work so hard, you start making mistakes. I know we're human, but if you make a careless mistake it can take our lives."

Moffett, who has been on dialysis for 11 years, left the Lufkin center, at 700 S. John Redditt Drive, in August 2007 after exhausting her concerns and feeling she was receiving unsafe treatments, she said.

"We take all patient feedback seriously and are committed to providing high quality patient care," Chee said. "We are very pleased to hear that Ms. Moffett is enjoying her care experience at our dialysis center in Dallas. That same experience is waiting for patients wanting to return to the Lufkin center as soon as it reopens."

The Lufkin center closed its doors April 28 after contacting state health officials and the local police department about a recent spike in patient deaths. DaVita officials have said they believe one employee, who has since been fired, is responsible for a cluster of four patient deaths. The total number of patient deaths being investigated has not been released by the local, state and federal departments investigating.

Lufkin police has said it is looking into the allegation as part of a "top-to-bottom" investigation of the facility. The state, which concluded its investigation two weeks ago, has not reopened the facility, and it is not known when it will open again. A state report is expected to be released in the coming weeks.

'Town hall meetings'

The Texas Department of State Health Services requires dialysis facilities to keep records of complaints filed at the center as well as how the company responds to them.

Moffett said DaVita officials granted her request for patient-staff meetings 18 months ago as a way to listen to patient concerns. The meetings took place on Sundays and were open to all patients and their families. Moffett said the meetings lasted a little more than a month and a half.

DaVita Divisional Vice President Jerry McNeill attended the meetings and listened to patient concerns, the patient advocate said.

Moffett said McNeill handled problems, but the solutions didn't last.

"It would go the way it was supposed to go for maybe two weeks, and then back to how it was," she said. "It was a cycle.

"Let's say, for instance, you are under fire. People would come in and put out the fire, but not completely," she said.

Moffett said the problems discussed included patients being given the wrong treatments.

"They were putting people on wrong dialyzers and not letting patients know," she said.

Concerns also included upper management at the facility.

"If (the facility) were shorthanded, they would put trainees out on the floors," Moffett said. "That was scary. It really was.

"When you are taking care of sick people, you have to care," she said.

Moffett said that while there were some staff members who worked hard and cared for patients, there were some who didn't care.

"You knew who those were," she said.

After Moffett left the facility, she said patients would continue to call her, as an advocate, and talk about concerns they had. She would pass those concerns along to staff at the Lufkin center, she said, but never knew what came of them.

'The Friday before closure'

The Friday before DaVita Lufkin Dialysis Center closed, April 25, it had 21 teammates (employees) working at the facility, Chee said.

The spokesman said the facility had five registered nurses (two who held the title of clinical service specialist, one facility administrator and two charge nurses), two licensed vocation nurses, six patient care technicians, two reuse technicians, one biomedical technician, one clinical coordinator, two administrative assistants, one dietitian and one social worker.

Those staff members cared for a total of 48 patients April 25, working in two shifts with 24 patients in each shift, the spokesman said.

The state requires End Stage Renal Disease Facilities to have a patient-nurse/technician ratio of 4 to 1 per shift. If the patient count is eight or more, during a shift, one of the licensed nurses qualified to function in the charge role shall not be included in that ratio, the state says.

"DaVita exceeded the state requirement for staffing by having double the required staff (12 clinical caregivers), Chee said. "There were 3.5 nurses for every 12 patients per shift at the Lufkin center on April 25. This also exceeds the state requirement."

Chee said the company performs background checks on all its employees and provides 10 weeks of intense training for hires with no dialysis experience. New employees with dialysis experience go through two weeks of training, the spokesman said.

"All these internal training requirements must be completed before any teammate is allowed to treat patients adequately," Chee said.

Deceased patient's family concerned with staffing

A man who accompanied his now-deceased father to treatments at DaVita Lufkin said he was concerned the center was understaffed. The man asked that his name not be used in this story.

"At the new facility they had all these stations. They just started filling the stations up, and they didn't have enough people to care for them," he said in a recent phone interview.

The man, who drove his father to treatments several times a week, said he arrived at the facility one day and found his father covered in blood.

"The blood was everywhere. He was totally soaked in blood," the man said.

By the time the nursing staff noticed what was going on, the man said, his father was barely conscious and was not aware he was bleeding.

"I think he had been sleeping," the man said.

The man said he and his mother could not get anyone at the facility to listen to them.

"For months they ran the machine too fast, and tried to take off too much weight. (Dad) would get nauseated — sometimes his blood pressure would go so low that he would almost pass out — but you couldn't get anybody to listen. There was nobody to talk to," he said.

He said his mother attended a couple of the town hall meetings.

"The meeting was held in a meeting room at Memorial," he said." There were a lot of people there, and the biggest complaint was that there weren't enough (staff)."

His father passed away shortly after a state surveyor in mid-2007 documented that the facility had administered some patient treatments against doctors' orders. The man did not want his father's death date public because it could possibly identify who he is.

"We both are beating ourselves up a little because Dad was always complaining about that mess — he hated the place — but we didn't know to question anything," he said. "We felt we had no alternative anyway.

"I don't know how much money they are making off this, but I think they could afford to train people better and make sure they 're doing what they're supposed to," said the man.

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Comments:

"For months they ran the machine too fast, and tried to take off too much weight. (Dad) would get nauseated ý sometimes his blood pressure would go so low that he would almost pass out ý but you couldn't get anybody to listen. There was nobody to talk to," he said." son of Lufkin dialysis patient

The above statement taken from the most current news article on the Lufin Dialysis deaths explains exactly how patients are worn down and die prematurely. There are numerous other incidents that occur, as the article also points out, that lead to injury and death. But this is the main scenario that occurs on a regular basis. Incompetent staff do not accurately assess patients thus they set their fluid removal rate too high. Patients are so frightened as at the end of every tx this occurs, they will become nauseated, dizzy, have strong cramps, go into shock or crash (pass out). Imagine having to go to dialysis treatments 3 times a week for life and getting treatments like this... it is horrifying!!! All trust in ones medical caregivers is gone. When patients experiencing this for the first time ask what is wrong, they are given bogus answers by the nursing staff causing them to think this is just the way dialysis is, accept it, it's normal. IT IS NOT NORMAL!!!!. THIS IS INCOMPETENT CARE!!!!. And this is how dialysis is for so many patients until they succumb to premature death, because the human body can not withstand such repeated abuse and neither can the human spirit. I have known patients who were highly educated and very successful in business and careers who could not figure out how to protect themselves from the incompetent dialysis care. I have seen a male patient who was 6' 4" crash to the floor like a tree going timber because he did not have a clue how to protect his life in dialysis. Patients have even committed suicide as a way out of this torture. Only those patients who have the ability to study dialysis and figure out what wrong things are being perpetrated on them by incompetent staff survive this ordeal. They learn to take control of the situation and insist that their treatments are set up right and all is as it should be. They are often the most hated patients in the clinic by staff who do not realize that it is their own education/training that is insufficient leading to patient deaths. Everyone who works in dialysis from the CEOs on down know this is the case, but it is NEVER EVER admitted to.

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