This is part three in a series of stories regarding the deterioration in San Bernardino County-owned Arrowhead Regional Medical Center (ARMC).
So far we have covered the degradation of the Emergency and Surgery Departments.
Now let’s take a look at overall management.
Serious issues centering around Dr. Dev GnanaDev, Medical Director, have emerged that may lead to GnanaDev’s ultimate departure.
GnanaDev is also immediate past President of the California Medical Association (CMA).
Some of the serious issues raised are as follows.
1.) The ARMC Medical Director and/or associates are maintaining privileges and other responsibilities at other local medical facilities. The question of dedication, loyalty, and conflicts of interest abound.
2.) The ARMC Medical Director and associates spend minimal time in the facility leading to questions of inadequate management and oversight.
3.) The ARMC Medical Director and associates engage in political activity at the Board of Supervisors level. A significant presence by Dr. Guillermo Valenzuela, Chief of OB-GYN in the area of political contributions is visible in public records.
4.) GnanaDev is reported to have boasted on many occasions in the past that he controls three votes on the Board of Supervisors.
5.) The quality assurance area is under pressure to contain serious incidents of medical malpractice.
6.) Morale in the professional nursing staff has also been damaged.
Of critical importance is the finance structure of the facility.
ARMC, like it’s predecessor San Bernardino County Medical Center is established under what is known as an “Enterprise Fund” within county government.
In other words ARMC is suppose to operate like a stand-a-lone hospital separate from county finances and in particular the “County General Fund”.
However what has happened over the past several years is questionable and troublesome. The county has dug its tentacles into the financial operation of the medical center. Rather than operate ARMC independently and have the “Enterprise Fund” contribute money back to the “County General Fund” when available, county management has instead forced ARMC to utilize county services while building in charges to ARMC for the services provided.
It’s a slick way of forcing ARMC to subsidize “General Fund” departments, especially purchasing.
The purchasing aspect of ARMC is described as a mess. Why would a “Level -1″ Trauma Center utilize the “Red-Tape” bureaucracy of the county purchasing department instead of the facility employing buyers familiar with the health care field. Having county purchasing involved in ARMC procurement increase costs to the facility.
In the area of “Specialty” medical group contracting, GnanaDev wields a sharp knife. As mentioned previously in this series, any sign of disloyalty by any physician who runs a contracted specialty group is subject to the wrath of GnanaDev. The ending result is usually non-renewal or cancellation of the medical groups contract.
Quality of care or pricing is never the controlling factor or concern.
Sources also tell InlandPolitics the level of ineffectiveness of ARMC executive management (non-medical) is no better than mediocre, with no ability existing to keep GnanaDev in check.
Combine the above with major billing snafu’s affecting accounts receivable and you have a facility in desperate need of a turn around.
County Supervisors need to get their arms around this situation sooner rather than later.
…tic, tic, tic… Dr. Guillermo Valenzuela doing dirty work… tic, tic, tic… what they saying in sacramento dr dev? … tic, tic, tic…
Sounds like Dr. Gev was in cahoots with Jim Lindley and Mark Uffer to establish this little circle of deceit. First purchasing and now Public Health, hmmmm.
County hospitals are there to service the indigent, not compete with for profit and non profit private hospitals. ARMC has always been the wrong business model. Now maybe someone will see that.
This article series is right on point; however, it only brushes the tip of the iceberg of the fraud and abuse at ARMC. Like Gnanadev cancelling the hospitals contracts with insurance companies so his surgery group and the hospital could make more money from trauma patients. He would bill the trauma patient for more money after the insurance company paid the hospital. The motto of the hospital is bankrupting patients at every turn.
Dr. Gnanadev claims to be the godfather of ARMC, protecting his corrupt compadres from justice and giving free healthcare to county administrators.
Reminds me of the old days when Orange County had a public hospital. It was a scary place. You only went there if you had no money and there was no place else to go.
Forunately, UC Irvine started a medical school, bought the hospital, and turned the scary Orange County Hospital into the world-class UCI Medical Center.
This article series is right on point; however, it only brushes the tip of the iceberg of the fraud and abuse at ARMC. Like Gnanadev cancelling the hospitals contracts with insurance companies so his surgery group and the hospital could make more money from trauma patients. He would bill the trauma patient for more money after the insurance company paid the hospital. The motto of the hospital is bankrupting patients at every turn.
Dr. Gnanadev claims to be the godfather of ARMC, protecting his corrupt compadres from justice and giving free healthcare to county administrators.
YES INDEED.
the “county” hospital has been double billing for years….sometimes billing “again” up to five years after the event…..
Mr Uffer what say you? Were you Dev’s puppet?
Rumor has it Uffer was Dev’s puppet.
Somehow Dev had Uffer believing he was responsible for his CAO appointment.
Which leads to the question, how smart is Uffer?
LOL
tic, tic, tic… soon it will be time to face the music little man… tic, tic, tic… the show has just begun… tic, tic, tic…
What’s been swept under the rug at ARMC by medical director and his circle of fear is what the BOS are concerned about. Colonies is nothing but a game. ARMC is failure at the top for keeping patient care a priority.
I hope that the BOS and the other people who read this blog understand that the complaints being brought forward are about patient safety and about providing the kind of care that we would want ourselves, our families and loved ones to receive if they were patients at ARMC. The concerns being brought forward are valid and should be investigated…or do more patients have to be injured or even die before something is done about it?
tic, tic, tic… medical director back from wherever… tic, tic, tic… he’s seen and heard rooting around making promises to riverside docs, the folks in sacramento are busy as beavers… tic, tic, tic…
My wife had emergency @ ARMC histerectomy there,and had to have surgery
in redlands community two years later.Blood sample found metal in her blood found from a metal patch that had deteriorated in her stomach!
could not do anything about it
I was in an accident and severly broke both bones in my lower leg. The Hesperia fire dept took me to ARMC. When I got there I told them I was unemployed and had no insurance. They also knew that I did not live within SB County! After the ER checked me out, they addmitted me in ARMC where I layed in a room for 2 full days with my leg severly broken before they operated on me. During that time, they could have transfered me to a hospital within the county I lived in! It took 18 screws and 2 plates to repair my broken bones. (I have pictures of the before & after) When I asked for the detailed billing I found the price for the 2 plates which were $1,800.00 and $3,100.00 and there was another plate of some kind on my bill that had a price of over $9,000.00! I also noticed that I was being billed for a total of 25 screws which was 7 more than what were in my leg! If you don’t think thats a big deal, then consider that the cost of each screw is $903.00! Thats $6,321.00 for screws they DID NOT put in my leg! There was lots of other items in my bill that were not in my leg!
A couple of months later, after all my incesions were completely healed, a small hole opened up where one of the incisions was and starting oozing a orangish fluid so I went back to ARMC and was told I had an infection and was admitted on the spot! 2 days later, what they refered to as a clean out surgery, they actually cut a skinny foot ball shaped chunk of flesh out of my leg that was 10 inches long and 2-1/2 inches wide and went all the way down to the bone & plate! With such a huge chunk of flesh having to be removed, that tells me that the infection went into my leg when they operated on me the first time! I was in the hospital for 28 days before I was discharged with Home Health Care visits to finish the treatment of my leg. The sad part is that while I was in the hospital, the doctors told me that after my bones healed, they had to open me up AGAIN to remove the hardware because once an infection gets into the hardware, even the strongest antibiotics can not kill it! Long story short, they kept stalling the surgery to remove the hardware for so long, that my leg was showing major signs of being infected again! So Instead of a quick same day surgery, I was admitted again and put on another 6 week regiment of I.V. Antibiotics!
In the end, I accumulated over $250.000.00 in hospital bills and because I don’t live in SB county, I don’t qualify for any assistance programs and the JERKS at ARMC collections have totally destroyed my credit report! Therefore I have been left no other choice but to file for Chapter 7 backrupcy!
US Citizen:
I’m sorry for your suffering at the hands of ARMC. Unfortunately you’ve been given a glimpse into the future. The future of Obamacare, e.g., US nationalized health care.
If you are not a pregnant illegal alien, ready to pop out yet another anchor baby, they care nothing about you.
True!
Not surprised about the Feds visiting ARMC and the little man. The BOS should seriously investigate the bidding process for ARMC’S construction. Guess who carried the blueprints in his car and bragged about choosing all the vendors.
@Former_employee: Uh, Muffer? Or Carl Alban, Director of Architecture & Engineering?
Update: During the filing for chapter 7 I had to gather up all the bills I received from ARMC and the San Bernardino Countys Central collections department. While I could match a portion of the collection letters I received from Central collections with the original billings I received from ARMC by using the 7 digit account numbers (ARMC does not assign a patient a single account number in which to bill to, you get a different account number for everything), there was another batch of letters I received from central collections that have completely different 8 digit account numbers and are asking for huge amounts of money as if they had totaled several of my bills all into one. Now you might think that sounds somewhat normal. The thing is that no where on the letter does it refer to what bills/account numbers were included in that total! Some might still say not a real big deal right? Well what do you say when you receive 3 different envelopes from Central collections on the very same day. You open them up and notice that all 3 letters have the same date on them and list the same exact amount of something like $77,500.00 BUT WAIT! EACH LETTER HAS A DIFFERENT ACCOUNT NUMBER! Then a month later I receive 2 more letters on the same day with the same date, an amount of $96,800.00 and 2 more new account numbers! This went on for about 6 months! I gave all the letters to my BK attorney to include in my case. Due to all the different account numbers, everything had to be included. When it was all added up, the total amount came to over 2.1 MILLION DOLLARS! Thats right folks! For what was in reality about $250,000.00, ARMC and S.B. Central Collections Created a bunch of new account numbers and double and tripple billed me for over 2.1 MILLION DOLLARS!
The irony is that unless the FBI does something about things like this, it will allow ARMC to write that much money off as a loss and soak the county and state taxpayers for more money to cover their “Costs” than what they really spent! And gee… I wonder where that money will really end up!
My 68 yaer old mother was treated for burns on ear head neck chest and entire hand,she had plastic surgery, and skin grafting as well as shark skin grafting on fingers, I live in Illinois and was called 3 times by a doctor hershey to see when I was coming to get her that she was about ready to go home, I called when i was on my way to fly 10 hours and then drive another 150 to the hospital, I arrived and no one new any thing or when she was going home , I also advised them that I was informed she was being evicted and I had no information as to the situation at her home, I called to check on her the next day they allready discharged her without me being there I had to find someone to get there, not knowing her care or treatment or even any info on her condition by any one I was shocked to see her in such a horrible state of condition , returned for outpatient appt and was still not given any info and was run around with no proper procedure or paperwork to get supplies or info on care & hours of hell for mom, returned next day and explained still no supplies and , moms condition is getting worse and still afterall that 2 med supplies and 1 pharmacy cannot give me the proper supplies to care for wounds, the nurses and doctors were unprofessional and not qualified in or knowladgeable at all they were confused and giving us miss information this place is very dangerous and i intend on reporting my moms story and all the details to the news this place is a butcher shop ,Oh and she returns for skin grafting surgery tomorrow and plan on releaseing her i hour after surgery, I am Outraged and plan to bring this to the attention of the public and higher athorities. Oh and when I needed assistance with wheelchair and getting thru a door they asked “what did you need?” please! I had another family friend with me the whole time and we where shocked at the entire experience and never seen anything as bad as this before.