Employees are starting to give a glimpse at just how cover-ups and vicious politics override patient care priorities at  San Bernardino County-owned and operated Arrowhead Regional Medical Center (ARMC).

Threatening physicians, profiteering, and strong-arming have become commonplace at the struggling hospital.

The Center for MediCare and MediCaid Services (CMS) has threatened to terminate reimbursements to the facility on July 31, 2010 if corrective action is not taken related to patient care.

Expect a surprise inspection soon.

Western University of Health Sciences

ARMC is a teaching facility affiliated with Western University of Health Sciences in Pomona.

Western University provides ARMC with Residents who are to be supervised by trained physicians. Residents rotate through the various services such as medicine, obstetrics and gynecology, orthopaedic, surgery, etc.

Disturbing practices are being alleged by employees.

Residents routinely perform procedures without the supervision of a licensed physician. The physician still bills as if they were in attendance and supervising the work.

Also, Western University pays the County of San Bernardino $380,000 as a part of their agreement with ARMC. Interestingly, the funds are reportedly flowing into the pocket of the Medical Director ($300,000) and the Vice Chair of Neuro-Surgery ($80,000).

Preferential Treatment

On another front, allegations have surfaced alleging preferential and cost-free treatment has been provide to various county officials.

Within the past few weeks ARMC Information Services guru, Mr. Colin Goodrum, has been interrogating employees over information access and registration of the those county officials. The facility is apparently attempting to retroactively load visit information into the ARMC charting and admittance system in an effort to make it appear everything is above board, when in actuality the situation is far from it.

Employees are being required to sign confidentiality agreements and being ordered not to answer questions related to the appearance of the officials, who have appeared at the facility for treatment. Something the Health Insurance Portability and Accountability Act (HIPAA) of 1996 would already prevent.

It’s also alleged that administrators, including former County Administrative Officer Mark Uffer ordered charges and bills placed for collection “fixed” and wiped out.

Violation of Purchasing Rules

The turmoil surrounding the anesthesiology services contract affecting more than 30 professional providers seems to be widening.

In 2008, the Chief of the Anesthesiology Services forwarded concerns over patient care which elevated over the head of Medical Director Dr. Dev GnanaDev. That individual started a chain of events that would lead to the non-renewal of his medical group’s contract next month.

GnanaDev did not use the county purchasing Request for Qualification (RFQ) process, but instead conducted his own handpicked recruitment.

GnanaDev went directly to Dr. Alfred Ma, Chief of Anesthesiology at Riverside County Medical Center. In addition, Dr. Robert Martin, Chair of Loma Linda Anesthesiology was also approached.

Ma responded with a proposal. Martin declined and in his place Dr. Cal Collier responded. Collier works under Martin at Loma Linda.

Ma has already been making it known he will be taking over the anesthesiology service at ARMC in July.

None of this process has made it before county supervisors.

It’s GnanaDev’s position that all the physicians work for him, not the county.

Concern over leaks

Amazingly, but of no surprise, the biggest concern within San Bernardino County government appears to be that of information leaks to media outlets. Particularly issues involving patient care.

Pressure to support

Various activities have commenced at ARMC in an effort to encourage what is described as support at gunpoint for primarily GnanaDev and his staff. The effort is being orchestrated by Dr. David Lannum, head of the medical staff.

Lannum works for GnanaDev.

Political Involvement

Politics plays a factor in the dealings at ARMC. GnanaDev plays in politics and makes it clear to everyone he does. From boasting of controlling three votes on the Board of Supervisors, to directing campaign contributions to them, GnanaDev is an active player. He’s perceived by some as caring more about being a mover and shaker than medicine.

Tens of thousands of dollars in political contributions appear on the campaign finance disclosures of county supervisors from ARMC-affiliated medical groups. People believe at the suggestion of GnanaDev.