Later On

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She Needed Lifesaving Medication, but the Only Hospital in Town Did Not Have It

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Another report from The Best Healthcare System in the World™ (which the GOP is determined to make worse), this one by Brianna Bailey, The Frontier, and Maya Miller, ProPublica:

Mabel Garcia had just said good morning to her grandson, who slept overnight in a chair near her hospital bed. Then suddenly, she stopped talking.

The right side of her face sank and her eyes fluttered as nurses at Memorial Hospital of Texas County in Guymon, Oklahoma, surrounded her bed. Her mouth gaped open.

“Mabel. Mabel. Can you look at me?” a nurse asked.

Her grandson, Fabian Daniels, used his cellphone to record while hospital employees attempted to get the 67-year-old to respond. He quickly texted his mom, who was at work waiting to hear how Garcia was feeling a day after she checked in with dizziness and chest pains.

“Mima is not talking to them right now,” the 17-year-old wrote early that Thursday morning in April 2019.

“Why?” asked his mother, Jennifer Daniels.

“They don’t know. She was talking a little bit ago,” he replied.

Health care professionals at the hospital, which sits in a remote part of Oklahoma known as No Man’s Land, determined that they couldn’t provide the “higher level of care” Garcia required, according to medical records reviewed by The Frontier and ProPublica. They called an ambulance to drive her to an airstrip where a medical helicopter took her about 130 miles south to a hospital in Amarillo, Texas.

More than 3½ hours after her initial symptoms, doctors at BSA Hospital in Amarillo found that Garcia had a stroke. They gave her Activase, a time-sensitive medication that helps break down clots, but told her daughter that too much time had elapsed since her initial symptoms.

Garcia had suffered brain damage.

“They said the result would not have been as bad if she had been treated sooner,” Jennifer Daniels said, recalling her conversation with doctors. (BSA hospital did not return requests for comment.)

Surrounded by 2,000 square miles of prairie and dotted with small farming communities, Memorial Hospital is among at least 13 facilities in the state that hired private management companies based on promises of financial turnarounds but were instead left scrambling after sinking deeper into debt, an investigation by The Frontier and ProPublica found.

The hospital cycled through four management companies in five years, including Synergic Resource Partners, which managed the facility until days after Garcia arrived. Memorial Hospital laid off about half of its staff, shuttered its obstetrics department and stopped stocking lifesaving drugs to treat strokes, heart attacks and rattlesnake bites in the 1½ years Synergic Resource Partners was in charge, according to interviews and records.

Records do not show whether hospital staff members diagnosed Garcia with a stroke or if they determined that she needed Activase. But even if they had, the hospital didn’t have the medication, according to Maria Puebla, the drug supply room manager, and Dr. Emmanuel Barias, who served as the hospital’s interim CEO from late April 2019 to March 2020. They said the hospital ran out of its supply in March 2019.

The hospital’s board has since cut ties with the company and taken control itself. Even with new leadership, efforts to repair years of financial strain under multiple management companies have grown increasingly difficult as the hospital faces a new challenge: The county has the highest rate of COVID-19 cases in Oklahoma. Patients have been sent to other hospitals because the facility in Guymon does not have the staff to handle the increased numbers.

Rochelle Leyva, chairwoman of the hospital board, blames a parade of management companies for the facility’s financial troubles. “I don’t think they’ve been here for the right reasons,” Leyva said.

Doug Swim, the owner of Synergic Resource Partners, declined interview requests.

Barias said he approached the supplier to try to purchase more Activase after taking the helm of the hospital but was told he would first have to pay off outstanding debts. The hospital could not afford to purchase the medication until July, Barias said.

Months earlier, in January 2019, state health inspectors released the findings of an investigation that revealed the hospital failed to provide basic emergency care, turning away one stroke patient because it did not have Activase. In response to the investigation, hospital officials said the facility kept Activase in stock but only used it for heart attack patients.

Officials pointed out that as a low-level stroke center, the hospital is only required to assess, resuscitate and provide emergency intervention for stroke patients before transferring them to hospitals with more resources. But Memorial Hospital used Activase for stroke patients before falling behind on payments and is again using the medication now that the facility is controlled by the county government.

Hospital officials declined to talk specifically about Garcia’s case, but Dr. Martin Bautista, a physician and the current chief of staff, said keeping the medication on hand to treat stroke patients is vital to achieving the hospital’s mission, which is providing access to critical care. Transferring patients to a larger facility can take more than an hour. The wait, he said, could cause permanent damage to the brain.

“That’s the difference between a for-profit and a not-for-profit community hospital,” Bautista said. “If we can’t serve our elderly people who’ve paid taxes all their lives, then we shouldn’t be open.”

Mounting Bills and Cuts to Services

Synergic Resource Partners was hired to run Memorial Hospital in October 2017 after Swim, an attorney from Oklahoma City, promised leaders in the meatpacking town of nearly 11,000 people that he could inject up to $2 million into the hospital’s coffers, according to former board members and Mike Boring, Texas County’s district attorney.

The offer from Swim, who had never run a hospital, arrived just as county officials were considering closing the facility. Across the country, rural hospitals face dwindling numbers of patients, shortages of doctors and nurses and low reimbursement rates from the federal government that place them at high risk of closure. Nearly 130 rural hospitals, including nine in Oklahoma, have closed in the past decade. . .

Continue reading.

Wealthiest nation in the world, but that’s for the wealthy.

Related:  Deep-Red Oklahoma Narrowly Passes Medicaid Expansion

Written by LeisureGuy

1 July 2020 at 1:47 pm

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