The Drug Enforcement Administration is currently investigating a case at South Big Horn County Hospital. The DEA, along with the Wyoming Department of Criminal Investigation and local law enforcement, are performing a joint investigation into possible patient safety violations.
South Big Horn County Hospital District board chairman Jeff Grant broke the news of the DEA and DCI investigation to more than 150 citizens who attended the monthly board meeting Wednesday, March 22.
The hospital is fully cooperating with the investigations.
For more than two hours the board heard concerns from local citizens, former employees and community leaders about what has been happening at the hospital. Grant stated that many of the changes that have happened in the last year at the hospital have taken place to comply with state and federal regulations.
In early March, Dr. Demar “Dusty” Hill, Physician Assistant Heather Sanders and Physician Assistant Sarah Watt all turned in their resignations. Many patients were looking where to turn following the news that their primary care providers would no longer be at the hospital.
Grant announced at the meeting that Watt had rescinded her resignation and will be staying on as a PA at the hospital.
“What do you people [not] get?” board member Sue Antley asked the audience during the meeting.
Many shouted out encouraging the board to talk to them and explain what they are missing.
“Our hands are tied. Do you understand that?” Antley said.
Many yelled out “no” to Antley’s question.
“Do you know what the DEA does?” Antley asked. “Tell me, do you understand that?”
“Yeah, they deal with drug cartels,” said Dan Kussro.
“Okay, I rest my [case] there,” Antley said.
“But what does that have to do with our local providers?” Kussro asked Antley.
“What do you think?” Antley yelled.
Many in the audience cried out saying they don’t know what it meant.
“You’re smart people; figure it out,” said Antley.
Grant then interjected with a makeshift gavel and said they should move on with audience questions.
“South Big Horn County Hospital District itself is not being investigated by the DEA or Wyoming DCI,” said CEO John Adlesich. “The District, however, is cooperating fully with their investigation.”
Love for providers
Many people in the audience had stories of providers and voiced concern over the loss of their primary care providers.
Dr. Hill, who has worked at the hospital for nearly 20 years, has found cancer in some of his patients and according to some has saved their lives and lives of family and friends.
Greybull resident Jamie Keisel addressed her concerns to the board and shared how Hill was a small-town doctor who would make house calls to her family and friends in the past.
“He will come to your house and he will sit with you and he will cry with you,” said Keisel. “You know what we love about Dusty. He chews and he cusses and if you don’t like that you can go somewhere else because that is Dusty Hill.”
Mike Laird also spoke of the good he has seen Hill do in the past. He recounted a story about a small, three-month premature baby that he rushed over in an ambulance. He talked about the work and the praying that was done in the ER to help save the baby.
“If it was not for Dusty Hill and the staff that night, that baby would not be walking today,” said Laird. “He saved that little girl’s life.”
He also added that after his son was in a vehicle accident he rushed him into the ER at the hospital.
“Sir, I don’t know if you have kids or not,” Laird said to Adlesich. “But you need to listen to the people who have kids along with the rest of the board. My son was 18 years old when I brought him in here in an ambulance. I found him in a vehicle accident. He was not breathing and I did CPR on him bringing him into this hospital. I cannot thank Dusty Hill and the staff enough for what they did for him to save six other lives. My son is not here today, but he is living today in six people and six other families are happy. Let me tell you it’s because of Dusty Hill and the staff that night. He saved six other lives.”
He also added that traveling nurses and doctors are likely to cost the hospital more money.
Randy Noble of Basin is concerned about losing providers, nurses and other familiar faces at the hospital.
“I didn’t plan on talking, but I think we are forgetting someone else here who is important who I think was treated poorly and that is (nurse) Tollyn Brewer,” said Noble.
“I have a little boy who has catastrophic health issues. Every one of those people who has resigned, Sarah, Heather, Dusty, they known my Landon. When I show up with him I don’t have to explain his entire list of issues; they know. And sometimes I don’t have time to explain that list of issues. So if we don’t have people here who are invested, who know us on a personal level… We are not some face that shows up. We are their neighbors. We are people that they genuinely care about. I’m not coming here. The last two times that Landon’s had to be treated I drove right past here and went to Cody.”
John Adlesich spoke after the meeting of concerns many in the community have about losing Hill.
“Community members are concerned about the future of their health care, particularly the loss of Dr. Hill,” Adlesich said. “Much of their concerns, however, are the result of the hospital’s inability to release specifics behind the recent investigation by the DEA and Wyoming DCI. Once more information becomes public, I believe most will understand the hospital and its board are acting in their best interest.”
Patient safety concerns
Many concerned citizens spoke to the board about instances of safety, care and negligence they have experienced at the hospital recently.
Basin resident Renee Naylor voiced her concerns after an incident occurred at the hospital involving her daughter-in-law.
“We were turned away from the emergency room,” said Naylor. “My daughter-in-law just passed away from ovarian cancer. We brought her here in December. We were told that they could not admit her because there are not enough beds.”
Naylor said they started making their way to Worland to see if they could admit her in their hospital’s emergency room. She called her daughter-in-law’s surgeon in Billings and was told by a nurse to take her back to the emergency room at South Big Horn County Hospital and that they would admit her.
“We brought her back,” Naylor continued. “The physician’s assistant stood at my daughter-in-law’s bedside. Before she got into bed she was on her knees crying in pain. I had a sour taste in my mouth. She passed away Feb. 4. I have heard lots of public comments. I hope the administration might feel like they need to fix some issues here. I just want everyone to be aware that there have been things that have happened that aren’t right.”
Basin resident Maryanna Wheeler also addressed concerns regarding her husband’s care when he was admitted to the hospital recently.
She stated that the staff was cold and uninviting and that four nurses stood behind the nurse’s station.
“The doctor just said, ’He is dying. We would like to keep him overnight.’ And we could take him home tomorrow and to call hospice. When I came the next day he was still in his clothes that we took him out there in. He said he kept telling somebody that his oxygen level isn’t right. The next day they found a hole in his hose.”
Wheeler said that in mid-March she and her family drove past the hospital and took her husband up to a hospital in Cody.
“There they met everybody in the emergency room. They kept him alive long enough for the kids. They set up food for all of us. They kept him comfortable until his last breath. Out here nobody seemed to care about him whatsoever. And to think I left him there and he was still in the clothes that I took him out in. That is disgusting. I just want people to know.”
Former nurse Margaret Dahike stated to the board that she felt like patient safety is a huge issue at the hospital. She stated she took her concerns to Director of Nursing Yvonne Bargeron and CEO Adlesich. After she reported issues to them, she stated, she became blacklisted.
“There are far deeper issues to be addressed and that is the nursing staff,” said Dahike. “I felt like my nursing license was in jeopardy.”
The hospital is conducting another interview this week for a possible provider.
“South Big Horn County Hospital District is committed to ensuring our patients receive safe care,” said Adlesich after the meeting. “Many of the recent changes are the result of this commitment and ensuring our residents receive the best care possible.
The ambulance service the hospital uses for transport has been an ongoing issue in recent months. Recently the hospital had started to use Powell Valley Hospital for transport up to Billings while letting the local Atwood’s Ambulance sit the transport out.
According to the hospital, they asked Atwood’s for a list of employees and their certifications along with a list of medications they have on the ambulance. According to Grant and Adlesich the hospital does not have a contract with Powell Valley Hospital.
Bob Paxton asked the board about a of couple of pictures he was sent by employees of the hospital. One picture was of a sign stating that the hospital could now use Cody for transports. It was dated January 2017 and signed by DON Bargeron. The second one was not dated and stated to use Powell Valley Hospital for ground transport.
“Since we do use some taxpayer money, why aren’t we using our local ambulance service for these transports?” asked Paxton. “If they are not qualified or if they need some extra equipment they don’t have on, why can’t we work with them and see if we can get this straightened out so that the money that we do pay with our taxes
goes back into this community instead of going to another community?”
Kent Dempsey read a statement from Claudine Murdoch regarding the ambulance service and her late husband Paul’s views on the local ambulance service. Paul served on the county’s rural health board until he passed away in February.
Dempsey read the following statement:
“As Paul Murdoch’s widow I would like to clarify some information that has been circulating in our community about Paul’s view related to our current rural health controversies. Paul was the chairman of the Rural Healthcare Board and there were certain issues he was passionate about. In fact on the day of his death he was engaged in efforts to continue to keep our local tax dollars within our district. There is no doubt that Paul supported our local ambulance service and the outstanding workers who serve us. He fought for our ambulance service to remain within our district until the day he died. Of course these facts have easily been turned around as we all grapple with the issues facing our local clinic and hospital and I felt like it was important to speak the truth for Paul and for all of you to hear.”
According to rural health board member Laura Huber, the matter regarding the hospital and Atwood Ambulance service has been resolved. She said Atwood’s has turned in the information the hospital requested and they are being used for transport.
“South Big Horn County Hospital District and Atwood’s Ambulance continues to work together in the best interest of our county’s residents,” said Adlesich after the meeting. “Past concerns have been resolved and we are now working together.”
Hospital work environment
Some concerns that have been circulating about the hospital have been allegations of a hostile work environment. According to a survey done by the board of directors, 12 percent of employees are unhappy or very unhappy.
Board member Margie Triplett dove into more of the statistics of the survey during the board meeting. She stated that seven questions were sent to 76 employees who were able to respond anonymously. Of the 76 sent out, 42 were returned. Roughly 33 percent had a positive view of the hospital.
Current employee Robynn Terry spoke on behalf of some employees during the meeting.
“I’m here to speak on behalf of the staff to show support for our administrator and our board of directors,” Terry said. “People do not always do well with change. Yes, we do have some staff that is not happy with the changes being made, but the majority are happy. Changes have been made for the better of this facility regardless of the information out in the community. We have complete trust in both the administrator and the board of directors.”
Connie Werbelow addressed the board about concerns of a number of people being fired or forced out of the facility.
“A person that feels appreciated will always do more than what is expected,” Werbelow said. “That is not the work environment at South Big Horn County Hospital. I’ve talked to numerous current employees and ex-employees and the common denominator they always tell me is the problem is the administration. I don’t doubt the board when they tell us there were violations and things need to be done differently. Rather than treating employees like they are a member of the team, John Adlesich has treated them as if they were disposable. I truly believe he lacks the compassion and the people skills necessary to build a positive work environment. The board is elected to represent this community and I, for one, do not believe Mr. Adlesich has the best interests of the community at heart.”
“I tell you, if I had those numbers and I’m not the math wiz that you probably are, that doesn’t sound good to me,” Dempsey said. “I would have lost my job 10 years ago if that many people were dissatisfied. I’m cautious of that and I think we really need to buckle down on what the issues are.”
This hospital and the board are going through people’s concerns and writing up written responses to some of them.
“This meeting was a good opportunity to give people the chance to talk,” said Grant. “This was not about arguing or debating. We sat back and let people speak their piece.”
“South Big Horn County Hospital District will continue to serve the residents of South Big Horn County Hospital District,” said Adlesich. “We continue to hire new staff, providers, and ensure the needs of our patients are met.”
He added that they hope to have written responses available to the questions by the end of this week.
“We will get through this and it will be good,” said Antley.