Cardiology monopoly: a lucrative game

February 3, 2010

Second in a series: Profit share versus patient care on the Central Coast

By KAREN VELIE

On Jan. 20, Barbara Williams, a retired civilian Army nurse who was born and raised on the Central Coast, went to French Hospital Medical Center in San Luis Obispo complaining of chest pains. She was sent home. Two days later, she again suffered chest pains.

On this occasion, she went to Sierra Vista Regional Medical Center, also in San Luis Obispo, and was diagnosed as having had a heart attack.

Emergency room staff transferred Williams to French where cardiologist Michael Famularo performed a balloon and a stent procedure. Following the surgery, Famularo told Williams to take it easy and see him in seven days.

However, when Williams arrived at Famularo’s office for her appointment, the receptionist explained she needed to pay them in cash because they did not accept her insurance, Williams said.

“How do you do surgery and then not see me afterwards?” Williams said with tears running down her cheeks. “He did a procedure on me and then left me out to dry.”

As access to cardiac care is dwindling in San Luis Obispo County, a number of local physicians, patients and others claim that a group of doctors and hospitals are conspiring to create a “cardiology monopoly” to the detriment of some cardiac patients.

These sources have told CalCoastNews during a year-long investigation that this monopoly – actually called a “cartel” by some critics – appears to have violated federal laws.

Concern is centered on a group of 13 cardiologists known as Coastal Cardiology (CC), and its practice of transferring patients to French Hospital Medical Center in San Luis Obispo from competing medical facilities in the county.

These cardiologists partly own the land on which French is located, leading some critics to question whether the transfer of cardiac patients to French presents a potential conflict of interest. An unknown number of doctors, including those from CC, purchased the land where French is located in 2005 and currently lease it back to Catholic Healthcare West (CHW), according to a $12-million promissory note.

Critics also allege that hospital administrators have struck a deal with CC to transfer lucrative cardiology care to French, providing financial incentives to these doctors.

Calls seeking comment from CC and French Hospital Medical Center were not returned.

Because CC transferred all but 18 cardiology patients to French in 2009, surgeons pronounced the patient volume too low at Sierra Vista to do work there.

Numerous local doctors and nurses allege that CC’s program of diverting patients has delayed care and, as a result, permanently harmed patients.

For example, a patient last year who suffered a heart attack and was subsequently transferred from Twin Cities to French, was left in a hallway for an hour and a half because the French cath lab, a cardiac patient examination room equipped with diagnostic imaging equipment, was already being used (French has two cath labs but normally only staffs one).

The doctor refused to utilize the cath lab at Sierra Vista.

Delays can cause permanent damage to heart muscles. Since the surgeons stopped providing backup to cardiologists at Sierra Vista last April, heart attack victims have had on several occasions to wait for treatment while the cath lab at Sierra Vista remained unused.

As a result of declining numbers, surgeons with another group, Central Coast Cardiothoracic of Pismo Beach, stopped providing surgical backup for cardiologists at Sierra Vista. Cardiologists require a backup surgeon in order to do emergency room acute interventions.

“I feel the evidence is quite strong that places with marginal volume have better results than places with small volume,” said David Canvasser of Central Coast Cardiothoracic. “If we could have two programs with adequate volume, we would be very happy.”

In 2005, CHW purchased French. A short time later, CC began transferring patients who needed cardiology tests to French from Sierra Vista in San Luis Obispo and from Twin Cities Community Hospital in Templeton, which are owned by Tenet Healthcare Corporation, even though the tests could be run at Sierra Vista.

At that time, Sierra Vista’s cardiac equipment was considered superior to that at French. Sierra Vista’s management had already purchased a high tech scanner that CC doctors chose not to use. However, when French eventually purchased the same scanner, it was then touted as a great piece of equipment.

Even though CC doctors are paid to be on-call at the Tenet and CHW hospitals, they currently transfer to French most of the Sierra Vista and Twin Cities patients they are called in to treat.

From 2005 through 2009, the number of patients CC doctors transferred from Sierra Vista and Twin Cities to French increased until almost all cardiology patients were transferred away from Sierra Vista.

For example, in 2006, CC physician Mark Bocchicchio performed 105 procedures at Sierra Vista. In 2008, that number had fallen to 83.

Last year, Bocchicchio performed only five procedures at Sierra Vista.

In 2008, CC physician and CHW board member Michael Famularo was paid $44,000 for serving as a director of French Hospital Medical Center according to French’s 2008 IRS filing.

Critics say that as part of the sweetheart deal with French, CC doctors received financial incentives to move their practices from Sierra Vista to French. As part of the move, the doctors bought out the last two years of their lease.

The Stark Law, a federal law named after United States Congressman Pete Stark who sponsored the initial bill, prohibits physicians from referring Medicare patients for certain designated health services to an entity with which the physician or a member of the physician’s immediate family has a financial relationship.

Last year, three doctors in Tucson, Ariz. who had set up a nuclear imaging business in 2006 agreed to pay the federal government $355,000 in a settlement with the U.S. Department of Justice involving violations of the Stark Law.

In another twist to this story, CC doctors routinely transfer patients needing nuclear scans away from French – to CC’s nearby office, where patients can be billed for both technical fees and professional fees, sources say. If a doctor performs a procedure such as a nuclear scan at the hospital, the physician only receives the professional fees while the hospital is paid the technical fees.

“As a former employee of CC, I can tell you that the physicians consider French’s nuclear camera to be substandard,” one insider told CalCoastNews. “French could be getting $8,000 or more in technical fees. Why are they allowing them to do this?”

In addition, local doctors allege that CC and French officials have used a number of tactics to keep other cardiologists from practicing in the area in order to protect their share of the lucrative cardiac market.

One of two non-CC cardiologists in the county, Ken Stevens, has been unable to get full privileges at French after more than a year in the area. It usually takes a highly rated, experienced doctor approximately three months to get full privileges.

Even though Stevens was asked to come from the Midwest to San Luis Obispo to run Sierra Vista’s cardiology department, he is no longer able to perform interventions there because he does not have surgical backup and French has not signed a transfer agreement with Sierra Vista.

As a result, if Stevens is working on a critical heart patient who requires an acute intervention, he has two choices: either transfer the patient to a Santa Barbara hospital or perform a procedure that requires surgical backup by himself – something his malpractice insurance carrier will not approve.

“I can’t start a procedure and then say I can’t do a full. . . ” Stevens said. “I can’t do acute interventions because there is no transfer agreement.”

As a result, patients with insurances such as Tricare and Anthem Blue Cross – insurances that CC does not accept – are not able to have numerous cardiac surgical procedures done locally. Many of these patients drive hundreds of miles to hospitals where the cardiologists accept their insurance.


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Paperboys

Wow, I’d always been told that if you needed an ER to go to Sierra Vista and if you have a heart attack go to French. My how things have changed.

I know of four people who went to SVH with health problems and died. All four caught a staph infection and that’s what killed them, not the illnesses they went in for.

My friends would be alive today if that weren’t such a filthy hospital. Another friend was going to SVH for months trying to find out what was wrong with his intestines, at a cost of a few hundred thousand dollars (insurance paid).

Finally he got into Stanford and they figured out what was wrong in one visit. And it wasn’t anything unusual or even rare. The doctor at SVH just did a piss-poor job with his endoscopy and didn’t find the necrosis in his intestinal tract.

Happy to say my friend is on the mend, but no thanks to SVH.

Moral of this story — go to Stanford or UCLA if you have the time. Don’t waste your time or money with local hospitals.


yodaiam

Paperboys….

You nailed it! So glad to hear your friend is on the mend!

For the past 33 years I have heard and experienced nothing less than inconsiderate, filthy behavior at both Sierra Vista and Twin Cities. I have had to remind nurses in both hospitals on more than one occasion to wash or put on gloves before tending to a patient.

The Doctors and Nurses are so busy gossiping about eachother they forget their prime directive.

The medical profession in this area is truly way behind the power curve and always has been. French has been the only saving grace especially for cardiac patients. No one hits 100% but the reputation French has for cleanliness and respect for patients far surpasses the others.


Jagerbomb

Obviously you do not work in the health care industry yodaiam, I see you did your homework. ALL hospitals are filthy! They are full of sick people with multiple medical problems who carry MRSA, VRE etc……. The best thing to do is take care of yourself and stay out of hospitals, because your are at risk.


yodaiam

Amen to that….but yes I do care for patients!

oops bet you didn’t see that one coming!


Use_it_or_Lose_it

.

,

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If you all appreciate Karen’s work, please make a donation.


“These sources have told CalCoastNews during a year-long investigation that this monopoly – actually called a “cartel” by some critics – appears to have violated federal laws.”


That’s a lot of work and I for one appreciate it.


My own personal opinion is that if you need good medical care, go out of county. I do. I refused to be treated at any hospital here and have specified that my health directive.


Use_it_or_Lose_it

specified that in my health directive


Tess TruHart

I was so concerned after reading this article (my Mother has Anthem Blue), that I decided to call Coastal Cardiology today for clarification. The insurance lady told me that they DO take Medicare AND Anthem Blue. This really made me feel much more comfortable about these Doctors.


SLORN

Well just be aware that they take patients to French Hospital when their insurance indicates they should be having procedures at Sierra Vista. They have found a way to circumvent the system. Maybe because the old ER Director is the Medical Director of SLO Select??


TexasHoldum

Tess, Let me get this straight, because you called CC and verified insurance & this is what is making you feel “more comfortable” about these doctors? If that is true perhaps you should stay with CC. I want a physician who takes time to talk to me, not a 15 minute appointment, to which they are usually late too. Someone who listens to my specific health needs and concerns and together we come up with a specialized plan. At CC it is a generic plan chalked full of medications. Not everyone needs or wants to be put on medications. Part of being an excellent doctor is listening to the patient and at CC the majority of them do not do that. Their reception staff is appalling.I have sat in the waiting room and the way their so called “receptionist” speak to the patients both in person and on the phones is ridiculous. When you are the biggest operation in town patients are just numbers and not actual people.


I guess all I can say to you is good luck with your healthcare with CC.


breakinghearts

What isn’t covered by Medicare is picked up by the secondary provider.(Anthem Blue). These doctors know the loopholes. So… why would they refuse your insurance, Having good insurance does not guarantee quality care, tell your mother to take her medical affairs outside of the community. She will just be another victim of the system


CA Native

It’s good to see the light of truth begin to shine on the management of CHW. They portray themselves as a benevolent giving, caring organization, but they are only self serving. They enjoy a tax exempt status which should indebt them to the rest of us, but it’s just a free ride for them. The county forgoes property taxes (a substantial loss of revenue) in the expectation that CHW will provide something of public benefit in return, and this is what we get.


Keep up the good work and continue probing; this is only the tip of the iceberg..

Don’t be afraid that CHW is some sort of sacred cow because of their ‘charitable organization’ status. Cold blooded avarice combined with an arrogant holier than thou superiority is what drives CHW. I’m referring to CHW’s top heavy management here. None of this is meant to impugn the people giving direct patient care at French or AGCH. Nurses, therapists, technicians and aides do their best under the onerous ‘kiss the ring’ mentalilty that is CHW managment.


visitor5

As a physician who has practiced in San Luis Obispo at the hospitals in question, the article is right on point and points to several potential Stark Law violations. The reporter is to be commended!


yodaiam

Well well well….I am not a professional writer or in the medical profession. I am however a patient of Coastal Cardiology as of 1/19/2010. I am 54 and I did have a heart attack that day.

Here is my point…I was transferred to French from Twin Cities ER. Thank Goodness! I was sent to specialists who preformed my surgery quickly and without incident.

If I was having transmission trouble with my car I certainly would not go to lube n go and expect a fix..

If I needed tax info I would not go to a family law attorney… come on people you go where you get the best people in that field.


Next point….. “Personal Responsibility” that should be the motto of our country, I think it used to be.

I have no insurance but ended up paying in cash for all my services less than I would have paid if I had insurance…now there is a racket someone needs to investigate. Become your own advacate and do the checking and the math. We don’t need insurance!

I also know that genetics and my lack of diligence got me in this situation and I will have to get out. I saved my money for a rainy day instead of pouring it down the insurance drain and at least that paid off!

The ambulance service! That is the next rip off I would like comment on! Where is their competition?


SLORN

Yodaiam,


I am very glad your situation worked out and you are fine. The thing is, those cardiologists have priveleges and accept $$ from Sierra to be oncall there as well. It is the same set of physicians who can work both places they just have a financial deal worked out with French so that it is better for THEM to go to FRENCH…not you. They have flip flopped between these 2 hospitals for years. When French/CHW displeases them they will probably attempt to go back to Sierra. I just hope that administration has learned their lesson and will not buy their load of crap..next step..stop paying them call $$.


SLOVisitor

The administration will never learn their lesson because Candy has been holding on to some hope since CC pulled out last April that the physicians will come crawling back to her. Two questions I have for everyone: Didn’t Candy (SV CEO) and Charlie (French’s Cath Lab director) used to be very good ‘friends’? And, what about the contract that SV supposedly has with the prisons? How are they getting around that?


yodaiam

SLORN

Hi just so you know ….the other benifit to the patient going to French vs. the Tenet Corperation is that French (CHW) is a not for profit ….which allows the cash paying customer the ability to negotiate the bill waaayyyy down from the original price set.

The costs to a private pay or cash patient at either of the Tenet Hospitals is twice that of French even after a discount because they need to show a profit.

So who is really looking out for the patient? I am confused? It certainly isn’t the corperations that have to give the shareholders profits! Maybe that Doctors group is really doing the rest of us responsible people a favor. At least they charge less so we who can do the math don’t have to go to government aid.

Again…. being truly an advocate for your own body is a must!

After 33 years in SLO county I have known hundreds of people who have had problems with both Sierra Vista and especially Twin Cities and only 3 complaints about French…I think Coastal Cardiology Doc’s are doing the public a favor keeping them out of those hospitals…just my opinion.

Take Care


SLORN

FYI —


French is also a dirty hospital, those doctors are not doing anyone any favors. Most people do not pay cash as you have, most people without insurance have no money to even attempt to pay the bill. Sierra Vista has higher indigent care than French does. If you actually believe that “not for profit” is not in it for the profit you need your head examined. I have known people getting screwed by CHW like you cannot imagine…they do not value their employees, they expect endless hours of work from you and when times are lean they cut you faster than you can imagine. Does Alan or the administration ever cut out their $100,000 bonuses?? nope..every manager/director gets high quarterly bonuses while they flex off their employees…does that sound fair. Multiple hostile work environment and sexual harassment suits are filed and are swept under the rug because of the POWER they weild. There is nothing “Catholic” about CHW. Fraudulant timecard issues are ignored. You clearly are deluded.


frenchrn

Exactly correct SLORN!! Someone who actually knows how it works at French. How soon we all forget that Alan’s (CEO) salary was posted to the public at around $1 million per year a couple of years back.


How can any “Catholic” based company sweep hostile work environment complaints, sexual harassment suits and fraudulent timecard keeping by Charlie Tagawa under the rug? I know that this is not just hearsay. I have first hand knowledge and know that this is all truthful.


Another question that I would like to know the answer to is why French allowed CC to open two nuclear cameras in the office connected to French and more-or-less let the nuc business go away at French????? Why would any business give it away if there wasn’t some sort of deal between the two?? That is like McDonald’s sending their customers over to Burger King. Do you ever see that happen?


slohealth

That scenario right there is the most blatant kick-back between CHW and CC out in the open right now. French Hospital is losing upwards of $8000 per Nuclear Study that walks out (or is discharged out) of their hospital.Now I understand them not being for profit, but something has to cover Alan’s million dolar paycheck. If CC performed the study at CHW their reimbursement is roughly $60, but being allowed to perform it in their office down the hall they are making 10 times that amount.


Now we must also ask ourselves…….

Better than UCLA

Better than Stanford

Better than UCSF


Crappy nuclear camera? Let alone 2 crappy nuclear cameras?


Please.


Jagerbomb

Kudos to you FRENCHRN. I have first hand knowledge that there is significant documentation from previous cases regarding the infamous CHARLIE TAGAWA that has never been addressed. He IS a repeat offender of sexual harassment suits and multiple workplace complaints that I am sure that are illegal and immoral. The Nurses Union has record of it as well. It has gone on too long! How does he maintain a management position to run the Cath Lab when he does not possess a degree? Obviously, these RN’s are patient advocates who care about their community and are disgusted with the cheating scumbags who say they are in charge of French Hospital!!!


yodaiam

OMG!

Sounds like sour grapes to me…. so much anger! If you really feel that way try another county or state then get back to me. Maybe personality or skills are keeping you from the big bucks. If you were in the loop you wouldn’t be complaining…just a guess.


Now that I know that I am calssified with the “ubber-rich” according to frenchrn I am shocked that I have missed out on all the bennies otherwise.


I make $24,861.00 annually and have been saving since I was in my 20’s for that “rainy day”. All of you who live outside of your means, buy new cars, have cable TV, take expensive vacations,have every electronic toy known to mankind, line up at starbucks every morning with your cars running, etc etc….. Just try living without all that stuff for 1 year if you have the courage and fortitude.

I am sure most of you make 2 to 3 times the amount I do and are still not happy. For you I am sorry.

Many of you who are complaining are no different than the ones you condemn! It is not about the patient it is all about the money for you as well, good luck.

And btw my situation is not as unusual as you would think. I know more people in this county than you can imagine that do business the same way as I do but just don’t go around complaining about it. We use common sense! We are proud not to be “freeloaders” and to earning our way instead of demanding an entitlement or handout!

No worries America we are sitll out here.

I hope all you angry RN’s are able to retire soon so we can get some new blood in, maybe that will help.


hoopitup

Hey Yoda,

I can almost promise you that if you are overweight and the main cardiologist of CC was your cardiologist that he made fun of you right around the corner. He detests the uninsured and overweight patients…i’ve heard it time and time again come right out of his mouth.


I would lay a years’ salary down on a bet with you that the RNs who’ve been verbally sparring with you have made attempt after attempt to correct the wrongs where patient care is concerned.


I agree with you that it’s essentially profit-driven business we’re talking about whether or not it’s NOT FOR PROFIT has NO bearing on that issue of profit. Profit is the name of the game.


I’ve worked in other facilities/cath labs in California and other states and the truth is…these professionals you refer to…the CC doctors…they are about seven years behind the current practices of cutting edge cardiologists in and out of California. I want to talk to you in two years about your bypass or your stents…see how you are THEN.


You can be proud you aren’t a freeloader. You can be proud you negotiated your bill. That does not change the situation of the cardiology cartel in SLO. SLO is not the sole recipient of these practices. It goes on in other places because the reimbursement practices have made cardiac cath procedures a little less lucrative. So the competition is up.


Speaking of competition. Now that Sierra Vista’s cath lab is no longer able to take you or your friends in on an emergency basis because the CC docs will transfer them to French…there isn’t much competition. No competition means little motivation to make improvements or meet or entertain cutting edge medicine. It won’t be long now before you and your friends will be ON HOLD at SV ER or in the flippin’ hallway at French WAITING and WAITING for your heart cath. In the world of hearts…time is muscle. Yes, it matters and matters alot.


Both facilities are dirty. I’ve worked at both of them. Both have corruption too at the top levels. That said, I wouldn’t ‘take my dog’ to French for heart issues nor baby issues. I would consider SV but then again it’s the same exact CC docs and both facilities share RN staff quite a bit…believe it or not. Likely I’d go out of town.


Good luck to you Yoda.


frenchrn

How many cash payers do you know??? That is only an issue for the uber-rich. Most cash payers actually don’t pay anything regardless of what the bill says. If you don’t think that CHW is a profit driven company, then you are kidding yourself. I know for a fact (from an upper level administrator at French) that all of administration receives hefty bonuses based on the financial performance of the hospital. Just because CHW is not for profit doesn’t mean they don’t see the bottom line. They are out for the money just like any other hospital.


yodaiam

frenchrn

Yes there are many “freeloaders” out there, many more than there should be I have to agree.

Having said that I think you would be shocked if you really knew how many of us who aren’t afraid of doing without some of the other amenities in life do save and keep an emergency fund! For those of us that haven’t bought into all the social “needs” including insurance you would be suprised how much one can save living on any wage, (in my case under $25,000.00 a year)

Now I will also say that I know personally as friends 23 RN’s and LVN’s whom I love dearly who have trouble living on their $70 grand a year (and yes they have very stressful jobs), jobs they went to special effort to choose because there was a good paycheck involved. They chose but have never be totally happy because the love to complain and gossip about eachother. Every time I ask any of them about changing occupations the first response is not….”the patients need me” but “where else could I make that money”.

Maybe you and slorn are the exceptions but I don’t know.

Check out the alternatives.


SLORN

yodaiam


I can only speak for myself but I am a happy working nurse. What you are judging us for is our frustration at the “business” of patients. Nurses go to school to learn to care for patients, not the $$ of reimbursement for doctors or hospitals. I have to protect my patients everyday and make sure they get what they are deserved in healthcare. Don;t you dare say to me that I need to explore another option. If it wasn’t for caring nurses, patients such as yourself would be in a very vulnerable position. The majority of doctors are good people and so are nurses but unfortunately the bad eggs are the only ones people seem to talk about. These CC/CHW people are the bad ones, this article is important to inform the community that they need to be aware of what is going on and to not accept them at their word. I am the person who is left to mop things up when the MD’s screw it all up..remember to value the nurses instead of putting us down for feeling negative about this “business” at times. I earn EVERY penny I make, I chose it because it was a calling and remember that when it is 2am and a nurse is the one saving your life.


yodaiam

SLORN


I am not the one that was complaining about nurses or doctors!

I am the truly grateful one here!

I also see the big picture. If you truly believe what you say, you will become a part of a soultion by any means possible. Although venting is crucial to our daily lives to maintain sanity we must also look inside to see what the real drive is and how to find a solution. Get together with those who agree with you and do something! Dare to buck the system instead of just talking about it.

Maybe you feel that you are doing something and maybe there is something more you can do.

Have you ever heard the term “making book”. Get your proof and then more willl listen. Until then this is just so much talk.

I do wish all of you well and appreciate most of you more than you know. Just remember if nurses are cleaning up after the doctors, there are others who clean up after the nurses as well.

Being further down the chain brings reality even closer to the heart. I am back to work this week so I for one won’t have time for this anymore. Again take care and look deep.


Jagerbomb

Yodaiam: Just remember there was a great and skilled group of Nurses caring for you during your surgery and JUST remember WHO provided your postoperative care. I’m sure it wasn’t the PHYSICIAN wiping YOUR A**!!!! You Have room to talk!


solarheater

Saying any medical organization is not for profit is a joke. Profits are good. Obscene profits by any organization is wrong. Non-profit is a method for those in charge to pocket more cash. Should the nurses really be whining they would do it at a bar or some other venue. Not taking the time to write here. Unfortunately because of the risk of retaliation not everything can be put on paper. Yes a history of retaliation does exist. Since when is cornering the market not for profit?


HospitalGuy

Yodaiam, get your head out of your ass! French and AG benevolent providers of non-profit care benefitting the County? Dream on! Did you know that the two Tenet hospitals provide 75% of the indigent care in SLO County and also pay about $2.,5M in taxes to the County each year. By contrast the CHW hospitals are getting a huge tax benefit and providng squat to us. Tenet Corp doesn’t give its investors dividends rather it spends its money on local hospitals as evidenced by all of the investment in its two SLO County hospitals the past 10 years. CHW hospitals cherry pick the most profitable services and leave the indigent and Medi-Cal patients to everyone else when it is their community beneift obligation to care for those in need.


grayotter

My wife and I watched Michael Moores “Sicko” last night. If you haven’t seen it, now would be an appropriate time. The current situation with our local hospitals validates the movie!!! Then google his bloog MichaelMooreSicko.com and write your congress representatives your thoughts. Our political system also needs Universal Health Care to eliminate the cancerous lobbyists that continue to infiltrate our political system.


DeepBlueSLO

Part of the underlying tone of this discussion is that patients are being harmed. Did you know that anyone can go to the Dept of Health and Human Services website and actually compare hospital quality measures?


Here is the link:

http://www.hospitalcompare.hhs.gov


If the link doesn’t work, just Google “hospital compare HHS”.


JordanJ

SLOhealth has posted a link where concerned citizens can file complaints. I just called in to the gov hotline and reported this fraud being perpetrated upon the citizens of SLO County and will follow up in writing. I also directed them to this site. I hope many more of you follow in line. We need to make a big noise, people. SAVE YOURSELVES and SPEAK UP.


http://www.oig.hhs.gov/fraud/hotline/


Thanks SLOhealth


Tess TruHart

I was stunned when I read the article regarding the problems Ms. Williams & others who have Anthem Blue Cross are having with CC Doctors. I know my Mother is insured with Anthem, so I checked her latest provider handbook and , sure enough, Coastal Cardiology are listed as “in network” provider! Could it possibly make a difference that she also has Medicare?


visitor5

I agree that the facts described in the article are potential Stark Law violations. Would encourage others to report to the Inspector general hotline as well. Otherwise nothing will change!


DeepBlueSLO

Wow.


CCN is accusing Catholic Healthcare West and the largest (I think) physician group in the county of felony violations of federal anti-trust laws, federal anti-kickback laws, conspiracy, and racketeering.


For CCN’s sake I hope they:


1. Consulted an experienced health care attorney prior to publishing this article.

2. Have more proof than “sources” and “critics”.


When Tenet (Sierra Vista’s owner) was indicted for these types of crimes in 2003 (Google “Tenet Alvarado Kickback” and click on the first link for a synopsis), they had internal documents and I think even photos of hospital execs handing docs cash and fine art. Even with that much evidence, it ended in a mistrial.


This article could cost CC and CHW collectively millions and if CCN is wrong or EVEN MISLEADING (“false light” I believe is the legal term) on any of these accusations, the author and everyone on the CCN Team could be financially responsible for the losses they incur. Saying that you think someone’s business practices are unethical is one thing. Accusing them of felonies is VERY different situation.


I’m not taking sides on this, just pointing out some of the potential pitfalls.


Nancy

“When Tenet (Sierra Vista’s owner) was indicted for these types of crimes in 2003” – “it ended in a mistrial”. Don’t doubt that knowledge is where these snakes get their testicular fortitude from.


slo101

They may not have had criminal action taken, but they settled the Stark violation fraud case for $900 million. The Stark laws are related to fines not jail.


kettle

“I’m not taking sides on this, just pointing out some of the potential pitfalls.”


This is BS, It’s clear from your first comment on this site that you have an agenda and had picked a side before you created your “anonymous commenter” account here. Back to your cave.


yodaiam

Kettel

Most of these angry people can’t come out of the cave because they are to comfortable where they are. It is easier to make noise and point fingers than really do anything. It is also clear these are the “perfect people” who don’t make mistakes.

The agenda is clear to anyone really reading the words.

I feel very bad that so many are so short sided. I hope they never need the care from the doc’s and hospital they are so against. I have seen it before though, just like ex smokers, once they have to take the cure or get monetarily compensated they will switch sides fast.


DailyGM

WOW IS RIGHT ….. As a former GM of a daily newspaper – I have to agree with DeepBlueSLO. I hope Central Coast News has a deep bankroll for the legals fees this is going to cost them.


DeepBlueSLO

I do not condone any unethical behavior. However, my point is missed.


You can accuse anyone you want of sub-par ethics and poor business decisions and be protected by the 1st Amendment. However, just because actions are unethical does not mean they are illegal. For example, I don’t see anyone from Goldman Sachs going to jail.


If you publicly accuse a company or individual of a criminal act, you better know the law inside and out … and anti-kickback laws are VERY complex.


And yes, doctors and hospital execs can be sent to prison for Stark Law violations.


SLORN

DeepBlueSea


While your concern for the writer of this article is nice, the bottom line is that there is a corrupt cardiology and hospital system in this community. I know for a fact all of these issues are in fact true. I too have sat back and watched it all happen. As a nurse, I protect the welfare of my patient in their physiological sense but unfortunately when it comes to $$ that is something nurses do not deal with. These physicians still to this day collect this call money and divert patients to French. I wish Sierra was successful in their bid to acquire a set of new cardiothoracic surgeons but they failed. It is very difficult to obtain surgeons to come into a marginal market AND have to fight these political battles. Most don’t want to even bother with all the politics, so again CC has won. They have said “no single cardiologist will survive in this town against them.” Believe it. I know French and CC are greedy and want all the business and have unfortunately created an unsafe situation for patients at French because of the shear volume they now must treat on a daily basis. Outpatient procedures are being done at 1am because of the backlog. Would you want you mom, dad, wife husband waiting in an outpatient area til 1am for a procedure then being sent home at 430 am? Ridiculous. I thought they took an oath of Do no Harm. I hope what comes of this is anaware community that they have choices to make, albeit difficult ones. I would not seek heart care here in this town.I appreciate the author going into to this arena full force, no one has ever been brave enough. It is about time they be exposed for the scheming swindlers they all are.


slohealth

Possibly in addition to contacting the OIG, we should all contact the Telegram Tribune and the LA Times and get this story out…..


breakinghearts

I’m all for getting this out to the press. Where do we begin? We have exhausted Physicians working until the wee hours of the morning at French Hospital .Dozing off at the nurses station between procedures, because of their greediness. Does that make you or your loved one feel safe? CC thinks they are “UNTOUCHABLE”?


visitor5

Hopefully patients and their family members who have been affected by the practices described in the article will complain to the Office of Inspector General. They can also file complaints with the California Medical Board @ caldocinfo.ca.gov.

These agencies will respond if enough affected patients complain about the same behavior!


TexasHoldum

You know what part of the pitfall of Sierra Vista was in my opinion was their CEO Candy Markwith. She seems to have had a big part in the demise of cardiology in Sierra Vista. She let CC and the CV Surgeons pretty much dictate what could be done at Sierra. Is she in on the CC/French deal? The way see seems to running down SVH it would appear to be.


jhelp

I don’t belive that at all. Candy has fought hard to maintain the cardiac program at SVH. CC and the CV Surgeons are in the money pockets of CHW. When CC moved back over to French, Their goal ( all of them ) was to take down SVH.We have heard it over and over. Now ” they won” and the patients have lost.


slohealth

You must work in Administration at SVH


jhelp

No. However, You must not be at the bedside


slohealth

So are you insinuating that Candy is bedside?


Truth is Sierra Vista had a chance to turn it around, and due to their “lack of balls” they didn’t. They allow certain Surgeons to decide the fate of their future programs based on a popularity contest and local politics. Real medicine and real care will not occur in SLO County until people stop giving more creedance to those they sunday bbq with, and start giving pathways to those genuinely working to provide service.


SLOVisitor

I think you nailed it right on the head TexasHoldum. Didn’t Candy and Charlie (French’s Cath Lab Director) used to be very good friends?


SLORN

Yes until he screwed her over.


frenchrn

very true…they were….but then again, who hasn’t Charlie used to get what he wants…..but i guess if no one in either admin. does anything about it, Charlie will continue to abuse the system which in the end affects the patients….the only ones benefitting at this point are CC, French and Charlie and his boys….the ones that are losing are the patients and the community of SLO.


solarheater

Who is the tech Charlie I keep hearing about?


slohealth

How many sexual harrassment write-ups is he at now?


frenchrn

interesting that French doesn’t do anything about those sexual harassment complaints


frenchrn

Charlie Tagawa….lots of negative occurrences connected with him. He has been investigated while working at SV and at French for multiple reasons.


frenchrn

Charlie is the manager of the cardiac cath lab…he is the one who has had several sexual harassment complaints about him and other accusations of creating a hostile work environment for anyone other than a select few male techs. There have also been complaints of falsifying timecards. I can’t speak to all of the accusations but can say for certain that at least some of the sexual harassment and hostile work environment accusations are completely true.


SLOVisitor

Charlie is out to make the Cath Lab at French completely male oriented. And people have gone to the Ethics board and Ethics hotline and no one has done anything about his sexual harassment antics.


Jagerbomb

Charlie’s too well protected by French because his transgressions make the hospital money. I have numerous sources who can corroborate the accusations made against him, whether it be sexual harassment against the RN’s in the Cath Lab, falsifying timecards, or juvenile antics such as getting male CVT’s to spy on undesirable employees of the Cath Lab.


frenchrn

Charlie is also very well protected by CC (what a coincidence) both French and CC protect someone that gives them what they want despite what he does to employees. Obviously, French allows this because they have been given the info regarding Charlie falsifying timecards etc and have done nothing about it….wow…I wonder what Charlie and his boys are making on this deal???


Jagerbomb

Well, well………… WHO did CHW pay off (or should I say Charlie Tagawa and his Cartel) for French Hospital to be recognized as one of the top 100 hospitals in the NATION for cardiac care by Thomson Reuters two years in a row? French Hospital is not patient driven, they are looking to step on people who get in their way through intimidation and bullying to make the almighty dollar and snuff out the competition. In my eyes receiving this sort of recognition gives one a sense of “Entitlement” to provide subpar care. Michael Moore is right on with his film “Sicko”, he has the balls to step up and make documentaries regarding unethical and sick behaviors. There are a lot of you who have been affected, TAKE A STAND! What are you afraid of? French Hospital should receive a reward for unethical behavior, backstabbing, lack of professionalism and…….narcissistic behavior!


cheseburger

I’ll testify for CalCoast as to the fraud, “Lying by Doctor Kromhout” about how many operations he had done and to think he hadn’t done any after claiming 100-200, wanting his first solo operation to be done on a non-U.S. citizen for legal reasons.


Scarlet

I’m showing this article to my mother who is a CC patient. But where else can she go? CC’s competitors would be smart to advertise with CalCoastNews right now.


slohealth

Ken Stevens at Premier Heart Care 540-3333.


justbcz

This story sounds like a rant. The sources and facts are weak. The author must have a friend, lover or family member that was fired from the practice. If CC doesn’t take Anthem and the hospital does then how is that CC’s fault? The doctors are focused on patient care not what type of insurance they take that day. As far as the relationship between French and CC – it’s natural for a cardiac hospital to have cardiac doctors next door. This situation is present all over the US. Good for CC – they saw an opportunity to make a thriving practice and that’s what they are doing it’s called capitalism. If you don’t like capitalism then move to mexico! Keep in mind – if the health care bill passes and the medicare rates are dropped 21% like the verbage says. Everyone will be waiting in line!


Nancy

You’ve obviously missed the highlights of this story. I suggest that you go back and read it again.


slohealth

There is a difference between being next door neighbors and facilitating kickbacks. Read the comments, this isn’t a rant. If it was there would be much more support for the accused.


frenchrn

compare the look of CC office when they were next to SV and look at their office now…..looks like an art exhibit now…wonder who paid for that????


yodaiam

justbcz

Thank you for your words! I couldn’t agree more. These are mostly angry healthcare workers who aren’t in the loop and didn’t get invited to the BBQ. They are just looking for someone to blame for anything because they have their own messes that others clean up after.

They can not see the forrest for the trees!


Concerned 4slo

I have been working in health care for many years. I have unfortunately been a witness to most things written in this article in regards to CC and the hospitals fighting over patients. The CC docs and hospital administration at French have been walking a fine line of poor ethics for quite some time now. The cardiology issue has been treated as a game when its actually our friends & families lives on the line. The delay of care to suit a doctors grudge or plan is disgusting. And Frenchs admin knowing this was occurring and encouraging it to win the “game” is deplorable. Players in this game including MDs, admin and staff have been very vocal of their plan to close Sierras cath lab. It was their personal goal. And in order for French to continue to grow it had to possess the entire countys patient load for cardiac care. Patients have been pawns. Another one stolen away from Sierra to French. No matter how the delay affected outcomes. How sad for the poor patients who do not know any better. Having watched this all unfold over the years has been very difficult. Why hasn’t this been brought to the public attention? Why has there not been an investigation of the practices of CC and French admin? And why has Sierra sat back & allowed these people to hurt patients in this community. All who have known of these practices and done nothing are responsible as well. I for one wish I had done more. I feel dirty just having known that patients lives were put on the line for other peoples greed. All the hospitals in this county say patient care is their key priority. They are all lying!! Its all about the money. When is someone going to stand up for our friends & families???


If anyone knows of who to report all this activity to please post it.


slohealth

If we all start calling, we can create a red flag.


http://www.medlaw.com/healthlaw/EMTALA/reporting/where-to-report-violation.shtml-stan


Think about your friends, your family, yourself. Large monopolies providing sub-standard care and service in this county need to be slapped on the wrist. We all know what’s going on, we have all been on the side of poor service, it’s time to speak up! Without it, how are we ever going to change healthcare for the better here? We chose to live here, we pay to live here, why are we accepting shoddy service in order to make a buck?


For years, CC has been stealing money from SVH in the form of “Call Pay”, i.e. being paid to be on call for SVH but automaticaly and immediately transferring all cardiac patients from SVH and TCCH to French. This was occuring even when the CV Surgeons were on call and staffed at SVH. Dr Doria is the Chairman of the Cardiology Department at SVH, amazing that he takes a directorship income but allows HIS program that HE oversees to crumble. Why don’t you all ask him how many heart catheterizations he has done in his Cath Lab at SVH over the past 2 years? All you need is 2 hands.


But CC isn’t the only cartel in this town……


DeepBlueSLO

slohealth,


Your link is bad.

Also, these accusations involve the Stark Law. EMTALA has zero to do with this.


slohealth

Hmmmm. Not good. The link actually provided information for both. I’ll recheck and repost. Thank you!


slohealth
Concerned 4slo

Thank you for the link.


yodaiam

Concerned 4slo

You have my utmost respect for calling it as you see it and taking note of your part.

As you said “everyone is guilty”.

The reason all this didn’t come out before is because everyone was comfortable in their own little niche. Now everyone is getting older and people are having regrets wondering what is coming their way down the line.

People make mistakes and find it is easier to blame others because taking personal responsibility as you have takes guts and fortitude.

I have been an advocate for patient care for 33 years. I have sat at the bedsides of many dying patients and friends. It is a long hard battle that never stops. There is no money in it and there is certainly no glory.

We push on!


jhelp

TRUST ME, NIETHIER DO THE DOCTORS OR FRENCH CARE IF THIERE BEHAVIOR IS MORAL, FAIR OR EVEN GOOD FOR THE PAIENTS. THEIR BEHAVIOR IS DRIVEN THE MONEY THAT CANE BE MADE. AND THEY DO NOT LIKE ANYBODY THAT STANDS IN THEIR WAY


hotdog

Using all caps is shouting. Gross misspelling is also very unfortunate. Try cleaning up your posts so they will get more credibility. You could always do them in word, spell check, and then paste in here. I wonder why no one has pointed out these issues here, laziness?


cheseburger

Right on hotdog, they do have spell check in the little box too!


solarheater

Stick to the point. This is serious if you are a patient. This is not a grammar or spelling lesson.


cheseburger

Solarheated read my other posts, my wife and baby were abused to the point of profound abuse by CHW, but if some posters can’t spell, maybe they should use the spell check in the little box, just makes since to me and because I can’t spell worth sh*t, it seemed like a good idea to point it out.


Jagerbomb

Keep writng in cheseburger about your abuse imposed upon you and your family at French Hospital. Its going to take people like you and others to make the difference because the ones in administration at French Hospital are blinded by the $ signs in their eyes.