Closure: A Response to the NY Times Article

By Anna Bennett

A day late and a dollar short.  That is how I feel about today's New York Times article "Unsanitary Dialysis Center Shuts Down Over Hepatitis"

I was an in center patient at Life Care from January 12, 2007 until October 26, 2007.  I had a rough time of it, and then Dr. Wasser wisely transitioned me to home hemo. From November 2007 until August 15th, 2008 I was a patient at Life Care, but I only visited the center on my monthly clinic visits. 

When I review my first posts on IHD from those times, and my Yelp review, I read about seeing bad industry practices, a result of under staffing and poorly trained staff.  This is not a case of one unit.  Yes, Life Care got caught, but I challenge NY State to enter unannounced to any NYC dialysis unit, they are going to find issues.

My biggest complaint with the news that is being reported?  Where is DaVita in all of this?  Life Care is a DaVita unit, yet Dr. Wasser seems to be the only name mentioned in both the State Press Release and the newspaper articles.  This does not exonerate Dr. Wasser or any of the management of Life Care, but it should also implicate DaVita.

I applaud NY State for taking a stand in cleaning up the Dialysis Industry.  As I have said in prior posts, it is good for the patient.  I am also committed to home hemo now, more than ever.  It was worth the fight to maintain my therapy, even after I was dumped.

Dr. Wasser is a good nephrologist.  I feel that he is being scapegoated in all of this.  There is blame to be had, but it ALL should not be put at his feet.  Dr. Wasser had been my nephrologist for five years prior to my starting dialysis.  I know great nephrologists, and I know bad nephrologists, Dr. Wasser was good and thorough in my medical care.  As far as hiring and managing a Dialysis Unit, well, that isn't what he went to medical school for, and Life Care had issues that are now well documented.  But DaVita is complicit in all of this.  The name tags on the staff had DaVita written on them. The blame needs to be shared.

Please, let Lufkin and now Life Care mean something.  Let those names mean that the industry has something wrong with it, and we need to fix it.  People's lives are at stake.

UPDATE by Bill Peckham
DaVita's involvement with Life Care can be seen on the Medicare website Dialysis Facility Compare listing for Life Care, the corporate name for the dialysis unit is listed as DaVita.  (DFC does not seem to provide a permanent link to search results - this is a screen shot of the listing).

Comments

[Roberta Mikles, Health Care Patient Advocate]

Anna, I understand all that you mentioned. Training and education is a major problem as well as unit supervision to ensure effective practices are being implemented. As an advocate, I have been attempting to bring concerns such as these (lack of oversight) not only to CMS, NKF, but other organizations and elected officials. As we are well aware, many states, can not meet the CMS request to survey facilities every three years. Much can happen in three years, let alone one year. Therefore, how does one know if the facility is in compliance. There is more to quality safe care than that which is noted on Dialysis Facility Compare. With infection continuing to be the number two cause of death, among this vulnerable population, one must ask who is overseeing to ensure effective practices are being conducted. As Dr. David Nash, of Jefferson Medical School, Health Care Policy Division, stated in reference to infection (to recall) 'it is the process of care'. This situation is most disturbing. Basic practices not being conducted!!! Is there understanding, by staff, of the patient consequences for lack of implementing effective practices. You said this is a Davita unit, then my question is what happened as Davita was awarded some recognition for their training program, to recall. Yes, Davita needs to take responsibility. However, our elected officials must understand the realities that occur in some units. I, once again, state the following "In spite of the newly revised ESRD COnditions, additional Clinical Performance Measures, as well as the Patient Safety Program, without an effective oversight and enforcement program (CMS) many quality care and patient safety areas will continue. It is the survey process that often identifies ineffective practices ie lack of implementing effective infection controls, lack of monitoring patients, lack of following facility policies/procedures. These aforementioned, as evidenced in many surveys, including Lufkin Davita, were and went apparently unnoticed by facility staff and facility management. What will have to happen before someone realizes that our oversight and enforcement program is greatly in need of repair. Should Medicare treat dialysis facilities as they do hospitals and withhold reimbursement for certain avoidable events/outcomes? Would this instill more thought to that which occurs in some facilities related to delivery of care? Roberta Mikles RN Health Care Patient Advocate RMiklesRN@aol.com

[Kathy Alter]

Bill - Just wanted you to know I'm alive and back blogging minus my right leg below the knee. Just thought you'd like to know.

Kathy Alter
Stayin' Alive

[Brian Steele-Sierk]

I am amazed that Da Vita has been able to keep it's name out of the news reports. Do you have any good documentation or links that will definitively show that Da Vita was running Life Care?

[Zach]

If you are concerned that the NYT reporter did not mention DaVita, then send her an eMail with some facts.

I've updated Anna's post with a screen shot from CMS's Dialysis Facility Compare site (comments don't allow images) which list the corporate ownership of the Life Care center as DaVita.

[Anna Bennett]

Thanks for adding the screen shot. Due to NY State ownership laws, DaVita was only the "Manager" of Life Care. The NY Times is aware of this, as is the NY State Department of Health (who failed to mention DaVita in their press release)

All of my equipment is branded DaVita, all if the posters in the Unit were DaVita, all of my legal forms are branded DaVita. The name tags of the staff, and the business cards of the social worker and dietitians are DaVita. My home hemo Nurse had a DaVita e-mail address.

The FA who was brought in during the week that the State was inspecting was introduced to me as a DaVita FA. (she then promptly boldface lied to me about what was going on) Life Care was a DaVita unit in it's staffing, policies and procedures. Don't let semantics and bypassing NY State law lead you astray.