FORT WORTH — The shakeup at JPS Health Network continued Thursday with the appointment of an interim chief executive officer and replacement of the company that was supposed to keep John Peter Smith Hospital clean.
Two board members — Don O'Neal and Ronnie Coulson — announced that they are stepping down.
And a top administrator defended his handling of scathing consultant reports, saying that the studies were available to many and had guided changes that the hospital board had endorsed in recent months. But the comments by Chief Operating Officer Ron Stutes drew biting criticism from some JPS board members, who said that the board should have been given the studies, which cost more than $650,000.
Interim CEO appointedThe board named Robert Earley, JPS' senior vice president for public affairs and advocacy, to take over, effective Friday, for David Cecero, who is to retire when his contract expires in September.
Earley, a six-term Texas legislator, university professor and political consultant, has been a JPS administrator since October 2005.
Cecero will be paid his annual salary of more than $700,000 through July 2009 to continue to act as an adviser.
Questions about reportStutes tried to calm the board about recent revelations that have roiled the taxpayer-financed health system, particularly concerning scathing reports by a Houston-based consultant, Insight Advantage. He received the 600-plus pages of findings and is responsible for many of the areas of concern cited, but he did not tell the board of the reports nor provide copies to board members.
Chief Financial Officer Gale Pileggi requested the studies, ordering them in increments. Because individual segments cost less than $500,000, board approval wasn't sought and board members were unaware of the contracts.
Stutes defended his handling of the reports, which were brought to light in a series of Star-Telegram reports.
"There were over 1,000 people involved in the process," he said. "This was not something that was hidden on the shelf. As you can tell from some of the consultant's reports, it was not sugar-coated."
The reports described a health-care system marred by filth, ineptitude and callousness. Doctors and nurses struggled with broken and missing equipment and medical records. Patients faced numerous delays and a dehumanizing environment.
Stutes also said several projects approved by the board had their genesis in the consultant's findings such as renovations to the sterile processing center, hiring patient advocates, and new clinic construction. And, Stutes said, some staffing changes have occurred to improve medical records management.
"There has been a lot said about who read the reports and who didn't read the reports. Let me just say lots of people had the information," Stutes said, after he gave the board an inch-thick summary of Insight's findings along with lists of issues that he said have been addressed.
"I think it was handled poorly," board member Dr. Bernard Rubin said. "Ultimately, we are paying for it and ultimately we are responsible. If you want people to make the right decisions, you need to give them the right information. If I don't have the information, I certainly can't make the decision."
Rubin also said that he was surprised that JPS had to turn to Insight consultants to point out "things that we should have already known."
Board member Dr. Gary Floyd sharply criticized Stutes for suggesting that the board was aware of the consultant's findings because of innocuous conversations at past board meetings.
"I am just livid," he said. "You may have said there was a study, but until I read it in the Star-Telegram, I didn't see any results. This board should have known about [the InSight reports)]. I think it is unconscionable to say you have seen bits and pieces of this and that we've taken action on this. We need to be transparent."
Board member the Rev. Ralph Emerson was supportive of JPS staff and applauded them for commissioning the study. "You didn't have to do this."
New cleaning companyAmong the most disturbing findings in the InSight reports were descriptions of filthy conditions, some of which could put patients at risk of infection. Consultants reported that trash cars overflowed, bathrooms weren't regularly cleaned, and nurses readying operating rooms found blood, bone and globules of fat on the walls and floor. Some rooms reeked, and some nurses told consultants that the environmental services staff should be fired.
Stutes told the Star-Telegram in April that the problems had been corrected with the hiring of additional housekeeping staff three times in the past six months, and management changes.
But Thursday, JPS officials recommended replacing the cleaning company, Crothall Services Group, that JPS has used for 15 years, citing poor performance and other concerns.
"I believe they should be more proactive, not waiting for me to come to them to say 'do this' or 'do that,' " JPS assistant administrator Charles Williams told the board, in describing problems with Crothall.
"I've been here 13 months and there has been 70 percent turnover in the management for the EVS contract," he said. "So yes, I am concerned about the quality of work. Housekeeping. They are the one service that goes into every room every day. They touch every patient's lives."
Crothall representatives lobbied the JPS board to renew its contract.
"Being here 15 years, we in the business call it the curse of the incumbent," said Richard Mensek, a division vice president for Crothall.
But the board voted unanimously to pay about $9.3 million annually to contract with Maryland-based Sodexo Health Care Services instead.