CHC's Death Imminent

September 25, 2012

Immediate Jeopardy: “A situation in which the provider’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.”

CHC is in such a state of mismanagement and disrepair that it is likely to close its doors completely within months. Rather the doors may be closed for the struggling health care center.

Even as administrators and board members argue amongst themselves U.S. Health and Human Services, Centers for Medicare and Medicaid Region IX investigators have filed a third status of Immediate Jeopardy against the institution.

This latest citation states, "Overall, CHC failed to have a system in place to adequately maintain medical equipment, repair medical equipment, service medical equipment, or replace medical equipment and failed to have a system in place to adequately track medical equipment services (repairs).” A list of eight failures were cited:
1. At least three patients were affected by not having a portable x-ray available (2 in NICU to verify line placements and 1 medical patient) 
2. CT scan machine broke down after 2 patients received oral contrast. The machine is still not repaired. 
3. Safety of employees and patients: Radiology technicians failed to wear radiology tags (last noted testing of radiology tags was 2010) 
4. There is no monitoring or tracking system in place in radiology to determine and identify when medical equipment breaks down, who repaired it, what repairs were completed, etc. Radiology failed to provide service reports for any of their equipment. 
5. Fluoroscope machine failed during at least one procedure. 
6. CT scan broke down on Friday and is still not repaired and may not be for some time. 
7. The dishwasher in dietary remains broken after years of repairs (new boiler installed last week, yet the temperature required to adequately sterilize has not been maintained). 
8. The triple sink is still not in working order.
CHC has 23 days to correct the problems listed in the three Immediate Jeopardy citations or face loss of about $13 million in federal Medicaid and Medicare funding.

Even as the CHC slips further towards its demise, the  hospital's administrators and board continue arguing and pointing fingers at each other.  Board member Anthony Aguon attacked CHC's CEO Juan Babauta for the sketchy billing contract given to International Consulting Services, an Idaho-based company that was created to land the contract.  The result was a huge loss of money for the crippled institution.   Aguon also accused Babauta of hiring a Tinian physician under an "illegal" contract.

Within a week CHC's chief financial and administrative officer, Alvaro Santos resignation, Dr. Daniel Lamar resigned his position as acting medical director. It was reported that Lamar resigned as acting medical director because he was not recognized as a board member.

Board members alleged that board chair Jack Torres refused to call a board meeting even though the hospital is in a state of severe crisis. The Marianas Variety reports:
“Dr. Lamar did not resign, he simply decided there was no point in shouldering the responsibilities of DMA without having a voice on the board as the previous DMAs had,” Raho explained. 
Raho and Aguon believe Babauta and Torres denied Lamar board privileges in order to deny them a majority for a board meeting. 
“Per the board’s by-laws and the open government act, myself, Anthony, Dr. Lamar, Roy Rios and Pete Dela Cruz set-up a meeting outside the regular CHC board structure because Mr. Torres refused to call a meeting as we requested numerous times…once the CEO and Mr. Torres realized we had a majority to call such a meeting, they began claiming that Dr. Lamar had no board standing and thus we had no majority to call a meeting,” explained Raho.
Even as the CHC faces financial crisis, three separate citations imposing Immediate Jeopardy status and total disorganization, Chair Jack Torres was quoted as saying, “An agenda is in process but the CHC administration must focus on rectifying CMS’ immediate jeopardy issues and should not be distracted at this time by a board meeting.”  

Other board members are rightfully outraged. Board member Anthony Raho said there was a "loss of confidence" in the administration and board.

Just like every institution and agency in the CNMI the CHC puts political games ahead of the public's best interest.

Arrests of CHC Employee and Relatives for Stealing $1.7 Million from CHC
As the Commonwealth Health Center struggles to pay personnel, repair and replace old equipment, and purchase needed supplies, it was revealed that employee Melvin G. Ada classified as Medical Supply Specialist I was arrested for stealing $1,796,441.23 from the CHC.  The 20-page indictment charged  Ada and his wife Leyda with 1 count of conspiracy to commit theft or embezzlement in connection with health care, 19 counts of theft or embezzlement in connection with health care, 1 count of conspiracy to commit health care fraud, 9 counts of health care fraud, 1 count of conspiracy to commit money laundering, 28 counts of money laundering, and forfeiture allegations.

In 2004 Leyda Ada worked for about a year as a sales person for MMS, a medical supply company based in Missouri with an office in Guam. MMS was a vendor of CHC.  From the indictment:
Manner and Means of the Conspiracy and Scheme and Artifice to Defraud 
9. It was part of the conspiracy and scheme and artifice to defraud that the defendant, MELVIN G. ADA, would and did use his position at CHC to misappropriate or divert CNMI Treasury checks issued for payments to CHC’s vendor, MMS. 
10. It was further part of the conspiracy and scheme and artifice to defraud that the defendant, MELVIN G. ADA, would and did use his position at CHC to create false invoices, purchase orders, and other documents necessary to cause CHC to authorize payments for medical supplies purportedly provided to CHC. 
11. It was further part of the conspiracy and scheme and artifice to defraud that the defendants, MELVIN G. ADA and LEYDA I. ADA, would and did open and maintain bank accounts at FHB which they used as repositories for forty-six (46) CNMI Treasury checks made payable to MMS, or variations of that name, and which checks in the aggregate totaled approximately $1,796,441.23. 
12. It was further part of the conspiracy and scheme and artifice to defraud that the defendants, MELVIN G. ADA and LEYDA I. ADA, would and did deposit and cause to deposit said funds into FHB bank accounts they controlled, and thereafter, among other things, withdraw cash in excess of $1,260,000, transfer funds in other bank accounts they controlled, and make check card purchases and other financial transactions.
The indictment details how Melvin Ada obtained a business license in May 2011 under the name "Melvin G. Ada dba Midwest Medical for the purpose of wholesale medical supplies. The next day he opened a checking account under that name. He then started submitted fraudulent documents along with legitimate documents for processing of inflated payments of MMS supplies. He manipulated the accounts payable vouchers at CHC and had payments deposited to his checking accounts.

Did last Thursday's resignation of CHC's chief financial officer Alvaro Santos is connected to this case. Who else in involved in this scheme?

Also arrested was Elisa Borja Ada, a/k/a Elisa Ada Aldan, a/k/a Lisa A. Aldan. She was charged with one count of embezzlement of program receiving federal funds. The information states that between 2007 to 2008 as President of the CNMI Association of Families with Disabilities she stole, embezzled or obtained by fraud CAFD property worth at least $5,000.


Anonymous said...

This is truly the ISLAND OF THIEVES!!!

Anonymous said...

Can any one confirm or deny the family connections of these Ada family embezzlers? I heard one of them is related to the Ada who is principalat KHS. Any one have the court stuff on the third Ada?

Anonymous said...

This hospital was the place that Taiji Sawada was taken after whatever happened to him at the jail. He was apparently pronounced braindead upon cursory examination, and despite showing no signs of the suicide he'd allegedly committed (this according to his mom and fiancee in a report in Shukan Bunshun, who saw his body) and a sign of an alternate COD, no autopsy was conducted either.

Contact Yuji Watanabe (the Shukan Bunshun reporter) in Japan at @yujing7 on twitter, or Mr. Sawada's fiancee Tomomi at @tomomi_red