State fines providers, says more to come

By Marshall Allen

Monday, Dec. 22, 2008 | 2 a.m.

Saying that the hepatitis outbreak at the beginning of the year taught them a painful lesson, officials are hitting Nevada health care providers with much larger fines for breaking rules intended to protect the public.

Fines in November and this month set records — and health officials say more hefty fines are coming.

They’ve come a long way since March, when the state fined a Las Vegas clinic a mere $3,000 for causing a hepatitis C outbreak and endangering 50,000 patients with unsafe injection practices.

As a result of that scandal, state Health Division inspectors visited every outpatient surgery center in the state — the same type of facility as the colonoscopy center that caused the outbreak — and found several places that were also engaging in unsafe injection practices.

Richard Whitley, administrator of the Health Division, said the offenses by other surgery centers — even after the publicity caused by the hepatitis C outbreak — made it clear that imposing small fines and educating the facilities on proper safety standards were not changing behavior.

The hope is that bigger fines will get health providers’ attention and spur compliance, Whitley said.

Another change: The Health Division sends out news releases to publicize the fines, an effort to address the public criticism of the inspection process that came after the hepatitis C outbreak. The public needs to understand that the health division takes enforcement seriously so people can have faith in the health care system, officials said.

So the division tried to spread the word that on Nov. 21, it fined Park Place, an assisted living facility in Reno, $121,600 for poor record keeping and failing to give residents medications.

The fine was the largest ever levied by the state Health Division — until Dec. 10, when the state fined Desert Springs Hospital & Medical Center $228,000 and required it to provide a year of donated services to select patients. Inspectors had cited Desert Springs’ mammography program with 228 violations. They found the hospital had no records to assure that equipment used for mammograms had been maintained properly. Hospital officials told inspectors they performed the quality assurance tests, but those tests were not documented over a period when 92 patients had mammograms, said Ed Sweeten, radiation physicist for the Health Division.

The violations did not do any harm to patients, and the hospital had the patients come back and redid the tests, Sweeten said.

Assemblywoman Sheila Leslie, D-Reno, chairwoman of the interim legislative committee on health care, said she is glad to see what she calls a “turnaround” in Health Division regulation.

She credited many of the changes to Whitley, who took charge of the division in January.

The larger fines “give me more confidence in the Health Division, and prove that government can work and should work to protect its citizens,” Leslie said.

At a time when the state’s health budget is being chopped because of declining revenue, the fines can also help support the programs.

Whitley said the Desert Springs fine will go into the state’s general fund, and the fines against the Reno facility will go into the budget of the Health Division, where they’ll be used to improve the quality of care at the facility.