EDINBURG — Doctors Hospital at Renaissance released hundreds of documents Thursday that address claims of impropriety made on social media last weekend, providing a glimpse into a Rio Grande Valley hospital’s COVID-19 response efforts that is unprecedented in detail.
The documents respond to a total of 14 claims, providing receipts, hospital protocols, inventories and staffing information. A four-page summary at the beginning of the document lists the allegations, DHR’s opinion on the facts of those allegations and the actions the organization took to remedy problems, if any.
Local officials, including Hidalgo County Judge Richard F. Cortez and state Rep. Terry Canales, were provided with copies of the document. Cortez and Canales said they had not fully reviewed the documents as of early Friday evening.
Though comprehensive in response, not every claim is addressed equally. The claim that the hospital lacked or was withholding PPE, for example, was rebutted with a single sheet strongly disputing that claim followed by well over 50 pages of inventories and policies in support of as much.
A claim that ants were found within COVID-19 units, on patients and on equipment was addressed more obliquely in five pages, three of which are screenshots of the Twitter complaints themselves.
The other two pages were receipts from BugWorks Termite and Pest Control Co., which treated DHS facilities for ants on July 7, 8, 10 and 17.
“Ant problem noted on 7/7/20,” the allegation’s entry in the summary reads. “Problem immediately addressed and BugWorks onsite same day.”
A response to a claim that a body had been handled inappropriately gives some insight into how Valley hospitals are dealing with a drastic increase in deaths, coronavirus-related or otherwise.
The hospital acknowledged that there was an instance in which a body was held for 11 hours, stating that staff had notified a funeral home within one hour of the patient’s death but waited for several hours before their arrival.
DHR responded to that incident by purchasing three refrigerated trailers on July 7, 17 and 21.
It also implemented a “morgue response team” on Tuesday responsible for removing bodies that haven’t been picked up in an hour, according to the documents, which also provided a list of protocols for that team.
Other allegations addressed include that of a “perfectly fine” patient dying due to lost oxygen supply. In the documents, DHR states that although a patient in one of the COVID-19 wards died on July 5 and an issue with oxygen supply was reported that same day, the patient’s condition was deteriorating prior to the low oxygen alert.
“After full assessment from medical technology associates Praxair and VP of Facilities and Assets at DHR Health it was determined that gauge needed to be replaced and oxygen supply was not lost due to auxiliary system providing oxygen,” DHR summarized in response to the allegation.
A timeline of the hospital’s and its contractors’ actions to address the low oxygen in the COVID-19 unit is presented to backup that refutation, along with a redacted patient file for a man who died that day, ledgers related to oxygen supply and delivery for the unit, invoices from Praxair and photos of oxygen gauges.
The document says that additional carts and racks were ordered for unsecured oxygen tanks referenced in one allegation, and responded to an assertion that COVID-19 positive staff were allowed to work by categorically disputing that claim and saying that the organization enforces CDC guidelines.
Many of the documents deal with allegations about staffing issues, including a claim that there was inadequate staffing before state assistance, a claim that respiratory therapists complained of staff abuse and staff abandonment and a claim that read “3 therapists for 90 patients tanks going out before we can even get there.”
The document says that DHR submitted a STAR request for additional staffing on June 26 and received 354 Krucial Staffing personnel to assist with staffing relief efforts, providing redacted Krucial Staffing timesheets. It also says that DHR provided an infectious disease pay differential to DHR staff on March 1.
The document says the IC emergency management coordinator and respiratory therapist coordinator provided contact information to all respiratory therapists to address questions in regards to the allegation of staff abuse and abandonment.
“Complaints from agency staff were not communicated to RT Director,” the summary portion of the document relating to that claim says. “The DHR RT Director supervised and integrated RTs on July 4th, 2020 during the onboarding process and continued to make herself available to assist as necessary.”
As for the allegation of the organization only providing three therapists for 90 patients, DHR says more hospital staff were on duty at that time, including CNAs, EMTs and RNs.
The document says that the hospital did submit a STAR request for additional respiratory therapists on July 12 and that it is reviewing the staffing agency’s proposal for those therapists.
Responding to criticism about not using every facility for COVID-19 patients and continuing elective surgeries, the document states that a small proportion of elective procedures are continuing at the discretion of physicians and patients within guidelines from the governor.
According to a timeline for DHR’s pandemic construction, the total COVID-19 unit capacity stands at 213 — 57 in its Special Infectious Disease Unit-1 (SIDU-1) at Cornerstone, 156 in SIDU-2 at the Rehabilitation Hospital and 25 in ER-Hold at Urgent Care.
By the second week of August, DHR Health anticipates bringing the total capacity to 297 by creating SIDU-3 with a capacity of 27 beds and converting the facility at Urgent Care into SIDU-4, with a total capacity of 57.
“Establishing COVID-19 care sites and segregating and isolating COVID-19 patients from non-COVID-19 patients is in accordance with recommendations from CMS,” one of the pages reads, citing information from the Centers for Medicare & Medicaid Services.
Additional documents provide details on SIDU-1 and SIDU-2, along with schematics for those wards.
Finally, to additional claims about do-not-resuscitate directives and policies on visitors for patients, the document says the hospital is operating according to state guidelines.