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N.H. Hospital CEO told to resign amid Dartmouth-Hitchcock staffing violation

  • New Hampshire Hospital in Concord as seen on Tuesday, July 5, 2016. (ELIZABETH FRANTZ / Monitor staff)



Monitor staff
Wednesday, May 03, 2017

Gov. Chris Sununu told New Hampshire Hospital CEO Bob MacLeod to resign Wednesday morning after state officials said that Dartmouth-Hitchcock has been violating its contract to fully staff the state psychiatric hospital since November.

“We’ve been paying for psychiatrists that haven’t been there,” Sununu said.

He called the situation, and the way it came to light, “deeply disturbing and troubling.”

Ten psychiatrists currently work at the hospital, while the contract calls for 12. New Hampshire Department of Health and Human Services Commissioner Jeffrey Meyers said he discovered the violations after Executive Councilor Chris Pappas raised questions about staffing during the council’s last meeting.

The positions became vacant when psychiatrists were promoted to management positions and were not replaced.

Councilors have received regular reports on the staffing levels at New Hampshire Hospital since the contract was put into place last year. But those reports, prepared by New Hampshire Hospital officials, had the wrong benchmark for staffing levels – showing that 10 was the maximum number when it was supposed to be 12.

“What has been brought to light to us is that those reports that have been given to us are absolutely wrong,” Sununu said Wednesday. “They’ve been wrong in terms of the amount of staffing we were led to believe was required, as well as the amount of staffing that they currently have.”

Dartmouth-Hitchcock responded Wednesday afternoon, maintaining it has been “completely transparent” with the state about staffing levels.

“Throughout the course of this contract the state agreed that the staffing levels have been appropriate and the patient care is high quality,” hospital officials said in a statement. “That is why we were surprised, and deeply troubled, to receive the Commissioner’s letter last evening and to learn of the statements made at this morning’s meeting of the Executive Council.”

Hospital officials also pushed back on Sununu’s statement that he will be looking at getting money back from the hospital for the missing psychiatrists.

“It is critically important to note that the agreement with the state is a ‘fixed price’ contract, and D-H has only been paid by the state through January of this year,” officials wrote.

Pappas, a Democratic executive councilor from Manchester, said he noticed a long-term pattern of lower staffing levels as he reviewed the reports.

Pappas said it was “disturbing” that the staffing deficiency was caught only because he happened to find it. He said he didn’t know whether the hospital was misrepresenting the numbers.

Sununu said it was not clear to him whether Dartmouth-Hitchcock or New Hampshire Hospital erred in preparing the reports.

“I think the folks at Dartmouth-Hitchcock, they’re the ones making the report, the folks at New Hampshire Hospital as well,” Sununu said. “Whether nobody noticed or nobody cared to say anything, I don’t know, to be honest. Either way, there’s a problem.”

Meyers said he brought the issue to the governor on Tuesday. MacLeod will be replaced by former Crotched Mountain Specialty Hospital CEO Don Shumway, who also served previously as commissioner for the Department of Health and Human Services.

The state has issued a notice of noncompliance to Dartmouth-Hitchcock; the hospital has five days to respond, Meyers said.

In the meantime, DHHS is considering a review to determine whether the staffing deficiency affected the quality of care, the commissioner added.

“We have no indication that there was an impact on the quality of care for the patients of New Hampshire Hospital as a result of the staffing deficiency, but we may take a look at that,” Meyers said.

The state’s contract with Dartmouth-Hitchcock to provide psychiatric services to New Hampshire Hospital has been marred by controversy from the beginning, when a labor dispute resulted in the departure of nearly a dozen medical workers. As a former executive councilor, Sununu said he was hesitant to vote for the contract, but ultimately did.

The day after the contract was voted on last year, the hospital announced massive layoffs; however, the number of layoffs ended up being far fewer than expected.

Pappas and Sununu both said each incident represents a breach of trust.

“If you take a step back, there’s really a malpractice that was done when Dartmouth-Hitchcock decided not to negotiate the terms of employment with the professionals that were there at the facility,” Pappas said. “Now here you have another instance where there wasn’t communication, potentially they weren’t being honest with the state with what they needed to provide. We’re going to need some answers on this.”

Sununu said he’s requested that the attorney general’s office do a review of the state’s contract with Dartmouth-Hitchcock to explore what additional action could be taken. He added he has had trust issues with the hospital “from Day One.”

“They have a lot of work to do, to earn the trust not just of myself but also this entire administration,” Sununu said. “We have huge concerns. To work with the state, you have to be transparent, you have to be open, you have to be a partner.”

(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)