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2020 Local story # 3: Hospital in turmoil

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A case of he said, they said? Or a matter of style?

It’s not the kind of day most people would want to live through. No matter which way he turns David Conejo, the CEO of Rehoboth McKinley County Health Care Services, faces trouble.

On May 8, protesters, comprised of physicians, nurses and supporting hospital personnel, along with concerned members of the public at large, gathered in the parking lot of the First Baptist Church of Gallup, across the street from the hospital.

They protested about the lack of support and personal protective equipment, misplaced priorities, and unsafe working conditions. Also at the protest was New Mexico Sen. George Muñoz, D-Gallup, who said seven doctors were threatening to quit because of the CEO.

The senator told the Gallup Sun May 8 that he had given Conejo an ultimatum in which he had 24 hours to resign.

“He called here and I heard later about comments he made … you got 24 hours and all of that,” Conejo said. “Kind of a lot of blustering ... he has no jurisdiction over me. He has no jurisdiction over my position.”

Conejo called it “grandstanding for the election.”

About the seven doctors Muñoz said were threatening to resign, the CEO said it seems to be the millennial doctors who have issues with him.

“My total service here is 16 years and I got along with many of the doctors. So, I don’t think it’s built-in that I’m doing something wrong now all of a sudden,” he said. “If I were not satisfied with a couple of doctors, I don’t think they would automatically say, well then I have to leave. Why would I leave because seven doctors are upset?”

More pressing, on his desk is a letter from the county demanding a list of documents including the RMCHCS General Ledger from Jan. 1, 2015-Dec. 31, 2018, bank statements from Jan. 1, 2015-Dec. 31, 2018, and an annual report on Mill Levy expenditures per Hospital Act from Jan. 1, 2015-Dec. 31, 2018, including an accounting for any deposits made of Mill Levy funds.

The letter from County Manager Anthony Dimas, Jr. also demands full payment for $1.7 million in outstanding back rent within seven calendar days.

In an interview with the Gallup Sun, May 13, the day he was due to pay out the $1.7 million in back rent, Conejo seemed tired, beleaguered, but still hopeful.

He pointed to the possibility that Dr. Laura Hammons would manage to get him a 30-day extension on the payment. And she did.

Even if it hadn’t worked out that way, Conejo said the hospital has “sufficient funds to be able to pay it.”

He explained that he’s tapping COVID-19 monies.

“So we would be borrowing from Peter to pay Paul,” he said. “In other words we would take money that’s designated for treating future COVID patients, COVID relief, and then using it to pay down this debt. So it would definitely put us in a bind.”

About the documents for the audit, Conejo said meetings with the county and the state auditor have given him a better understanding of what is being requested. He expects to provide the necessary information in the near future, probably by May 15.

If things at the county don’t go his way, Dr. Laura Hammons, who sits on the hospital’s board of trustees, still has faith that there will be a positive resolution.

“I’ve lived here almost 32 years and I’ve seen hospital administrations come and go,” she said. “We’ve seen this before. We eventually fix it each time and the staff is great.”

But Conejo faces more difficulty, within the hospital itself.

On May 4, a group known as the RMCHCS Employed Providers signed a ‘Vote of No Confidence in David Conejo’ letter. It was reportedly signed by 30 medical professionals, several of whom expressed their concerns in exhibits attached to the letter.

Much of this information was shared at a meeting of the hospital’s board of trustees May 7.

One of those exhibits came from Chief of Pediatrics, Michelle Stam-MacLaren, who talked about a pediatric clinic nurse who was asked to help out during the crisis, but found herself without help or any explanation of how to do things in an unfamiliar department.

“She is doing this because it was requested to help in the crisis, but she feels very unsafe there,” Stam-MacLaren said.

Another doctor who spoke up in the letter was urologist Christopher Hoover who took issue with Conejo’s alleged lack of transparency. Hoover said he expressed disappointment that more than a dozen nurses were let go in early April. He felt the CEO’s response about not renewing the nurses’ contracts was dishonest.

“It turns out he actually did cancel those contracts,” Hoover said. “This was two weeks before our first case of COVID-19, and well into steady, hourly, global media coverage of the pandemic.”

In the Gallup Sun story, “The Devil’s Dilemma” April 10, Conejo said he had the option of ending contracts with the 15 traveling nurses whose agreements could be renewed or canceled with a two-week notice, as long as the hospital paid the nurses for those two weeks, which was confirmed by nurse Mike Kenyon.

At another point during the May 7 meeting, a doctor read aloud from an email written by a nurse who described a particular day when she said she was so overwhelmed, she didn’t answer call lights and threw bags of food into patients’ rooms without stopping to feed them.

The board did not announce any decision about Conejo’s future at that meeting.

Meanwhile, the Gallup Sun also heard from medical professionals, privately, outside of the meeting, who spoke on condition of anonymity.

One of those individuals was a nurse who expressed concerns about using the same gown that other people had worn, day after day, to treat a patient, and then leaving the gown in the room for the next health professional who would work with that same patient.

“We get one gown per patient … then we have to leave them in the room, and when we go back to that patient, we put that gown on again,” the nurse said.

The nurse also said the gown stays with the patient in the room. Sometimes gowns sit in the corner day after day until an employee gets tired of the pile of dirty gowns and throws them away.

This nurse also expressed concerns about face masks, saying it was hard to get an N95 mask, and when one was made available, it was the wrong size, not properly covering the nose and mouth.

When questioned about the N95 masks, Conejo said the hospital is well stocked these days. He calls it a different kind of problem.

“That’s a distribution problem, it’s not a shortage problem,” he said. “So when these boxes come in and they have all of the masks in different sizes, whomever was taking those masks out of those cases, needed to make sure that they had the appropriate sizes for the appropriate areas.”

The same nurse also expressed a concern about keeping positive COVID-19 patients on the same hospital floor as other patients. She felt this put vulnerable patients at risk of catching the virus.

However, Conejo said the situation is not black and white.

“This building is pretty long,” he pointed out. “And if somebody said, we’ve got somebody who’s been here for 13 days and they’re being discharged today, and at the other end of the building, 120 feet away, they’ve got somebody being admitted. I wouldn’t say we would isolate them that much.”

Another complaint, from the same anonymous  nurse, is that an asymptomatic staff member who tested positive for COVID-19, returned to work before the end of the Centers for Disease Control’s recommended 14-day quarantine.

Conejo didn’t deny it. He answered with a discussion of rapid testing.

“You can test somebody to make sure they’re clear and you can get results in as little as 30 minutes. Things are progressing all the time,” he said. “And again the public is reacting to what they hear and know. And they go, well how could they know that that person is clear? Just because they’re asymptomatic doesn’t mean they’re clear.

“But we can bring them here and say we’re going to test you, and in 30 minutes you will know whether they’re clear or not,” he said. “And if they’re clear, you can say … you can go back to work.”

Impact Aid and the Yazzie/Martinez suit, as well as concerns about Remote/Hybrid learning, Internet hotspots, proper cleaning of classrooms and danger to teachers generated heated discussions in 2020.

The Yazzie/Martinez suit which made our front cover in January emphasized some of the obstacles students, particularly Navajo Nation students have been facing for years.

By Beth Blakeman
Associate Editor