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Provident and its patients

Thursday, August 04, 2005
Chicago Tribune

Babies 2 days old should not die in their mothers' arms while waiting for medical care. When that happens in an underdeveloped country, it's a tragedy. When it occurs at a public hospital with a $100 million yearly budget, as happened last year, it's also an outrage.

The tragedy of Provident Hospital on Chicago's South Side is twofold. The hospital, part of the Cook County Bureau of Health Services, serves one of the poorest, most medically forgotten areas of the city. Its emergency room is the only contact with a doctor many residents have.

This same facility also is one of the most mismanaged branches of Cook County government. And County Board President John Stroger's choice of a new administrator to run Provident doesn't inspire great faith that the ailing hospital's condition will improve.

Recent investigations by the Illinois Department of Public Health, on behalf of the Chicago regional office of the Centers for Medicare &Medicaid Services, have uncovered a catalog of horrors, beginning with a security guard who beat up a patient in the waiting room. That incident triggered further probes.

Investigators found that Provident's pharmacy was filling prescriptions incorrectly, bottles of medicine were dirty, and pills were strewn on the floor. In one of the CAT scan rooms there was soiled linen on the table and scattered on the floor. A patient's room had dried fluids splattered on the walls, holes in the wall and an unflushed toilet. The hospital's fire alarm system had not been tested or maintained properly.

Such conditions evoke images of a hospital in a banana republic, not a major American city.

Spokesmen for the county do not contest these allegations, which led to threats of a cutoff of Medicaid and Medicare payments--Provident's financial lifelines--unless the violations are resolved by a September deadline. A spokeswoman for the Bureau of Health Services says the violations are being corrected.

This mountain of problems calls for assertive, effective management. But instead Stroger's pick to be Provident's administrator (at $149,000 a year) is John Fairman, who, according to published reports, was fired from Denver's public hospital in 1990 and 10 years later from a public health system agency in Washington, D.C. The dismissals came amid allegations of mismanagement and questionable expenditures.

Why would Stroger pick someone with Fairman's cloudy background to run a hospital in critical condition? Well, while Fairman may not have a sterling record in hospital administration, he does have a key qualification for county employment--connections. His brother is chief of the county's Bureau of Public Safety.

Stroger says he has no apologies or intention to change his mind.

County Commissioners Forrest Claypool and Larry Suffredin have questioned the hiring of Fairman. They also want an investigation of the death of another baby in 2004. The attending physician allegedly ignored several signs the baby's life was at risk.

Provident's failures could be related to its too-broad mission. Despite its ample budget, on average only about 80 of its 222 beds are filled. County Commissioner Michael Quigley wants a panel to study whether Provident could be retooled as a large primary-care facility. He correctly notes that emergency rooms are expensive, inefficient providers of basic care.

Beyond that, Quigley and Claypool--both of whom have announced their candidacies to replace Stroger--want to compensate for Provident's strengths and weaknesses by linking it with hospitals in the area. Quigley says Provident could dispense general medical attention while partner hospitals provide specialty care.

What's clear is that the present mix of mismanagement and politics ill serves county taxpayers and, more important, South Side patients who depend on Provident for essential care.

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