iePolitics: ARMC and Dr. Gnanadev defrauding insurance companies?

We have discussed the protocols in the Behavioral Health unit in the past that violate state law.  Here is a recap:

5150. When any person, as a result of mental disorder, is a danger to others, or to himself or herself, or gravely disabled, a peace officer, member of the attending staff, as defined by regulation, of an evaluation facility designated by the county, designated members of a mobile crisis team provided by Section 5651.7, or other professional person designated by the county may, upon probable cause, take, or cause to be taken, the person into custody and place him or her in a facility designated by the county and approved by the State Department of Mental Health as a facility for 72-hour treatment and evaluation.

5151. If the facility for 72-hour treatment and evaluation admits the person, it may detain him or her for evaluation and treatment for a period not to exceed 72 hours.

Arrowhead Regional Medical Center (ARMC) has a long-standing policy in effect that they say gives them the right to detain patients longer, sometimes much longer, than 72 hours as authorized by Welfare and Institution Code sections 5150-5151.  San Bernardino County’s crack legal beagles have interpreted these code sections to mean that the 72 hours does not start until the patient is admitted.  That seems like a minor problem unless one understands the “admission process” at ARMC. Continue reading

iePolitics: Can anyone provide additional information?

I cannot make sense of the information I have received from a variety of sources.  There is a doctor at ARMC by the name of Dan Miulli.  Here is the line:  Dan Miulli

Reading his bio on that page, he sounds impressive.  He is the ARMC director of medical education for the facility.  I’ve been told he was going to become the chief of staff—of what I’m not sure.

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iePolitics: Time To Cut Out The Cancer At ARMC

As a child growing up with a mother who prescribed to old-fashioned thoughts about medical care, I was always told never to allow doctors to operate on cancer because exposing cancer cells to air would cause them to grow exponentially.  Of course, today we know how to use surgery to cure an otherwise fatal tumor.

Several years ago all of Southern California watched the crisis at the Los Angeles County-run King-Drew Medical Center.  If history can predict the future, we have a similar, fatal cancer growing at Arrowhead Regional Medical Center (ARMC) that needs to be excised fully and quickly.

The residents of San Bernardino County are being led to believe that the current investigations and accusations at San Bernardino County’s only county-run hospital are routine and relatively minor.  We keep hearing that they are part of the “learning process.”  ARMC has been in business for over 10 years and San Bernardino county has operated a hospital for decades before that.  If the county hasn’t learned how to run a hospital by now, I’m not sure it ever will. Continue reading

iePolitics: Pharmaceutical companies and ARMC

As I am sitting here tonight, I am listening to Coast to Coast.  The subject tonight is about food additives and medications.  The current guest is describing how pharmaceutical companies get doctors to prescribe certain medications.  When I worked at Arrowhead Regional Medical Center, I got to witness this on a small scale, up close and personal.

My last assigned workplace was out in the village.  I was told my first day that lunch would be provided two to three days a week and even though I am not a doctor, I was free to help myself.

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iePolitics: More arrests on the Fifth Floor?

We have been hearing for several months now that D-Day for Arrowhead Regional Medial Center would be in June or July.  More recently it was narrowed down to early July.  Today, we are hearing within the next two weeks charges will be filed or indictments issued against Supervisor Josie Gonzales and former Supervisor Paul Biane.

That is what other sources are saying.  My sources that are super close to the investigation do not believe they will be able to get Josie.  They also don’t believe they will be able to get Mark Uffer.  However, there is a strong indication there will be serious charges against Dr. Dev GnanaDev and Biane.

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iePolitics: Colonies rumors and more

There are two opposing rumors of sorts out there.   First, in this week’s issue of the Sentinel, Mark claims that Supervisor Josie Gonzales filed a Grand Jury complaint in 2006 over the Colonies issues, thus making the powers-that-be aware of some of the overt acts two years before the District Attorney’s office claims they actually knew.  This was supposedly part of her Grand Jury testimony last week.  That seems to be very problematic if true.

And, in the opposite direction is word that by the county waiving attorney/client privilege, the District Attorney has been able to obtain enough information to prosecute Supervisor Gary Ovitt for his part in the Colonies scandal.  Apparently, they have emails and other documents that now prove a quid pro quo arrangement between Burum and the three supervisors.

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iePolitics: BOS still protecting Dr. GnanaDev

The Board of Supervisors has updated the San Bernardino County Conflict of Interest Code at least once since we pointed out the fact that Dr. GnanaDev is listed as a Category 2 filer instead of a Category 1 filer, as he should be. Why is this important?

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iePolitics: Memories of ARMC

I’ve run into a couple of former co-workers in the past few days.  That combined with the tremendous amount of pain I have been in have been making me think about Arrowhead Regional Medical Center (ARMC).

Those who don’t know my story, I was working in a position at ARMC  that was comparative to my ESS position at TAD.  The job duties were very similar and the QME that I was sent to by the county said that I was being accommodated adequately, which was fine with me.  Almost as soon as the county received the QME report, they called me up and told me to go home as they were exercising their right to no longer accommodate my disabilities (which were work related) and put me on an unpaid leave of absence.  My health benefits were taken from me which meant I was not able to get much-needed surgery and have been without my medications for almost a year and a half.  There are days it is hard to deal with the pain and lately the pain has been severe.  My headaches have also been severe, which I’m sure is due to my blood pressure being so high.  That is not the point here as I long ago decided I don’t care about the meds.  If I stroke out, I stroke out.  I really don’t care.

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iePolitics: Are ARMC employees violating HIPAA or is Gonzales planting supporters?

Gonzales always ethical

Posted: 01/22/2011 07:13:14 PM PST

Re “Attempt to enact ethics panel thwarted time and again,” Jan. 12, by San Bernardino County Supervisor Neil Derry.Almost 30 years ago, I had an 1,800-pound horse throw itself on top of me, and broke much of my back. After a divorce following 26 years of marriage, I was left almost destitute, and have been treated at Arrowhead Regional Medical Center (ARMC) over the past five years, both on an inpatient and outpatient basis. I have gotten to know many employees in various departments at ARMC and especially Physical Therapy and OMT (Osteopathic Manipulative Therapy). In PT, I am often there for an hour at a time, several visits per week. Supervisor Josie Gonzales’ name has come up in many conversations.

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iePolitics: BOS wimps out again

It’s been over a year since we first started writing about the abuses at Arrowhead Regional Medical Center (ARMC), San Bernardino County’s only county-run hospital.  And it’s been over six months since doctors appeared at the Board of Supervisors meeting to express their own concerns.  During this same period of time, the Federal Bureau of Investigation raided ARMC and took boxes of records.

And how has our Board of Supervisors responded?  Do I have to ask?  We all know the answer.

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InlandPolitics: Federal Grand Jury begins activites

www.inlandpolitics.com

Wednesday, December 8, 2010 – 03:45 p.m.

Sources tell The Insider a federal grand jury has convened to examine evidence and hear testimony related the ongoing investigation into possible illegal activities involving public officials at San Bernardino County-owned and operated Arrowhead Regional Medical Center. (ARMC)

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iePolitics: So when will the lawsuits commence at ARMC?

Official word last week that the Federal Bureau of Investigation served warrants on San Bernardino County-run Arrowhead Regional Medical Center (ARMC) signaled a turning point in the county’s plethora of corruption scandals.  The wrongdoing at ARMC is widespread and encompasses many aspects of hospital operations.

Continue reading

InlandPolitics: The Insider: Feds calling shots in ARMC investigation

www.inlandpolitics.com

Wednesday, November 10, 2010 – 9:28 a.m.

Is the District Attorney really calling the shots in the investigation involving activities at Arrowhead Regional Medical Center (ARMC)?

The evidence is building, and it’s beginning to look more and more like the answer is “no”.

Confidential sources tell The Insider that federal agents were doing the questioning of hospital staff, not investigators for District Attorney Michael Ramos, as everyone is being led to believe.

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iePolitics: More on ARMC

Reading the spin from county personnel on the issues at San Bernardino County-run Arrowhead Regional Medical Center (ARMC) has been interesting.  Or perhaps disgusting is a better word.

Some of you may remember the Fair Political Practices Commission complaint I filed back in March against Mark Uffer and Supervisors Paul Biane and Josie Gonzales.  I received notice from the FPPC that there was no violation despite the fact that all three of them along with countless others had been given free medical care at ARMC and did not report this gift of public funds on their FPPC Form 700s.

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iePolitics: My personal experience with free medical care at ARMC

I won’t bore everyone with the details that led up to it, but the bottom line is that in 2008 the county of San Bernardino cut off my medical insurance illegally.  I had used Kaiser for close to three decades and suddenly had nothing despite a number of physical issues as well as the fact that I was dealing with major depression from a workplace injury.

The bottom line is that I had no way to get any of my medication including anti-depressants.  The end result was my first suicide attempt.

I was supposed to be returning to work but was pretty distraught and very depressed.  At that time I was still friends with Mark Kirk, who was Supervisor Ovitt’s chief of staff.  Kirk went to bat for me with then County Administrative Officer Mark Uffer and asked him that the county reinstate my medical insurance so that I could get my medication.  Uffer instead insisted that I go to the Emergency Room at Arrowhead Regional Medical Center (ARMC).

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iePolitics: The Brown pile

Perhaps this should be called “All in the Family – Part Three,” but as more and more comes out about Matt and Jessica Brown and Jessica’s mother Sandy Harmsen, somehow this title seemed more appropriate.  Matt, of course, is the former chief of staff for Second District Supervisor Paul Biane.  Jessica is an analyst in the County Administrative Office.   Harmsen is the director of the Workforce Development Department.

Sandy’s brother-in-laws, Adam, also works for the county as a social worker.  I’m not sure if any other family members are in county employ or not.

Recent weeks have seen all three of the family members in the spotlight.  First up was Sandy Harmsen, who as director of a department that is responsible fori spending large sums of federal stimulus money, was discovered to be falsifying records once again.  That is only a small part of what she is doing, but so far County Administrative Officer, Greg Devereaux, who Harmsen answers to, is covering for her.

Continue reading

InlandPolitics: S.B. County officials, past and present, run for cover

www.inlandpolitics.com

Saturday, November 6, 2010 – 12:20 p.m.

Last Updated: November 6, 2010 – 05:30 p.m.

Now the lid has finally blown on the scandal at Arrowhead Regional Medical Center (ARMC).

What a surprise to us all.

Well, not really.

Saturday mornings local news articles related to federal agents raiding the facility and seizing records were horrendous to say the least.

All of those denials. Or should I say lies.

The most outrageous is courtesy of former ARMC administrator and fired county administrative officer Mark H. Uffer, who through his attorney Sanford Kassel, denies any knowledge of free health care for county elected and appointed officials.

Kassel says Uffer was shocked to hear about the goings on at ARMC.

Continue reading

iePolitics: Another ARMC update

I finally had a chance to speak with several of my Arrowhead Regional Medical Center (ARMC) contacts.  I have been told that both problem individuals in the DBH unit have now left.

I continue to be contacted by staff at the DBH unit at UC Irvine, where one of them found a job, because she is causing the same kind of havoc there.  I believe I have mentioned on the blog that an EEOC complaint has been filed against her and the EEOC has been on the blog researching some of the entries.

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iePolitics: Let them burn! – Part Two

I received the following from ARMC yesterday:

This morning at ARMC a small fire broke out at 0555 hours in stairwell 7. The cause was a faulty light fixture. Colton FD responded and we security block off and evacuated the area. Hospital administrator Debra Pease showed up and didn’t know what to do and ordered us security NOT to evacuate or block anything off. She stated that any employee can walk into the fire situation if they want. Knowing she is a moron we disregarded her orders and continued to do our job. Also as a side note also she has ordered security to announce room numbers over our in house PA system when we announce medical emergencies such as Code Blue. This to us is a HIPPA violation and should not be announced. With your pull around the county can you help security out and stop this woman from destroying ARMC Security.

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iePolitics: Guess what Ruthie has done now to embarrass the BOS

Back in early June, iePolitics was tipped off that Dr. Dev Gnanadev, medical director for Arrowhead Regional Medical Center (ARMC), had real property in San Bernardino County and the beach area that he was not reporting on his FPPC Form 700.  We were also advised that he employed his wife in his medical billing business and required some of the doctors that contract with ARMC to use his medical billing service.  His wife’s income was also not reported on his FPPC Form 700.

We obtained copies of his last four 700s and determined there were discrepancies.  We also had the Assessor’s Office check his name for real property and found several possible properties he did not claim in this county.  Because the information he put on his Form 700 was done very sloppily, it was hard to tell exactly how much he under-reported but it was clear he had not reported everything he was required to report.

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iePolitics: I thought I would take a moment to explain

For those who took the time to read the emails in the Hey Paul Biane post, here is some more information.

Last year I was invited by Supervisor Neil Derry to tour the Fifth Floor on a Friday.  The reason for that was the many complaints that certain districts and offices were taking off every Friday but charging the county for time worked.

This was during a time when District Attorney Mike Ramos was making all the accusations about time card fraud at the Assessor’s Office.  As we all know, the Assessor’s Office executive staff were hardly the only employees to abuse their exempt status.  It has become commonplace to work far fewer than 40 hours but charge the county 40 hours worked.

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iePolitics: ARMC: Thank You Supervisor Derry

Back on June 21 I wrote this article about ARMC:  Why things will never change.  I’m happy to say that after over a year of telling high-level officials about what was going on there, the Third District stepped up to the plate, got County Administrative Officer Greg Devereaux involved, and had one aspect of that situation investigated and resolved.

My understanding is that is they only found a little over $100,000 in billings that could not be collected, but part of that was due to the fact that I had destroyed millions of dollars worth of old billings that were never worked.   At least at the time I left, there had been another person up there assigned to dig out all the work that was being hidden rather than billed.  At the same time, just before I left ARMC I wandered up there to check on the state of affairs only to find that the filing system I had created so that billings would not fall through the cracks had been decimated and thrown by the wayside.  They had returned to  two-foot high piles of billings stashed in every hiding place imaginable.  But all that really matters is all that revenue can be collected and maybe save a job or two.

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iePolitics: ARMC: Another Blatant Violation

In writing this series about corruption at San Bernardino County’s only county-operated hospital, Arrowhead Regional Medical Center (ARMC), there was one thing I could never understand about the situation and that is why does ARMC contract out over $28 million in services every other year but is not required to go through the RFP process even though many of these contracts are for a million dollars or more, well above the statutory limit for no-bid contracts.  So I asked an expert and here is his answer:

Contracting for Physician Services

There are two ways for a county hospital to contract for professional services.  The one that most academic-oriented hospitals such as ARMC uses is as follows: Continue reading

iePolitics: ARMC – Why Things Will Never Change



The best term for it is blackmail.  Anyone who has read the blog for a while knows about the methods San Bernardino County Arrowhead Regional Medical Center (ARMC) Medical Director Dr. Dev GnanaDev uses to control the Board of Supervisors.  He does whatever it takes to assure he always has at least three votes on the Board of Supervisors.  Whether it is campaign contributions or free medical care, Dr. GnanaDev secures his position and controls the voting habits of the Board of Supervisors.

But Dr. GnanaDev is not the only employee at ARMC where less than ethical means are used to control others.  I witnessed it first-hand when I worked at ARMC for a year.

I know now that I was sent to work at ARMC by Mark Uffer so I could be watched.  The problem with that is that the person who was assigned to watch me had more skeletons in his closet than just about anyone I have worked with in thirty years of county employment.  That person was Fred Mendoza, PMQ/Insurance Verification Department Manager.

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iePolitics: ARMC: Our BOS wants more stupid?

So is our illustrious San Bernardino Board of Supervisors up to stupid again?  We hope not.  But we won’t know for sure until Tuesday’s meeting.  BOS agenda item No. 16 has left us scratching our heads.  This board item approves new,2-year contracts with all of the various medical providers for Arrowhead Regional Medical Center (ARMC), with the exception of the Anesthesia contract, which is extended six months.

ARMC has been under investigation almost continuously since the final quarter of 2009 for a variety of reasons including malpractice, patient abuse, billing issues, and violations of state regulations.  All three levels of government, federal, state and county, have been involved in these investigations and they have not been completed.  The situation at ARMC remains so dire that it could lose its Medi-Cal and Medicare funding which in turn could lead to the hospital being shut down.

Special Agents from the California Department of  Justice are currently investigating possible criminal misconduct at ARMC.  It is rumored that it has to do with, among other things, the medical care received by Supervisors Biane and Gonzales and former County Administrative Officer Mark Uffer and his family and friends.  That makes sense because otherwise it would be the San Bernardino County District Attorney’s office investigating.  However that agency has very close personal ties with all involved and that is why it appears the investigation has been turned over from the District Attorney to the Attorney General.

There has been a battle going on at ARMC for months now.  Those doctors who are tired of the mismanagement and despotic rule by ARMC Medical Director Dr. Dev GnanaDev have started speaking out.  And at least one has paid a price for doing so, that being the doctor in charge of Anesthesia, which is why his group’s contract is being extended rather than receiving a new 2-year contract like all others at the facility.  Dr. GnanaDev wants to replace him with one of his own but there is too much heat to do so right now.

The new series of contracts has one change and that is there is a separate contract for Dr. GnanaDev as medical director and one for Dr. GnanaDev for patient care.  However, the conflicts of interest still exist: Continue reading

iePolitics: ARMC: An Open Letter to Dr. GnanaDev

Dr. GnanaDev,

Rumor has it that you claim you do not understand why you are being attacked.  Well let me tell you all about it from my personal perspective.

I have discussed the issues with some of your colleagues but I also worked at Arrowhead Regional Medical  Center (ARMC) for just over a year.  Much of what I write about I witnessed first hand.

ARMC is a county-operated public hospital.  As such, its primary function in the community is to serve as a safety-net for those who would otherwise have no health care.  Its purpose is not to line your pockets. Continue reading

iePolitics: More Problems for Dr. Dev GnanaDev

Life must be tough these days for a medical director.  Let’s see, we have the Attorney General’s office investigating Arrowhead Regional Medical Center (ARMC) for who knows which of the many accusations of patient abuse,  Medi-Cal/Medicare fraud, gifts of public funds, conflicts of interest, and a host of other concerns.   Then we know a formal complaint has been filed with the San Bernardino County Grand Jury.  And a complaint was filed with the Fair Political Practices Commission (FPPC) because ARMC Medical Director Dr.  Dev GnanadDev didn’t consider reporting millions of dollars in real property to be important.  And now we find out there have been at least two more complaints filed. Continue reading

iePolitics: Dr. Dev GnanaDev Exhibits Contempt And Arrogance

Several weeks ago iePolitics was tipped off to the fact that Dr. Dev GnanaDev, medical director for San Bernardino County’s only county-run hospital, Arrowhead Regional Medical Center (ARMC), owns a number of pieces of real property in San Bernardino County and elsewhere.  Because of some of the accusations surrounding at least one piece of  said property, which we will detail at a later date, an attempt was made to verify that Dr. GnanaDev properly reported his real estate investments on his Form 700.

iePolitics obtained a copy of Dr. GnanaDev’s contract with the county of San Bernardino and verified that pursuant to his contract, he is in fact required to file an FPPC Form 700.   However, when iePolitics attempted to review Dr. GnanaDev’s Form 700 on the San Bernardino County Clerk of the Board’s website, it could not be found. Continue reading

iePolitics: ARMC: Hey Paula and Natalie, Ya’ll Waiting for the Handcuffs?

Did you two see this morning’s Sun:

Report reveals ARMC issues; Hospital preps for reinspection

Posted: 05/29/2010 07:07:15 AM PDT

Staff at Arrowhead Regional Medical in Colton failed to properly screen children for abuse, overmedicated patients with antipsychotic drugs and painkillers and failed to follow proper guidelines for restraining patients, according to a recently released federal investigative report.

Read more: http://www.sbsun.com/news/ci_15189008?source=rss#ixzz0pQowXE1s

Yep.  That’s right.  They are moving in on the two of you.   You can only falsify patient records to achieve your own desired goals for so long.  Did you know that two of the shrinks were out smoking on the patio talking about how they were worried the state and feds were going to find out about the falsified patient records that kept patients in restraints illegally for four months?  Yep, the shrinks are worried they might lose their medical licenses over this.  And who will they have to blame but the two of you.

InlandPolitics: ARMC employees starting to speak out

  • Written by Administrator
  • Posted May 28, 2010 at 9:32 am

The following e-mail was received from an employee st San Bernardino County-owned and operated Arrowhead Regional Medical Center (ARMC).  InlandPolitics would like to reiterate to our readers that the the lack of concern for quality of patient care is alarming and of most concern to us here. Tags for the Center for Medicare and Medicaid Services (CMS) and the California Department of Justice have been attached to this story to allow the agencies to flag the post. InlandPolitics has learned Special Agents for the California Department of Justice have been questioning employees connected to the facility.

From: ****Redacted****
Date: Fri, 28 May 2010 08:28:46 -0700
To: <GnanadevD@armc.sbcounty.gov>; <inlandpolitics@yahoo.com>
Subject: Waste, Fraud and Scandal at Arrowhead Regional Medical Center

Arrowhead Regional Medical Center has been my home for over 10 years as a county employee and I am sick seeing it run into the ground first hand. The waste to the taxpayers is extraordinary and the tolerance for incompetence among the medical staff is unbelievable.

To be specific, the emergency department continues to contract with doctors that are surrounded by lawsuits and a desire to spend our tax dollars to inflate their sense of self-importance and fatten their paychecks.

Continue reading

iePolitics: ARMC: Attention Paula and Natalie

Paula and Natalie, you two need a lesson on internet IP addresses.  You see, it doesn’t matter how many different names or email addresses you use, your IP address remains the same.  Every website administrator can see the IP addresses of all their visitors.

So TonyTony and True Christian and FBI Agent and the rest of the fake names you have used do not hide your true identity.  Here is how it works.  You have a static IP address so all I had to do is trace it and then do an address search on you to find out who you are.  It is all public record easily available for free over the internet if one knows where to look. Continue reading

iePolitics: Yesterday’s BOS Meeting

Gee, San Bernardino County Second District Supervisor Paul Biane admitted he reads the blog.  Well, Paul, you did something VERY shitty to me in connection with County Fire last December and I haven’t forgotten.  And what you guys did to Pat even after you knew the truth is outrageous.  So, you deserve every negative thing we can write about you.

Josie, do you know how stupid you sound?  Seriously.  Granted, your threat to speak out is a serious threat to any of us who have ever had to listen to you.  Hear you’re a bit worried about all the free medical care you received now that Mikey is no longer investigating.

iePolitics: Need Some Advice – Former ARMC Employee

There are a few articles here but mostly I wrote on the old blog about some of what was going on in the Behavioral Health Unit at Arrowhead Regional Medical Center (ARMC) under the dictatorship of Paula Martin.  Some of you may remember the story of  the former employee who ended up 5150 because of what happened to him on the job in that unit.  Even though he had VA benefits and should have been transferred to the VA facility in Loma Linda, Martin refused because she wanted to humiliate him.  He ended up committing suicide.

Paula was also behind the patient who was left in restraints for four months and wasn’t being bathed regularly as well as other situations of patient abuse.  There was also plenty of employee abuse at her hand. Continue reading

InlandPolitics: Insiders give peek into climate at S.B. County facility

  • Written by Administrator
  • Posted May 25, 2010 at 9:18 am

Employees are starting to give a glimpse at just how cover-ups and vicious politics override patient care priorities at  San Bernardino County-owned and operated Arrowhead Regional Medical Center (ARMC).

Threatening physicians, profiteering, and strong-arming have become commonplace at the struggling hospital.

The Center for MediCare and MediCaid Services (CMS) has threatened to terminate reimbursements to the facility on July 31, 2010 if corrective action is not taken related to patient care.

Expect a surprise inspection soon. Continue reading

Frank Comunale, M.D.: Myths Spread by Current Administration

Note:  Dr. Comunale was the Medical Director for San Bernardino County Medical Center from 1979 to 1997.

Myth: The Medical Director has been a department chair as well as a corporate owner for over 30 years.

Fact: Not True.

Dr. Francis L. Comunale was selected to serve as Medical Director of San Bernardino County Medical Center as a result of a national search starting April 1, 1979.

The search committee was composed of 2 members of the Board of Supervisor, two members of the medical staff, two members of the San Bernardino County Medical Society, two resident Physicians from the Medical Center’s Family Practice Resident Training Program and two Associate Deans from UCLA School of Medicine. The interview was held over a three-day period. Continue reading

iePolitics: Should we expect fireworks at the BOS this morning?

We have the possibility of a very interesting San Bernardino County Board of Supervisors meeting this morning.  Two weeks ago, Arrowhead Regional Medical Center doctors, Dr. John Steinmann, an orthopedic spine surgeon, and Dr. Keyvan Safdari, an anesthesiologist, both spoke of heavy handedness and retaliation by Arrowhead Regional Medical Center (ARMC) Medical Director, Dr. Dev Gnanadev.

The following was posted under an ARMC comment a few days ago and with other knowledge we have, suggests we could see a showdown today:

Tuesday’s Board meeting should be very interesting in that while there will be several people there commenting on the fact that: 4 administrative assistants, 3 Anesthesia Techs, about 6 Medical Billers, 2 Nurse Practitioners, 10 Certified Nurse Anesthetists, and 6 Anesthesiologists will lose their jobs on June 30th.

In addition, according to the Medical Staff by Laws those employees who hold clinical privileges to provide care to patients at ARMC will automatically lose these privileges because of the termination of their employer Inland Anesthesia Medical Group Inc.’s contract to provide these services as an INDEPENDENT CONTRACTED CORPORATION.

More importantly the notification of the non renewal of the contract was officially announced at such a late date that these dedicated health care providers and workers will not have sufficient time to seek employment elsewhere. Even more tragic,is that they have not been told who the new corporation that the Medical Director (without following appropriate County standards) has contracted with.

Thus, they do not know what positions will be available to them and most importantly will not have sufficient time to negotiate fair working conditions, salaries and benefits.

This has happened simply because their boss who, acting in his role as the independent contracted corporate appointed Associate Medical Director of Peri-Operative Services and Chair of the Department of Anesthesiology and Pain Management simply recommended that several incidents of patient care should be reviewed in accordance with standards established by CMS and other accrediting agencies.

At the same time their will be other contracted staff members, employees and their families dressed in white to show support for the current Medical Director and HIS administration just to insure that this does not happen to them.

When will the Board of Supervisors acting in their role as the Board of Trustees at ARMC finally say enough and end this reign of tyranny by a self centered individual who acts only in his own interests without concern for the consequences.

That’s right Dr. Dev these people work for the corporation not for you and you have put them out of work and in many instances have put them at risk of being unable to support their families.

Is this revenge enough for you?


That comment was made by Frank Comunale, M.D., former Medical Director for San Bernardino County Hospital and Arrowhead Regional Medical Center, for the 18 years prior to Dr. Dev GnanaDev being appointed to replace him.  Dr. Comunale did not recommend that GnanaDev replace him but instead recommended that a nation-wide search take place, which did not happen.  Now the taxpayers and employees of San Bernardino County are paying the price. Continue reading

InlandPolitics: ARMC director cuts deal with medical group he once labeled as “incompetent”

  • Written by Administrator
  • Posted May 20, 2010 at 12:00 pm

InlandPolitics.com has learned the Medical Director for San Bernardino County-owned Arrowhead Regional Medical Center (ARMC) has cut a deal with a Riverside County-based Anesthesiology Medical Group to replace its current provider.

There’s just two problems.

The first, no request for qualification (RFQ) or request for proposal (RFP) was ever initiated.

And the second, Medical Director Dr. Dev GnanaDev previously criticized the same medical group provider has being incompetent. Continue reading

InlandPolitics Commentary: Is politics complicating county oversight of ARMC ?

  • Written by Blogger
  • Posted May 21, 2010 at 10:41 am


Many people are asking why it appears San Bernardino County seems to be ignoring many of the problems occurring at its own Arrowhead Regional Medical Center (ARMC).

The answer that seems to be surfacing is political.

As in campaign contributions.

Sources tell InlandPolitcs that county politicians routinely request donations from medical service providers. Many of those contributions are handled through various medical groups. Continue reading

InlandPolitics Commentary: Is “culture of cover-up” plaguing S.B. County government?

  • Written by Senor Blogger
  • Posted May 23, 2010 at 1:39 pm

One things for certain.

San Bernardino County doesn’t want any bad news made public. And when it does go public by way of internal leaks, the course of action is to downplay or deny.

The current situation at San Bernardino County-owned and operated Arrowhead Regional Medical Center (ARMC) is a prime example.

When allegations alleging a breakdown in quality of care began surfacing several months, hospital and county officials denied any problems existed. This was until outside investigations surfaced that found critical breakdowns in medical care and other areas.

Medicare and MediCal have threatened to terminate reimbursements to the facility. A threat that doesn’t materialize until after at least two prior warnings.

I can’t find any public disclosures of any prior warnings to the facility. Continue reading

Rules That Govern Medical Services

The rules that govern the delivery of medical services are multifaceted. It is not just one agency or level of government who oversees its delivery. Each discipline has its licensing or certification board that dictates how that profession may practice. Each setting (hospital, nursing home, clinic, etc.) has guidelines that allow it to operate and be licensed. Then there are rules that dictate how private insurance pays for services. Rules on how care of private-paying patients can function. Government funded care such as Medicare and Medicaid also have their rules on how they should be billed and what acceptable services can be billed. In addition, there are often both state and federal rules within the same area that must be adhered to. Each of these may have different expectations. When this is true the “Most Restrictive” rule must be followed.

To their detriment, most health care professionals have expertise in one or two of these areas. They often unwittingly violate regulations they don’t know but are responsible to follow. The violations here are not whether a physician can give away free care or whether services can be undocumented by a physician. The physician scope of practice rules are only one component of compliance in a hospital setting. The fact that services are delivered in a hospital setting means that the hospital is responsible for the services delivered and that the rules and laws that govern it must be followed.
Potential non-compliance may exist in two areas:
1. State and federal licensing laws, and
2. State and federal reimbursement guidelines

Title XXII is the group of state laws that dictate licensure of health facilities. Services delivered in a health facility must be documented. It is not an option whether or not to document care or not. It is a requirement. Federal licensing laws also require that all care delivered must be documented. Late entry of documentation is possible if for some reason it was not completed at the time of services. But if done is must be dated on the day it was written not post dated back to the service date. Back- dating is considered fraud or forgery, . Bboth of which are not just a violation of rules, but criminal offenses. There is an example of a facility in Riverside County where nurses asked to falsify records were arrested and taken to jail. The electronic medical record system in use at ARMC should prevent this, but it may be able to be overridden by those with “Administrative” authority.

Healthcare billing and reimbursement is unlike any other profession. There is not a direct correlation between what is billed and what is paid. When an agency or service provider is a Medicare provider they are subject to a concept called “Lesser of cost or charges”. Basically, Medicare sets rates that they will pay. If you participate as a provider of care and bill Medicare you must bill at least the Medicare rate to all others. If you bill less than the Medicare rate to others then Medicare expects that you will bill them at that lower rate. If it is found that others are charged less than Medicare and that is accepted as payment, then the difference that was paid Medicare and what would have been paid at the lower rate is owned to Medicare. Care of County Supervisors and their families is certainly less than the Medicare rate. All similar service delivered at that rate is potentially in jeopardy.

Each facility who bills Medicare or Medicaid must submit an annual “Cost Report”. This is another area that both lack of documentation and failure to bill affects. This annual report is to reflect all appropriate costs and incidents of services delivered. Distilled down to a simplified equation, the total costs divided by the increments of service gives an average cost of service. Where facilities can get into trouble is when they inflate costs by including inappropriate items or report fewer increments of service. In the latter case reducing the denominator inflates the cost per increment. If a facility is found to be providing an inaccurate cost report, Medicare/Medi-Cal can trigger a financial audit that can result in paybacks, withhold of payment and/or fines.

InlandPolitics: ARMC staff attempting to mislead

  • Written by Administrator
  • Posted May 19, 2010 at 8:51 am

This mornings article in the Inland Valley Daily Bulletin newspaper titled “Top doctors defend quality of care at ARMC” appears to have been written about a medical facility somewhere else.

Maybe in a “Banana Republic”.

While San Bernardino County and some of its doctors at county-owned Arrowhead Regional Medical Center (ARMC) try to mitigate and deflect allegations of misconduct and medical treatment gone haywire, more information continues to leak out of the facility that paints a grim picture.

News of five “sentinel events” involving the hospitals Obstetrics and Gynecology Department have surfaced.

That’s right five. Continue reading

iePolitics: More ARMC Cover Up

Sometimes I really wonder who is the worst lawyer, District Attorney Mike Ramos or County Counsel Ruth Stringer.  From Ramos we have learned that the Constitution of the United States is not applicable in San Bernardino County, at least not in connection with political enemies.   And County Counsel Ruth Stringer has taught us that copulation involving public resources is covered by the “deliberative process” and therefore not subject to review, not that we wanted to review the copulation, only the expenditures attached thereto.

Now we find our two legal beagles are at it again.  Well, not with each other we hope, but in consort of sorts, with those at Arrowhead Regional Medical Center (ARMC) who wish to cover for the misdeeds of members of the Board of Supervisors, the county’s Medical Director Dr. Dev GnanaDev,  ARMC Chief Executive Officer Patrick Petre, and a handful of doctors and other ARMC employees. Continue reading

iePolitics: Grand Jury Complaints

Seeing the absolute in-your-face willingness of certain department heads and county officials to lie, cheat and cover up misdeeds, I have come to the conclusion that the Grand Jury needs to receive multiple complaints to spur them into action.  The complaint process is relatively easy.  The complaint form can be found here:  http://www.sbcounty.gov/grandjury/complaint.asp

Two issues deserve our attention.  First, the depth of the P.O.S.T. issue has been covered up long enough.  The public has the right to know how many Sheriff’s Department personnel were involved, their ranks, the length of the scam, and how much it cost taxpayers. Continue reading

InlandPolitics: ICEMA diverting trauma patients from ARMC

  • Written by Administrator
  • Posted May 18, 2010 at 2:43 pm

InlandPolitics has learned from reliable sources that the Inland Counties Emergency Medical Agency (ICEMA) has been diverting critical trauma cases from San Bernardino County’s Arrowhead Regional Medical Center (ARMC) to Loma Linda University Medical Center (LLUMC).

The primary reason? Substandard trauma care. Continue reading

iePolitics: ARMC Coverup

Evidence is surfacing that a major coverup is in progress at Arrowhead Regional Medical Center (ARMC).  Allegations surfaced months ago that San Bernardino County Board of Supervisors Second District Supervisor Paul Biane and Fifth District Supervisor Josie Gonzales received extensive free medical care at ARMC.  A complaint has been filed with the Fair Politicial Practices Commission (FPPC) alleging Form 700 violations due to the fact that these supervisors, along with former County Administrative Officer Mark Uffer, received free medical care, which constitutes a gift of public funds, and did not report said gifts as required by law on their Form 700s.

Today, iePolitics learned that ARMC Chief Executive Officer Patrick Petre at the behest of  ARMC Medical Director Dr. Dev Gnanadev, has ordered privacy statements  be signed and backdated by ARMC employees in regard to anything they witnessed in reference to members of the Board of Supervisors or other elected and appointed officials who may have been given free  medical care at the facility.  It appears that this process has been put into place to interfere with a criminal and/or Grand Jury investigation into practices at ARMC.

iePolitics has been contacted by employees who have been threatened with HIPAA violations if  they discuss the wrongdoing at ARMC.  It appears every effort is being made to sweep the current scandal under the rug. Continue reading

iePolitics: ARMC: Dr. Gnanadev and a Horrifying Revelation – Revised

Today I had the chance to meet directly with an Arrowhead Regional Medical Center (ARMC) doctor, who contacted iePolitics due to the articles we have been writing about the hospital.  The doctor provided iePolitics with a plethora of documentation to prove claims of mismanagement, inappropriate financial arrangements by ARMC Medical Director Dr. Dev Gnanadev, and a host of other accusations.  We will be discussing some of these issues in the days to come.

Out of all the discussion that took place this morning, one 60-second portion affected me more than anything else.  This doctor described a procedure that they have personally witnessed which is known to be occurring by Dr. Gnanadev for the purpose of bringing in more revenue for one of the groups he oversees, the Emergency Room doctors. Continue reading

iePolitics: ARMC – Time For Action

Yesterday we witnessed something at the San Bernardino County Board of Supervisors session that we don’t see often.  Subordinates of a sort spoke out against their administrator. Dr. John Steinmann, an orthopedic spine surgeon, and Dr. Keyvan Safdari, an anesthesiologist, both spoke of heavy handedness and retaliation by Arrowhead Regional Medical Center (ARMC) Medical Director, Dr. Dev Gnanadev.

Steinmann indicated to the members of the Board of Supervisors that patient care is suffering as a result of Gnanadev’s leadership.  As we have discussed here repeatedly, retaliation is the name of the game at ARMC, a practice likely initiated and certainly promulgated by former County Administrative Officer Mark Uffer.  And now we learn it is more true than we realized. Continue reading

iePolitics: Special Treatment at ARMC

When I read yesterday “And Comunale said not renewing the anesthesiology contract – which is held by one of Comunale’s relatives – is ‘just a vendetta on GnanaDev’s part’” in the San Bernardino Sun, I assumed the vendetta was against Comunale.  Well it turns out I was wrong.

As mentioned in the last Arrowhead Regional Medical Center (ARMC) article I wrote, San Bernardino County Supervisor Paul Biane had two MRI’s under anesthesia at the hospital.  As we have been reporting, board members frequently have procedures done without charting so that they do not have to pay for the procedures or co-pays.  And Biane expected the same in this instance.  But the anesthesiologist refused to complete the procedure without charting.  So Biane doesn’t want the contract renewed.  And Biane and Gnanadev cover for one another.  Are you listening Mike Ramos?