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Medical Waste

More allegations on prison health care emerge.

Medical personnel at a New Mexico state prison don’t have protective gear to treat inmates with infectious diseases. Nurses at the same prison lack sanitary wipes for sick inmates who have soiled themselves. Inmates regularly miss doses of critical medicine because their prescriptions are not renewed properly.

These are just some of the allegations made by Norbert Sanchez, a nurse for Wexford Health Sources, the private company that administers health care in New Mexico's state prisons.

Sanchez asserts that Wexford suspended him on Sept. 6 from his post at the Long Term Care Unit (LTCU) at Central New Mexico Correctional Facility in retaliation for continually raising concerns about Wexford’s operations at the facility. But he recently spoke with SFR in an exclusive interview. His account follows a series of stories by SFR in which a wide range of former Wexford employees have raised similarly serious concerns regarding Wexford’s treatment of inmates [Cover story, Aug. 9: Hard Cell? ].

"There were no guidelines, no policies from Wexford. It was unsafe for the inmates and the employees," Sanchez, a 20-year veteran nurse, says.

Sanchez says he began to work for Wexford in April and quickly noticed problems. Incoming nurses received only scant safety training from Wexford and were immediately thrown into intense treatment settings to plug staffing shortages, he alleges.

More disturbingly, Sanchez says that there weren't protective gowns and masks for medical staff who needed to treat inmates with infectious diseases, dangerous for staff, inmates and the general public. There also was a shortage of linens and sanitary wipes, which are particularly critical for chronically ill inmates.

"I was shocked," he says. "You'd have to use a sheet or anything you could find to wipe off the inmates. They were living in unsanitary conditions."

Another area where Sanchez found problems involved the dispensation of prescription drugs. Often, prescriptions would run out, and because of miscommunication between Wexford pharmacy staff and administrators, inmates had to wait before their dosages were renewed. In one instance, that meant an inmate with congestive heart failure missed nearly two days of medication, Sanchez recalls.

"I had to raise holy hell to get him the medicine he needed," Sanchez says.

Sanchez claims he regularly complained to Wexford administrators at Central but got little response. Since SFR began its series on Wexford in August, Sanchez says, the company has frantically hired temporary medical staff from nursing agencies to fill staffing gaps. He says that in early September, too many agency nurses reported to LTCU for duty, further evidence of the endemic confusion at Central. When he questioned whether all of the agency nurses were needed, Wexford administrators placed him on leave, Sanchez says.

"I believe it was retaliatory for the times I raised my voice when I saw a problem," he says.

Following his suspension, Sanchez says he sent a series of letters recounting his concerns and asking for further explanation about his suspension. In a Sept. 9 follow-up letter addressed to Wexford's regional director of nursing, Catherine Moore, Sanchez refers to the medical shortcomings at Central. Specifically, Sanchez tells of an inmate recovering from hip surgery being moved into a room still dirty from another sick inmate. He also writes that systemic confusion over the dispensing of prescription drugs resulted in the altering of records by management.

Sanchez says he's received no reply from Wexford to any of his letters.

Wexford Vice President Elaine Gedman responded in a lengthy Oct. 2 e-mail to SFR. She would not comment on the details of Sanchez's suspension but denies he was disciplined for complaining.

With regard to Sanchez' claim that there isn't protective gear at Central, Gedman writes:

"Wexford provides Personal Protective Equipment (PPE) Packs at all of the facilities where we provide medical services including the Central New Mexico Correctional Facility. We have verified that the PPE Packs are currently at all facilities."

As for the alleged medical supply shortage, Gedman also denies any problem. Concerning the cleanliness of the rooms, Gedman says, "The linens and cleaning the rooms are not Wexford's responsibility under our contract with NMCD and therefore we cannot speak to these issues."

Gedman also denies any confusion with prescription drug dispensation, and cites the national accreditations the company's New Mexico facilities have received.

"Wexford has numerous protocols in place to ensure that our patients receive their medication in a timely and accurate manner," she writes. "We have installed a state-of-the-art PIXIS machine to assist in the timely and accurate ordering and administration of medication."

Gedman also rejects Sanchez' assertion that Wexford began hiring nurses after SFR investigated the situation and maintains that the company's regional and national offices actively recruit in New Mexico to help combat a nationwide nursing shortage.

"The vacancy rate at Central New Mexico Correctional Facility is the lowest it has been in months," Gedman writes.

SFR also queried New Mexico Corrections Department (NMCD) spokeswoman Tia Bland on Sanchez' allegation of retaliation and his issues with Wexford's health care. Bland says NMCD has no information on Sanchez' employment status and is unaware of a shortage of medical supplies or protective gear, as well as prescription drug lapses, but that the Department is looking into it. As for Sanchez's assertions about dirty linens, Bland says:

"The linens are our responsibility. We have gotten a little behind with linen laundry in LTCU because of some electrical problems. We've ordered new linens, and we're working on fixing the problem."

Regarding the staffing shortages Sanchez and other ex-Wexford employees have complained of, Bland says: "We've always acknowledged staffing challenges. We are happy to say the vacancy rate is the lowest it's been in months. We applaud Wexford's efforts and encourage them to keep it up."

NMCD and Wexford could be in the hot seat in the coming weeks. Both will likely face tough questions from the state Legislature’s Courts, Corrections and Justice Committee at a hearing in Hobbs. State Rep. Joseph Cervantes, D-Doña Ana, co-chairman of the committee, has called for all those with concerns about Wexford to attend the hearing, slated for Oct. 20 [Outtakes, Sept. 13: Checkup].

Ken Kopczynski, executive director of the Private Corrections Institute watchdog group in Florida, says that aside from the hearing, NMCD should consider liquidating damages or fining Wexford if it refuses to live up to its contractual obligations.

NMCD hired Wexford in July 2004; last fall, a $35,000 agreement was reached between NMCD and Wexford over the state's concern that Wexford didn't provide enough work hours for its full-time employees, particularly psychiatrists.

"You're only as good as your contract. And if there are systematic problems here, than the state might need to hit Wexford where it hurts," Kopczynski says.

Ultimately, though, Kopczynski maintains that it is up to the Legislature and Corrections Secretary Joe Williams to ensure that Wexford upholds humane standards of care.

"Somebody needs to be enforcing that contract. And it should be up to the Legislature to hold the secretary's feet to the fire," he says. "And if the secretary chooses not to, then they need to get rid of him."

Meanwhile, Sanchez says he plans on speaking at the forthcoming hearing in Hobbs.

“Wexford doesn’t care about its employees,” he says. “And they don’t care about the inmates.”

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