For her part, Commissioner Sako raised numerous questions on August 17, including concerns that the lease with DaVita may not prevent it reducing or changing its services. She’s concerned a private company may have no requirement for it to have a Prop. Q hearing if it decides to change the level of services in the future.
Sako asked for a description of the current San Francisco dialysis population and the current capacity of outpatient dialysis services in San Francisco, and asked for information on how often dialysis patients have “code” situations while receiving dialysis care.
Commissioner Illig asked how many of CPMC’s 245 current dialysis patients are “safety-net” patients using Medi-Cal.
Commissioner Waters indicated Institute of Medicine research documents that 12-hour shifts, as DaVita may be considering implementing, negatively impacts nurse performance care.
The Commissioners raised other significant questions, which have yet to be answered by CPMC.
Although CPMC and DaVita held a follow-up meeting with CPMC’s dialysis patients on August 31 to address 22 outstanding questions pending since December 2009, up to this point only one question has been addressed, say dialysis patients.
The most critical unresolved question deals with how to handle patients who go into Code Blue during their dialysis treatments. A clear and definitive response has not been forthcoming about whether CPMC will permit DaVita to utilize hospital resources, or whether patients who Code Blue will have to rely on 9-1-1- being called to transport them to an emergency room elsewhere.
Both CMPC and DaVita seem to be stalling providing a Code Blue solution due to “liability” issues lawyers appear to be haggling over, since CPMC’s final agreement with DaVita over legal terms remain[ “pending.”
Once DaVita takes over, dialysis patients may be expected to deal with excruciating pain or will be expected to interrupt a vital treatment so they can be sent to an ER. DaVita’s representative, an administrator of the DaVita dialysis center on Webster Street in San Francisco, stated during the August 31 meeting with patients, “DaVita does not have a license to provide medications such as Morphine.”
Patients who asked if this is medically ethical received no response.
Dialysis patients also requested seeing comparison data for DaVita and CPMC regarding infections and cross-contaminations. They were told, “There are no readily available comparison data for infections and cross-contaminations since these are self-reporting items and each dialysis facility reports them differently.”
Continued in Part 3 …
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