State pursues probe of Kuakini
By Robbie Dingeman
Advertiser Health Writer
The state attorney general's office is continuing its investigation into allegations of financial irregularities, mismanagement and patient-care issues at Kuakini Medical Center first raised in July, while hospital officials maintain there is no substance to the claims.
The attorney general has received an initial response from Kuakini officials to the inquiry that began in July. Kuakini chief executive officer Gary Kajiwara said Friday that the hospital expects to send additional documentation within the next 30 days.
"Our desire is to try to wrap up our side obviously as quickly as we can," Kajiwara said.
Kuakini and its parent, Kuakini Health Systems, fall under the attorney general's oversight as tax-exempt public charities. In July, state Deputy Attorney General Hugh Jones sent an eight-page letter to Kajiwara and 19 members of the board of directors that detailed allegations of concern about possible mismanagement, financial problems and issues that could compromise patient care.
Jones said it is too early to predict what the next step will be. "We haven't drawn any conclusions," he said.
Kuakini officials declined to provide to The Advertiser a copy of the hospital's initial response.
The union that represents the registered nurses at the hospital, the Hawai'i Nurses' Association, had described similar concerns in a letter sent to the attorney general's office in July. That letter, written by nurse and labor relations specialist Claudine Tomasa, said a decrease in nurse staffing "severely impacted patient care and has caused a significant amount of work-place injuries of our members."
Tomasa also wrote that inadequate staffing has led to an increase in patient falls, a rise in medication errors, increased incidence of patient infections and increased injuries and absences by staff.
Two hospital officials, Dr. Izumi Kobashigawa, chairman of the board of the medical center, and Dr. Stuart Sugihara, medical center chief of staff, wrote to Jones in July, discounting those claims and vowing full cooperation in the investigation.
The two reviewed the surveys, licensing studies and reviews that the hospital undergoes regularly. "Contrary to the allegations made, patient falls, hospital acquired infections, and medication errors continue to be low at Kuakini with a downward trend reflected in our data as current as June 30, 2003," they wrote.
Kajiwara declined to provide actual number of falls, errors, etc. as well as the rest of the response, saying that it included proprietary financial information as well as other information that hospitals are not now required to report publicly.
After Kuakini first responded, Jones sent an 11-page follow-up letter asking for clarification, more documentation and some additional information, he said. Jones said Friday that he had not received a response and was now asking for a target date of when that information will be made available.
Kajiwara said the hospital sent its response and a series of documents to back up its statements that amounted to "a stack of about eight inches thick."
Kajiwara said the hospital is committed to patient care and disputes the allegations, but said he takes them seriously and is focusing much of his time on responding. He said he wonders what criteria the attorney general uses in determining what allegations to investigate.
Jones said the attorney general has the duty to investigate allegations of mismanagement that involve public charities. "We hope that Kuakini's statement that the allegations are without any factual basis are true," Jones said. "We are as anxious as Kuakini is to conclude this investigation in a fair and objective manner."
Kajiwara said he doesn't know what's behind the allegations against a hospital that has had a good reputation in the community for patient care and for being financially sound. "We're puzzled," he said. Compared to some other hospitals in the community, Kuakini has remained in a favorable financial position for seven years, he said. "We try our best to have good patient care," he said.
Kuakini spokeswoman Donda Spiker disputed claims of high staff turnover. She said 2002 data reported the Employees Benefits Research Institute show the average length of service for Kuakini employees at 11.4 years compared to an industry average of closer to five years. "We feel we have a low turnover rate."
Spiker said the hospital is working to provide whatever information is needed to the attorney general's office.
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
