The Broken Corrupt Record of Emory University

This is the main page of the U.S. Finance Committee's investigation entitled Aligning Incentives: The Case for Delivery System Reform. It is an ongoing investigation which Senator Chuck Grassley and Senator Max Baucas recently updated. It is an investigation that centers on a Professor Charless Nemeroff currently a professor in the Department of Psychiatry and Behavioral Sciences at Emory University. He was until recently the Dean of the Department. According to the findings currently published for years Nemeroff took money from firms like Cyberonics, Glaxo Smith Kline, and Pfizer. For this money he published favorable articles about many of their drugs. Rarely if ever did he disclose his financial relationship with these companies when he published these puff pieces. Furthermore, while accepted about $2.6 million in contributions from these pharmaceuticals, he only reported about $90,000 in contributions. As such, not only was he bought and paid for by the pharmaceutical industry for eight years, but he evaded paying taxes on most of these bribes.

In this letter from Senator Charles Grassley, Grassley details a web of fraud, tax evasion, and an utter failure to report repeated incidents of conflict of interest.



This is a copy of a chain of emails within the Medical Department of Emory University on July 20, 2006. In it, one of the Deans of the Medical School, Claudia Adkison, is corresponding back and forth between Nemeroff and her own superiors. She admits to attempting to cover up this egregious fraud. She even alludes to being thankful that a Wall Street Journal reporter wasn't

sophisticated enough to ask the right questions

...

in working on handling the reporter I tried to make this story go away because Emory's name is in the middle of it.

...

I am embarrassed and uncomfortable that I write to colleagues around the country to try to defend this when I know all the issues.

(I wonder what the right questions would have been)
More than one internal correspondence within Emory University show that the school was aware of the fraud going back as far as 2000. Only last month was Nemeroff finally removed from being the Dean of the Psyschiatry and Behavioral Science. He continues to be employed as a full and tenured professor making well over six figures. Nemeroff appears to have made $2.6 million in income from the cumulation of payments from all these drug companies in an eight year period. He only reported about $90,000 in fees.



To understand the total context of this story you need to go back to 2000 to another case involving Emory University. The National Institute Health approached then Professor Jim Murtaugh of the Pulmonology Department. Murtaugh began to blow the whistle on misuse of Federal NIH grant money. In July of 2001, Emory University and Jim Murtaugh entered into an agreement in which Emory University paid $1.6 million for his silence. Soon after that, docuements related to the NIH investigation began to disappear, and soon after that, the investigation was swept under the rug and went away.



In June of 2004, the Department of Health and Human Services approached Kevin Kuritzky, then a medical student at Emory University, about illegal and unethical activities at the V.A. Hospital Emory staffs and Grady Hospital, which Emory also staffs.

One night that is what happened. One time he was left in charge of the entire step down unitfrom 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was
panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.

Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.

In April of 2004, Kevin Kuritzky was expelled from Emory University 41 days prior to when he was scheduled to graduate. The reasons given related to a handful of tardiness by Kuritzky. The information that Kuritzky provided eventually lead to another investigation of Grady Hospital that concluded

the conditions at Grady Hospital pose an immediate and grave danger to the health and safety of the patients.

Nearly the entire staff of Grady Hospital is faculty and students from Emory University. Kuritzky described being left alone as a medical student without any supervision while he took care of an entire step down unit for days on end.



On top of this, Grady Hospital was also implicated when corruption there and beyond lead to the conviction on more than 130 counts by then State Senator Charles Walker.



The current investigation is both remarkable in the brazen manner in which the corruption is carried out and in the total lack of context that the investigators and the media place on it. It seems with each successive investigation no one from the media to the investigators seems to put two and two together. The common thread is Emory itself. In fact, most of the players remain the same. One player I haven't mentioned yet is Kent Alexander. Alexander is the lead Counsel of Emory University. He arrived just before the NIH approached Jim Murtaugh. Formerly, Alexander spent a great deal of time in the Federal Prosecutor's office, including eventually becoming the U.S. Attorney for the Northern District of Georgia which included Emory University. In the link I provide a mention an email in which he asks his former colleagues to quash the investigation that Kuritzky was leading.



What we have in the current reincarnation of Emory corruption is ironically unremarkable. In fact, just in the last year, Emory has been embroiled in much bigger scandal than its current reincarnation with Nemeroff. At the end of last year, things got so bad at Grady Hospital, Emory University's Medical School's prize possession, that JCAHO, the governing body of hospitals, threatened to shut it down. Had it followed through Grady Hospital would have joined an exclusive club with one other hospital, King Drew in L.A. That hospital got shut down following the disclosure of a tape of a woman begging on the floor for forty five minutes, getting no help, and then dying. For reasons only known to JCAHO, Grady, and Emory after JCAHO threatened to shut down Grady JCAHO eventually dissipated the investigation and it went away. At the same time, Grady was begging everyone in the Atlanta area for dare I say a BAILOUT. They were in need of an infusion of $200 million or face potentially closing. This would have unleashed a medical disaster on the Atlanta area. Grady is not only one of the world's biggest hospitals it is the primary care facility for almost the entire indigent population in the area and provides the only trauma center for hundreds of miles.



As such, Grady was finally given a lifeline only that lifeline came from the Woodruff Foundation. This foundation is named for former Coca Cola CEO Robert Woodruff. Woodruff's name also graces an enormous amount of the buidings at Emory University. While there is no direct links between the Woodruff Foundation and Emory University many Emory faculty and administrators can also be found on the board of Woodruff. Grady has and continues to pay Emory University $50 million yearly in order to staff its hospital. After being infused with money, the hospital also created a 501(3)C board to oversea the hospital. Much of the board is made of folks from Emory and Woodruff and Pete Correll can be found on pretty much every board.



For real conflicts of interest we only need to look no further than Pam Stephenson. She is currently simultaneously a State Senator, Chairwoman of the Board of Grady, and it's interim CEO. As the head of the Board, she played a key role in securing herself the interim position of CEO. Furthermore, she was instrumental in the peculiar firing, after only seven months on the job, of Otis Story Jr, the previous CEO.



In other words, everything currently revealed in the case of Charles Nemeroff has been done by the powers that be at Emory University over and over and in much worse scenarios really. Just think about this. Charless Nemeroff received millions in unreported income. He failed to disclose cash payments while he wrote favorable articles in trade journals for companies that paid him routinely. He failed to disclose consistent conflicts of interest while he acted in much the same way as a hired gun for most of the pharmaceutical companies. For this, he was asked to step down from his post as Dean of his college. He didn't however lose his job entirely and continues to draw a six figure salary from Emory. Kevin Kuritzky was late to classes on a handful of occasions and he was kicked out of Medical School and deprived of a medical career entirely.



This is the proper context of this story. It is a story incidentally that has been reported, poorly I may add, in the New York Times, the Atlanta Journal Constitution, and the Wall Street Journal. The Emory Wheel has dedicate all of four articles to the matter. This one commends Emory University for its handling of the situation and points out that the investigation is still ongoing which would mean it continues for a ninth year.



The reality is that this latest piece of brazen corruption is the latest in a long line of seeming never ending corruption at Emory University. Whistleblowers are routinely silenced. The media is incompetent, corrupt or both.

Grady Hospital: The Plot Thickens

Based on what I have been able to gather from the Atlanta area media, the current narrative seems to break down very simple. Either Grady is allowed to transform its board into new board structured as a 501(3)C or Grady will have to close. This 501 (3)C structure was first recommended by the Grady Task Force. Since then, an anonymous source has stepped foward and committed 200 million dollars if the board is allowed to restructure.

It continues to be a mystery what this new board will do that will save the hospital. 501(3)C is an obscure sub universe in the tax code. It is frankly unclear what it will do that the previous board couldn't do. Its even less clear how this new structure will benefit Grady. Furthermore, the previous board won't be dissolved but rather it will cede much of its power to the new board. This will only confuse an already confused structure even more. It seems to me that the last thing a hospital with a history of corruption should be allowed to do is complicate its structure even more, but that is exactly the narrative that you are seeing in the media in the area.

Yet, the narrative seems to be that only this new board can save the hospital. Of course, this is a nonsensical and faulty view of the situation. For instance, if you look at the state of Georgia, you will see that Georgia provides significantly less funding to its safety net hospitals than most other states. If one compared the funding the state of Georgia provides to say the state of New York, they would see the state of New York does significantly more with its resources. The hospitals in that state have significantly fewer money issues. Of course, if the state were providing more money, the state might also want to scrutinize how that money is spent. That is likely something the powers that be at Grady want to avoid. In fact, I have already made it clear that I believe this new 501(3)C is nothing more than an attempt by the powers that be to create an extra layer of insulation to make Grady even more corruptable. That said, a more reasonable answer would be to demand that the state finally pony up the money it should to keep this crucial hospital open.

The best idea that I have heard is providing contracts for such unions as AFSCME and other unions that serve employees typical in a hospital. In return, the unions would use their health insurance at Grady. This plan is actually quite ingenius. That's because it solves one of the biggest structural problems at the hospital. The hospital currently has too many non paying patients. The best way to save Grady Hospital is to find a stream of paying patients that would offset the enormous number of uninsured that are treated there yearly. The unions would bring with them a plethora of patients that have good medical insurance. The unions would bend over backwards for the opportunity to unionize the staff at a hospital as big as Grady. It seems to be a win win...

So what is the problem with such a plan? I believe that a union would also bring with it the sort of scrutiny that the powers that be doesn't want at Grady. With a union protecting its workers, whistle blowers wouldn't be retaliated against. The union would be in a position to scrutinize much of the corruption that is going on there now. Since the powers that be are more interested in continuing the systemic corruption they have been committing there, they want no part of any union (in my opinion of course).

Grady Hospital has a long history of conflicts of interest turning into disaster. State Senator Charles Walker used a sophisticated web of conflicts to commit so much criminality at Grady and beyond that he wound up being convicted of 127 felonies. Robert Brown, long time prominent board member, often wound up giving lucrative contracts to his own architecture firm. (the most infamous was a multi million dollar addition in the early part of the decade) Even now, the CEO, Otis Story, resigned and was replaced with Pam Stephenson. Stephenson is now the CEO, a board member, and also a state legislator. Despite all of these past conflicts, it appears that financing will come with its own set of conflicts of interest.

The reason I am certain that this 501(3)C is nothing more than a sham is first, that it is presented as the only hope when there are clearly plenty of options. While it remains unclear what a 501(3)C is, let alone why it would help the situation at all, it continues to be billed as the savior. Furthermore, this 501(3)C plan is loaded with new conflicts of interest that are neither explained or dealt with. Since it was the brainchild of the Grady Task Force, it would be a reasonable assumption that most of the new 501(3)C board would be made of previous members of the Grady Task Force itself. If that is the case, this new board would be filled with all sorts of conflicts of interest. While the board is made up with plenty of people of high credibility, it is also made up almost exclusively with people that have an inherent conflict of interest at Grady. Almost every member of the Grady Task Force is tied to Grady financially, (Michael Russell who has had several lucrative contracts at Grady), professionally (Dr. Michael Johns head of Emory University's Woodruff Health Sciences Center) or politically. None of these inherent conflicts is explained or dealt with by the Task Force or in any plans of the new board. (In other words if this new board is allowed to be formed it will likely be filled almost exclusively by folks that have an inherent conflict of interest with the hospital itself. Exactly the sort of situation that lead directly to prior corruption would be allowed to form again)

This brings me back to this anonymous donor. Since the donor is anonymous, the exact identity can't be made with certainty. That said, multiple sources have speculated to me that the donor is the Woodruff Foundation. While I will keep my sourcing close to the vest, figuring on Woodruff being the anonymous donor is mostly a process of elimination. There are very few folks or entities with enough capital to provide 200 million dollars. Besides the Woodruff foundation, the only other entity is Emory itself. If it is Woodruff, then this raises all sorts of other conflict of interest issues. The Woodruff foundation has all sorts of ties to Emory University. (Emory University of course provides most of the staff at Grady Hospital) There are very few people or entities with 200 million to begin with, and even fewer with enough capital to be able to part with 200 million. Those that can only two have any motivation to keep Grady open: the short list is the Woodruff foundation and Emory University itself.

The name most prominently mentioned to head up the new 501(3)C board is Pete Correl. Correl is the former CEO of Georgia Pacific. Correll is currently a board member of Emory's School of Medicine. If my information is accurate, then this new plan is nothing more than a ruse by Emory University to consolidate even more power at Grady Hospital. Emory University already enjoys the benefits of yearly lump sum payments to staff the hospital and it even has Grady pick up the tab on its malpractice insurance. (Here is the sourcing on that)

Thus, if I am right, this so called 501(3)C will mostly have the practical effect of consolidating even more power at Grady Hospital into the hands of Emory University and its friends and allies. Yet, none of the media questions the false narrative that this 501(3)C is the only way to save Grady. None of the media scrutinizes this anonymous donor to make sure this donor doesn't have any alterior motives for giving the money. None in the media raise the obvious concern that Pete Correl's appointment to the new board would have.

What I am seeing in this evolving fiasco is pretty simple. At its time of greatest need, the powers that be have devised a plan that will make Grady even less transparent, will consolidate even more power into less hands, and will create even more conflicts of interest at a hospital with a long and sordid history of disastrous conflicts of interest. The worst part is that they are doing this with a largely apathetic media, public and political class looking the other way and not questioning any of the actions one bit.

The NY Times Prints Gibberish Regarding Grady Hospital (Updated)

Prologue: After originally publishing this piece, I thought about it and updated it appropriately. If you have recently been here, read the piece again and see if it is any better. If you haven't, you are getting my best work right away.

Introduction: The role of the media in the Grady scandal cannot be understated. I have already pointed out how the Emory Wheel acts no different than any mouthpiece for any corrupt, totalitarian regime with regards to Grady Hospital. The Wheel plays a vital role in hiding the administration's role in the crisis. I have also pointed out several instances of shotty reporting on the part of the AJC that has effectively failed to add the proper context to this story. This contributes to an Atlanta population that is confused and uninformed when it comes to Grady Hospital.

The media's incompetence, corruption, and willful ignorance have contributed to muddying the waters and keeping the truth from reaching the mainstream. This latest piece from the NY Times is another example of the media's of will in reporting this story accurately. I will explore the consequences of the media's ceding of the first amendment in future diaries. For now, I want to focus on how this particular piece distorts the issue and leaves the reader confused and uninformed.

Here is the piece...

Immediately, the authors attempt to identify the forces that they believe have caused one of the largest hospitals in the country to be on the brink of collapse. These two paragraphs are both found within the first 20% of the piece.

Although the hospital is unique in many ways, the code red at Grady is emblematic of the crippling effect America’s health care crisis has had on public hospitals around the nation. Though Grady is among the most distressed of the country’s 1,300 public hospitals, others have faced similar challenges in recent years, including those in Miami, Memphis and Chicago, said Larry S. Gage, president of the National Association of Public Hospitals and Health Systems. There are 300 fewer public hospitals today than 15 years ago, with hospitals having closed in Los Angeles, Washington, St. Louis and Milwaukee, Mr. Gage said
....

Like other public hospitals, Grady is operating on a business model that is no longer sustainable. A third of the hospital’s patients, including those treated as outpatients, are uninsured, among them a rapidly growing group of immigrants.

As the article later points out, Grady Hospital is in need of funds in the neighborhood of $360 million and the supposition of the authors is some sort of mysterious and nefarious pseudo socioloeconomic forces. (I believe that corruption was the primary factor, however that is beside the point now) No studies, evidence or facts were given to back up this supposition, and furthermore, it was never explained how mere market forces could cause such a huge cash shortfall.

The issue of corruption is addressed though way in the back 30% of the piece and with a passing mention.

There have been charges of corruption and cronyism, most notably in 2005,
when a powerful state senator was convicted of using his influence to secure
overpriced Grady contracts for his temporary services business.

The State Senator (Charles Walker) is not identified by name. The specifics of the case aren't detailed...127 felony convictions. Clearly, the authors don't believe that corruption plays any sort of a major role in their current crisis.

This sort of absurd socioeconomic arguement is only apparent to someone with as much knowledge of the situation as me. To others, they may very well believe that one of the biggest hospitals in the country is failing due to socioeconomic forces outside its control.

Here's what makes this so absurd. One of my favorite quotes throughout this came from an Atlantan friend of mine...

they can't close Grady the rest of the hospitals don't want their patients

The idea that providing health care to the poor is fading due to market pressures is faulty because providing health care to the poor is no market. They aren't competing for those patients. Those patients go there because they have nowhere else to go.

Costs may in fact be going up, however if they are they can be documented. If they are being documented and the funds still aren't getting to the hospital, then someone is responsible for that. Since the article never goes beyond mere assertion, none of this vital information is explained.

The article is clearly trying to create a certain theme. First, it uses Pamela Vaughn as the symbol of Grady. Pamela Vaughn is not only a nurse at Grady, an infallable profession, but she herself was born there. Vaughn is referenced multiple times throughout the piece.

The first paragraph goes like this...

Like tens of thousands of Atlantans over the last 115 years — like Gladys Knight, the soul singer, and Vernon Jordan Jr., the presidential confidante; like more than one in three babies born here in the last decade — Ms. Vaughn entered the world at Grady Memorial Hospital, one of the nation’s largest safety-net hospitals.

Then it painstakingly recites a resume of good deeds performed at Grady Hospital. You find passages such as this sprinkled throughout the piece...

The hospital, sandwiched between downtown and the neighborhood where Martin
Luther King Jr. was born, was the place where victims of the 1996 Olympics bombings and countless other disasters have been treated. It is so intrinsic to the city’s identity that Maynard H. Jackson Jr., the first black mayor, liked to say that Grady babies should be allowed to vote twice.

The bearded, middle-aged man was bleeding from a self-inflicted gunshot wound to the left side of his chest. “Don’t let me go out in pain,” he moaned in a drawl to the doctors and nurses treating his injury. “I was born at this hospital.”

The patient in Trauma 3 was a Grady baby, though no one could have guessed it when the ambulance pulled in at 1 a.m. that Saturday.

This sort of fawning praise is actually quite a bit obscene. It is the first time I have read a puff piece where the target of the puff was an inanimate object like a hospital. The praise is also beside the point. Whether or not good work is being done in the hospital is not the issue. The issue is that the hospital is so deep in debt that it is estimate that up to half a billion dollars maybe necessary. At the same time, its patient care has become so suspect that JCAHO has been moved to act as it has only done once prior in history. Of course, this is something that is barely touched upon in the article.

Last month, the Joint Commission (JCAHO), the country’s leading health care accrediting agency, raised serious concerns about Grady’s status after observing numerous significant shortcomings during a five-day inspection. Although the commission has not yet released a public report, hospital officials, speaking anonymously, said the commission’s concerns included broken equipment, sanitation and the adequacy of staff supervision

Here the article fails in what it doesn't mention and then put together. This move by JCAHO is only the second time in the history of hospitals. The other was King Drew and here is the story that forced JCAHO's hand...

It might have gone down as the death of a "quasi-transient" woman with a history of abusing drugs. That's how the May 9 death of Edith Isabel Rodriguez was initially reported to the Los Angeles County coroner's office.But five weeks later, her demise has become a cause celebre, a symbol of bureaucratic indifference. It is fraught with significance not just for one struggling inner-city hospital but for political and health leaders in the Los Angeles area and perhaps beyond. The county Sheriff's Department, health officials and the Board of Supervisors all are feverishly trying to determine who was to blame and how to prevent a recurrence...

This means the level of patient care is so bad at Grady Hospital that it is on the level of a hospital that stood by and watched while a patient begged for help for forty five minutes and then died. They do what every media does when it refers to the JCAHO action. They mention it in passing and then move on.

The piece of course, then, doesn't put two and two together. The situation at Grady Hospital is so critical that it is simultaneously need of somewhere in the neighborhood of half a billion dollars and its patient care is so bad that it rivals a hospital that sat by while a patient begged for help for forty five minutes before dying.

Of course, again, the layman is not going to process that. Instead, they will feel that shutting this hospital down is a travesty because of all the good work they are doing.

Then, the article makes two rather interesting observations...

Over the years, the cost of caring for the uninsured and underinsured has grown while taxpayer support has stagnated. Suburban counties have declined to pay a share of those costs, though their residents regularly wind up in Grady’s emergency room and its highly regarded centers for burn and poison treatment. Management problems within the hospital have played a role, and community pressure has kept Grady’s politically appointed board from making deep cuts. As a result, the hospital has faced deficits for 10 of the last 11 years.

...

Only the state can force other counties to pony up money for Grady. And the state legislature and the governor’s office are controlled by white Republicans, whose core constituents have historically not viewed themselves has having a direct stake in the hospital’s future.

Those are rather startling accusations. If I read the article correctly, there was a clear increase in costs and at the same time the budget from the legislators became tighter, and it may even have been racially motivated.

First, had the authors researched the case they alluded to they would have known just how absurd and inflammatory those statements are. State Senator Charles Walker was convicted for a number of crimes...127 felonies total. He routinely used the power of the purse strings to curry favor. He himself was black and he was doing all of this within the last decade. This case paints a completely different root for the purse string problems in the Georgia legislature.

Thus, it is unclear how they came to believe for instance that,

the cost of caring for the uninsured and underinsured has grown while taxpayer support has stagnated

These are measurable things however nothing is measured to back up the theory. It is frankly gibberish and worse than that, intelligent sounding gibberish. Unfortunately, it is found throughout the piece. Even worse than that, much of public is likely to fall for much of this gibberish.

CONCLUSION: The conclusion they would get is that this sympathetic hospital is failing due to some sort of pseudo socioeconomic factors outside their control. If they don't get money quick, this staple of the community will close down. Meanwhile, politicians with tight belts refuse to increase funding even though costs are clearly going up.

Epilogue: This scandal has lots of twists and turns. If this article has been confusing, I suggest you read this updated summary of the entire fiasco...

Re Examining the Case of State Senator Charles Walker

For more than a decade State Senator Charles Walker was among the most if not the most powerful politicians in the state of Georgia. His reign came to a humiliating end in June of 2004 when he was indicted on 142 separate counts of corruption related charges. His indictment read like an alphabet soup of terms straight out of your favorite law or cop show: wire fraud, conspiracy, tax evasion, extortion. If it was on your favorite lawyer show, he was probably charged with it. Of those 142 charges, he was convicted on 127 counts.

The scope and breadth of his crimes was staggering, shocking, and ultimately it is the back bone of the widespread corruption that is currently leading to the potential closing of Grady Hospital. Walker used a network of power and influence to either get into bed with powerful people or strong arm those that refused to play ball. For instance, Walker ran a newspaper and anyone that wouldn't play ball would be threatened with negative publicity from his newspaper. He used his ability to procure government funds as a string to get hospitals to hire temps at his temp company.

Here is where the case gets shocking. After being convicted on 127 counts he was sentenced to ten years in jail. Now, normally, when someone receives such a light sentences after being convicted of so many things, we would assume that he flipped on others. In this case, he didn't. In fact, besides Walker, his daughter, and the companies they ran, NO ONE, NO ONE, was charged or convicted of anything. Furthermore, the authorities would have us believe that the proper sentence, without ratting out anyone, for 127 separate convictions is ten years. There are people busted with drugs that are serving more time than that. It seems the corruption that Walker pulled off was nothing compared to the corruption involved in investigating and executing his case.

In fact, we don't need to speculate as to whether or not others were involved in the corruption. One only needed to be in the courtroom on the day that Joyce Harris, the chief prosecution witness, testified. According to a source that was there when she testified, she accused Walker of demanding a quid pro quo. Grady is a public hospital. Walker, who again was one of the most powerful politicians in Georgia, was able to influence just how much money they received. He demanded that the temp company he ran hire up to 50 people per day (if you read the link Grady normally hired a handful per day) in order to receive funds. Harris testified to a lot more than just Walker. She accused Grady CEO Ed Renford, and Tim Jefferson Chief Legal Counsel of Grady, of threatening her safety if she blew the whistle. She accused Robert Brown, President of the board of Trustees of Grady Hospital, of accepting kickbacks and sexual favors. She accused William Casarella, Chief Medical Officer at Grady, of looking the other way. Yet, despite these incendiary accusations and 127 separate convictions of Walker, the powers that be at Grady were never investigated.

In other words, first, the authorities would have us believe that this guy was able to pull off so much criminality that it lead to the conviction on 127 separate counts, and that he pulled all of this off on his own. Furthermore, the authorities would have us believe that a proper sentence for the conviction on 127 separate charges is ten years in prison.Furthermore, right around the time that Walker's trial was ending, the Center for Medicare and Medicaid Services (CMS) in the Dept. of Health and Human Services issued a report on Grady. Here is the conclusion of the report.

the conditions at your hospital pose an immediate and serious threat to the
health and safety of your patients

You think that is shocking. What is really shocking is what happened to all of the players that were not only involved in the corruption of Walker but the conditions that lead to the scathing conclusion of that report.

The only one to lose their job as a result of the Walker scandal was Joyce Harris the one person who tried to stop the corruption. Ed Renford retired with a pension that pays him six figures per year. Tim Jefferson continues in the exact same position. William Casarella was actually promoted within Emory University. Robert Brown did eventually lose his sweetheart position but that was due to a separte scandal.

The reason this is important is because Grady is on the verge of collapse and its collapse threatens the entire medical system in Atlanta and Georgia. As a friend and Atlanta resident recently told me, the people the are the most scared are the other hospitals because Grady treats the patients no one else wants. Now, the legislature is debating whether or not to feed Grady with millions of more dollars. Make no mistake, Grady is in this mess because it is obscenely corrupt, and the exact same people that caused the corruption continue to be in power now. If they are fed more money, that is the ultimate throwing good money after bad.

If people are serious about saving Grady the first thing they need to do is clean house. You cannot save Grady if the same people that put it in this mess are in charge of getting it out. I hope the good people of Georgia will wake up to the obscene levels of corruption that have put this essential hospital on the brink of collapse and that they demand that the resolution is once and for all no longer the same old same old.

(Updated)Much of the story about Grady Hospital is so confusing that anyone that winds up in the middle is likely to be confused. I don't believe that this particular one is an example of this, however, you should also know how State Senator Charles Walker fits into the entire puzzle so to speak. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

Also, please follow this link so that you can hear me and a colleague discuss the Walker case along with several other matters related to Grady and Emory.

The Consequences of Shutting Down Grady Hospital and its Political Ramifications

As I mentioned earlier, Grady Hospital has joined a dubious category when the JCAHO threatened to revoke its accreditation. Only King Drew in California was ever threatened with such an extreme measure. An investigation by the L.A. Times that was ultimately highlighted by this story forced JCAHO's hand.

Despite a long history of problems at Martin Luther King Jr.-Harbor Hospital, two things set the Rodriguez case apart: the existence of a security videotape showing the woman writhing for 45 minutes on the floor of the emergency room lobby and the public release this week of two 911 calls in which witnesses unsuccessfully pleaded with sheriff's dispatchers for help.

In the case of Grady Hospital, it was community activists, not the media, that alerted JCAHO to problems. Since Grady won't release the findings we don't know what specific problems there are yet. Of course, one only needs to read these pages to know the sorts of horrors that have happened at Grady Hospital. (this story involves a medical student left alone in charge of an entire step down unit)

One night that is what happened. One time he was left in charge of the entire step down unit from 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was
panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.

Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.

I set this context so everyone understands what a total nightmare Grady Hospital is right now. Keep in mind that Grady's current financial crisis is in many ways divorced from the findings of the JCAHO report. In other words, whatever patient nightmares were going on at King Drew, they didn't also experience a financial crisis concurrently. King Drew was ultimately forced to shut down. That is a distinct possibility for Grady as well.

I believe shutting down Grady would create an even bigger nightmare with all sorts of unintended consequences and frankly a situation no one can predict or control. Let's lay out some numbers. Grady Hospital serves roughly one million patients per year. It has five thousand employees and contributes roughly 1.5 billion dollars to the economy in the area. Despite only serving two of Georgia's roughly 100 counties, Grady provides some or all of the training to one quarter of Georgia's doctors. Ninety percent of the staff at Grady is from Emory University with about 400 residents from there on staff at any given time. The entire medical school of Morehouse is trained at Grady Hospital as well. Grady Hospital has about nine hundred beds available. For comparison, South Fulton, the other hospital primarily for poor folks in the area, has 36 beds.

Its important to understand that Grady serves the poor, the indigent, almost exclusively. More importantly, in Fulton, Dekalb, and to some extent the surrounding counties, the poor and indigent are almost exclusively served by Grady. In the case of King Drew there were several other area hospitals that were also already serving the poor. Not so in the case of Grady. Without Grady Hospital the poor would be unleashed on the entire remaining health care system that remains. As a friend in Atlanta once told me

there's no way they will close Grady because the other hospitals don't want their patients

Keep in mind that most of the folks that go to Grady either have no insurance or Medicare at best. In other words, treating them is in no way a for profit operation. Soouth Fulton is the only other public hospital in the area, and there is no way it could handle the entire indigent population of Fulton and Dekalb Counties. Furthermore, Grady is the only level 1 trauma center for hundreds of miles. Severe gun shot wounds, bad car accidents, dismemberments, and other such traumas are all treated there and there only for hundreds of miles. Many times other neighboring states have their level one traumas treated there. In case of a terrorist attack, it would be Grady that would be the only hospital equipped to handle mass casualties in the area.

Furthermore, since Grady is also the main teaching hospital in Georgia, the entire health care teaching system would be traumatized. With 25% of the doctors receiving some or all of their training at Grady, the impact on the medical training is beyond words. Emory's medical school would be the equivalent Northeast Texas State Community College and Morehouse would cease to exist altogether.

I recently pointed out the absurdity of AJC reporter Mike King's column in which he called Grady board members arrogant for making demands not requests in their time of crisis. I doubt very much that you will find anyone in the Atlanta area media that will ever break down Grady's impact the way I just have, however I am certain the powers that be at Grady know full well the numbers that I have laid out. In other words, crisis or not the powers that be know what a vital part of Georgia Grady is and thus they can afford to be arrogant.

This context has political impact and it is also something that I do not believe the Atlanta media will ever explain properly either. Late last month, the Grady board approved a plan that would infuse Grady with much needed cash and make the board quasi private. The timing of this move is very important because it came right before JCAHO's announcement. While this plan purports to deal with Grady's fiscal issues, it in no way addresses the obvious medical care problems currently going on at Grady. Frankly, given the make up of the task force that recommended this plan, as well as other factors, I have already concluded that this quasi privatization plan is nothing more than a stunt that allows the powers that be to continue running Grady the exact same way only with even less oversight.

Now, I believe that the legislators and the Grady board are playing a high stakes game of chicken. It is frankly difficult to surmise which is worse: allowing a corrupt Grady to continue to operate or shutting it down and unleashing its patients on the rest of the medical system and disrupting the states medical education. It is even more dificult to figure out which is the better move politically. So far the politicians appear to be balking at Grady's proposal.

State Senate President Pro-Tem Eric Johnson (R-Savannah) took issue with the demands that state officials support $30 million more a year in funding to Grady and provide state funding for hospital trauma units around the state.

"What? They didn't require us to fund an ice cream cone for every patient?" Johnson said. "I don't think the Legislature responds well to blackmail. ... Grady cannot be treated any different than any other hospital."

I would have to beg to differ with Johnson on one point. Grady can and always has been treated differently than other hospitals. The reasons for this are numerous however most of them have been laid out in this piece. There are very few hospitals in America and the world that are more vital to the community they serve than Grady Hospital. The powers that be at Grady know this all too well and they are now using that fact to try and force the hands of the politicians in Georgia. The politicians can talk tough however if Grady is shut down, that is a situation no one can predict and control. What's going on now at Grady is despicable, corrupt and frankly evil, however it is done almost exclusively to poor folks who really don't vote. By shutting Grady down, on the other hand, the politicians will unleash a nightmare upon everyone else in Georgia, and most of those people do vote.Thus, we have this complicated and high stakes game of chicken.

EPILOGUE:If you would like to know how Grady got to this point, please read this summary. Also, please take a look at the recommendations that my colleagues and I have drawn up to fix Grady Hospital.

The Changing Political Dynamic Surrounding Grady Hospital

From a purely political junkie level the current dynamics surrounding Grady Hospital are absolutely fascinating. Here is a quick run down. Late last month, the board at Grady Hospital approved a plan to go quasi private and asked, or demanded depending on your perspective, for roughly half a billion dollars in order to stay solvent. Then, not two weeks later, the JCAHO threatened to cut off Grady's national accreditation. Now, let's take each one at a time and then look at them together.

I believe the board is playing a huge political game of chicken with the Georgia legislature. I believe this plan does NOT have the best interest of the hospital in mind whatsoever. While that is certainly important, it is unfortunately a side issue in this political battle. As a friend of mine once put it

Grady can't shut down because who would take care of all the poor folks then

Without the money called for in this plan, Grady WILL shut down. The powers that be know this, and I have said as much. While Grady Hospital has had a long history of corruption and mismanagement, much of the power structure has continued to boldly and brazenly manage it in much the same way that has landed it in its current state. The reason for this is of course quite complicated, however it is due in no small part to Grady's vital role in Georgia health care system and society at large. Remember, Grady Hospital is among the largest in the world and is overwhelmingly responsible for taking care of most Georgia's poor folks. Without it all of the many "nice" hospitals in the area would have to take care of those folks.

I have fallen in love with the Latin phrase, Res Ipsa Loquitur. (The facts speak for themselves) Given Grady's long and sordid history with corruption and mismanagement, the fact that most of the power structure in Georgia never tried to really stop it tells me that most people don't much care as long as some other entity was taking care of those that no one else wanted to take care of, THE POOR. I believe the powers that be are counting on the exact same dynamic now. I believe the only thing most of the power players in Georgia want to avoid is for the poor folks to be dropped on the rest of the health care system. As long as they are Grady's problem, in my opinion, most everyone else turns a blind eye.

Thus, we have this game of chicken. The legislature doesn't want to hand Grady Hospital anymore money. They must know that the systemic problems currently going on at Grady aren't going to be solved with this plan, however without an infusion of cash, Grady shuts down. The powers that be at Grady are counting on the legislature blinking first. The legislature meets again in January so, for now, that part of the story is on hold.Enter the JCAHO. Just last week they publicly threatened to revoke the accreditation of Grady Hospital. To put this move in perspective only one hospital, King Hospital in California, has ever actually lost their accreditation. Many of allies on this story have extolled this move as pivotal. I am a lot more skeptical. There must have been the same kind of excitement when State Senator Charles Walker was convicted of 127 felonies at Grady and beyond. Yet, he, along with his daughter and the companies they ran, were the only ones that were convicted, and of course he got the absurd sentence of ten years. In 2004, the department of Health and Human Services conducted an investigation that concluded this...

the conditions at Grady Hospital pose a serious and immediate threat to the
health and safety of the patients

That was pretty damning however besides the then CEO, Dr. Andrew Agwunobi, no one lost their job as a result of this report and the power structure stayed in place despite its damning findings.Even in the late 1990's, Georgia Attorney General found Grady Hospital guilty of Medicare fraud. All of these were opportunities lost to clean up the corruption at Grady Hospital. The reason it didn't happen is also quite complicated, however I believe much of the blame goes to the media in Atlanta, headed by the Atlanta Journal Constitution.

In each of these stories, the truth is quite complicated and it was never fully explained to the citizens of Georgia. For instance, in the case of the HHS report, the report itself was damning, however how many people know the specifics of the report? Four departments were singled out: oncology, cardiology, General Surgery, and obgyn, in the report. Each of these departments had heads. None of these people lost their jobs because the specifics of the report weren't ever reported properly in the media. Furthermore, the heads of these departments had one boss, the Chief Medical Officer. His name is William Casarella and he has since been promoted within Emory University. This also happened because the media didn't properly report the specifics of the case. All people knew, if anything, about the investigation was the conclusion. While that was damning enough blame was impossible for a layman to determine without understanding the specifics as I now explain them.

In the case of Medicare fraud in the late 1990's, three departments were also identified: cardiology, obgyn, and oncology. Again, these departments have heads and a Chief Medical Officer above them. All of them including the CMO should have been and would have been fired if the media had properly exposed that case. As you can see the same departments are now coming up in multiple reports. No one outside the Grady structure knows this because the media, either through incompetence or worse, doesn't report the specifics of each case.There is one other case that the media did an atrocious job of reporting. That is the case of Dr. Sam Newcom. He was for about a year, the head of Oncology at Grady Hospital and Emory University Professor. He tried to speak out about the corruption and poor patient care at Grady Hospital and he was fired and ultimately paid off and silenced, but before that he wrote an article entitled Fighting Class Cleansing at Grady Memorial Hospital. You won't find this article in any mainstream Atlanta publication. As head of Oncology, you would be right in concluding that much of his indictment centered on his own department. In other words, oncology is the subject of a great deal of indictment from people of varying motivations and knowledge.

Nothing much has happened to clean up the oncology department and that is because the media has been asleep in reporting the specifics of what is going on at Grady.Then, there is Emory University. When the heat gets hot on Grady, Emory does a great job of distancing itself. In fact, they are doing their own disappearing act now. The truth is that they are for all intents and purposes one and the same. Each of these departments indicted by several different groups was run and almost fully staffed by staff at Emory University. The Chief Medical Officer, Dr. William Casarella, during much of this malfeasance has since been promoted within Emory. In other words, when there is sytemic problems at Grady Hospital, the blame must be laid at Emory University since it is staffed overwhelmingly by Emory professors and students. When Dr. Newcom indicted oncology, he was indicting his own colleagues since oncology is overwhelmingly staffed, like most of Grady Hospital, by Emory University personnel.

Now, what about the JCAHO findings? We know they are threatening to cut off accreditation however why? That, we don't know because for reasons unknown (I plan on calling the JCAHO on Monday for further explanation) the specifics of the findings aren't known. We can assume that multiple specific departments are the cause of it. It might be oncology, General Surgery, obgyn, cardiology, etc. The heads of any of the departments involved must be removed. If your department contributed to an investigation that ultimately lead to the accreditation of your hospital being threatened, THAT IS GROUNDS FOR REMOVAL, in my opinion at least. The current chief medical officer, Curtis Lewis, must be removed. If you are overseeing a hospital and the hospital is threatened with the removal of its accreditation, THAT IS GROUNDS FOR REMOVAL. The Current CEO of Grady Hospital is Otis Story, Sr. He must be removed for the same reasons. In fact, the entire board ought to be removed, however the board is overseen by Vernon Jones, and anyone that knows anything about Jones knows not to expect that to happen. Of course, how many Georgia folks know the real story behind Vernon Jones? That would require the media in Georgia to actually competently report the whole truth.

This whole case proves why the first amendment, the free press, is first not second or tenth. I hope everyone sees what happens when the media itself cedes its own freedoms and doesn't bother to report the whole truth. In order for this cycle to stop, the whole truth of the JCAHO findings must be reported by the media in Georgia. The media must keep the pressure on until all parties are held responsible. That is what has to happen.

Here is what will probably happen. There will be no more then a few more articles in the AJC about this report. Anymore reporting will be on the eventual deal made between Grady and the JCAHO, a deal that will no doubt be made in some back room. The major media in Georgia will NOT reveal the specific departments responsible for this latest investigation. They won't name names and they won't demand for heads to roll. Finally, they won't call Emory out when they distance themselves. Emory University will throw its significant weight around the Georgia Legislature and no one will report it. Grady will be given a golden parachute and none of the obvious systemic problems I have pointed out will ever be reported on or addressed. I hope I am wrong and I will be watching.

For more information on this case, please read this article. Also, please read the recommendations that my colleagues have come up with and compare them to the current plan.

JCAHO Threatens to Shut Down Grady Hospital

The Atlanta Journal Constitution (which I believe to be a suspect news organization) broke this this morning...

As if things weren't bad enough for the financially strapped Grady Health System, now the hospital faces a list of criticisms, including issues with patient care, that put its national accreditation at risk.

In a five-day inspection last week, the Joint Commission —- formerly the Joint Commission on Accreditation of Healthcare Organizations —- identified "numerous requirements for improvement," according to a statement issued by Grady on Monday. Hospital officials gave no details about the kinds of shortcomings inspectors found. Dr. Christopher Edwards, vice chairman of the Grady board, said the report cited "opportunities for improvement in various areas, including patient care."

Anyone who has been reading my work, knows that the tone of this article is wrong. It is frankly long past time that the powers that be, be held responsible for the mess at Grady. Keep in mind that about three years ago, the HHS conducted an investigation that concluded this about the patients at Grady Hospital...

there is an immediate and serious risk to the health and safety of the patients

Obviously, it can't get any worse than that for a hospital. Now, three years later the hospital needs an injection of half a billion dollars to stay solvent. Before that, Grady Hospital was convicted of Medicare fraud. State Senator Charles Walker committed so much criminality at Grady and beyond that he was ultimately convicted of 127 felonies. I am fond of the Latin phrase Res Ipsa Loquitur (the facts speak for themselves), and in the case of Grady Hospital, Res Ipsa Loquitur.

One only needs to do a Google search to discover that there are serious and systemic problems at Grady Hospital that frankly, in my opinion, warranted intervention from authorities long ago. Given the current crisis and latest report from JCOHA, it is clear that proper steps weren't taken in response to the report from HHS about three years ago. I hope that this latest episode winds up with a different result.Here is the so called inside baseball on how this transpired.

Much of the credit should end up going to Ron Marshall of the Grady Coalition. He sent letters for years to JCAHO complaining about stonewalling on the part of Grady staff as far as open records requests and in answering their many questions on a whole host of issues related to corruption, poor patient care, and effective hospital management. Here is an example of an email that he sent that I got a hold of...

Mr. Bressler,>> YOU often appear not to have the evidence we have presented to you> over the years. We hope you have protected all documents we have sent> to you from spoilage.>> NATIONAL WITNESSES: THE GRADY SYSTEM HAS FAILED> Because of the severe suffering at Grady, we cannot rest until JCAHO> violations are stopped. We are bringing on board new witnesses.

Dr.> Linda Peeno, formerly a top executive at Humana, has analyzed the> situation and finds that this is a breakdown of the medical system.> Peer review is an essential part of the system to protect patients.> Bad faith peer review effects the medical judgements of all doctors> in the system, and leads to systematic poor medical care. Testimony> demonstrates it is impossible to deliver minimal standard care when> peer review has been subverted.>> CONGRESSIONAL ALLIES> We will be meeting with Congressional allies next week, and we will> be holding a press conference. We hope we receive a statement from> you by noon, Tuesday that you will implement a plan to enforce JCAHO> regulations at Grady.

>>GOOD FAITH PEER REVIEW IS ESSENTIAL TO THE INTEGRITY OF THE SYSTEM> I know you do not want to enforce peer review standards. However, I> don't see how you can enforce any standard if bad-faith peer review> is being used to hide malfeasance at the hospital. Peer review is> part of a system to protect patient care. If peer review is> subverted, doctors and staff are unable to speak up for patients and> to enforce patient care standards. The whole system is stood on its> ear. I hope you will reconsider your position and enforce JCAHO's own> standards. Grady has violated each of the provisions you outlined in> your last letter.>> BAD FAITH PEER REVIEW HAS BEEN CORRUPTING THE MEDICAL SYSTEM FOR DECADES> This has been a horrible problem for years.

Verner Waite wrote to you> about widespread violations in peer review leading to patient harm> ten years ago, and you did not respond. It is our position that you> must enforce all standards, especially peer review standards, that> impact patient care. This is at the core of your function.>> BAD FAITH PEER REVIEW IS CORRUPTING POLITICS IN GEORGIA> We have presented extensive evidence, including evidence from an> assistant DA, that the huge amounts of money stolen from Grady has> perniciously influenced Georgia politics. The 142 felony count indictment against Senator Walker was based in large part of his corruption of Georgia's hospitals by corrupting its peer review system. Bad faith peer review is a cancer on the body politic of the> entire state. Bad faith peer review can only bestopped by JCAHO.>
JCAHOs failure to enforce its standards is harming the entire state.

HOWEVER, EVEN IF YOU WILL NOT ENFORCE YOUR OWN STANDARDS, PLEASE AT>LEAST MAKE GRADY CORRECT DEFICIENCIES IT HAS ADMITTED IN MORE THAN THIRTEEN AREAS. GRADY IS THE MOST IMPORTANT HOSPITAL IN THE SOUTHEAST THAT SERVES> MINORITY PATIENTS. PLEASE TELL US IF YOU WILL ENFORCE YOUR STANDARDS> AT GRADY.

>> 1. For your convenience, we have created a database showing how> violations in JCAHO policy at Grady have resulted in severe patient harm over the last five years: http://www.geocities.com/ron_marshall21/

2. We also document how Grady has retaltiated against witnesses to> prevent you from getting evidence: http://www.geocities.com/ron_marshall21/

3. We summarize severe corruption and its impact on patients:

4. We summarize witnesses available and ethics violations:

5. Current staff document new retaliations, and JCAHO violations. The staff fear tospeak to you.

6. Patient care is greatly compromised.THE HARMS TO GRADY'S PATIENTS ARE STAGGERING. PLEASE RULE ON OUR> COMPLAINT IMMEDIATELY.> A BLUE RIBBON COMMISSION TO INVESTIGATE UNETHICAL PRACTICES IS NEEDED NOW.> ROBERT BROWN AND PAUL HOWARD MUST RESIGN.>>

Thank you. We know this is a lot of information, but all of it has> been sent to youpreviously. This is but a portion of the documents> already in your possession.>> Ron Marshall> George Anderson> The New Grady Coalition

While many of the names are probably unfamiliar, please note this particular email is one of many over several years. Clearly, Grady refused to respond to good faith efforts to address issues that years later JCAHO has finally gotten around to forcing them to address.I hope that everyone grabs the bull by the horn in this situation and takes steps to institute the sorts of institutional changes that are necessary to rid Grady of the culture of corruption that seems so apparent to me.

Here is the plan as set by the Grady Task Force. If anyone can make sense of it, let me know because I can't. Here is the plan me and my allies have developed. I hope that everyone has a chance to read it. The time for Grady Hospital is critical, and it is time for real solutions.

For reference on how Grady Hospital got to such an extreme point you can go to this tag, or you can read this summary.

No Mike King: You're Out of Touch

Here is the latest column by AJC columnist Mike King.

It takes a special kind of arrogance for the Fulton-Dekalb County Hospital Authority to stiff Emory and Morehouse medical schools out of $63 million and then demand the schools keep sending doctors to Grady Memorial Hospital. As a condition of turning over the hospital to professional management, the authority demanded that Emory and Morehouse give a written guarantee they will continue their residency and teaching programs at Grady. The money for those programs comes almost entirely from the state and federal governments, but the Grady board has kept much of it in recent years to use for other expenses. The hospital's mismanagement is now threatening the quality of on-the-job training both schools offer. It's one thing to ask Emory and Morehouse to renegotiate the debt, which both have said they are willing to do. But demanding it, as well as a promise that they won't cut back their programs, reveals how truly out of touch with reality the authority can be.

Now, really quickly, here is a run down for those that haven't been following this story. He is speaking of Grady Hospital, which is one of the largest hospitals in the country. It services the poor and is in such dire financial shape that it needs somewhere in the neighborhood of half a billion dollars to stay afloat. Emory and Morehouse provide much of the staff at the hospital (with Emory providing most between the two) and each university gets paid for providing the staff. According to King, Grady wants to not only be relieved of their yearly obligations but they insist that each university's staff remain on duty. Grady is a public hospital so ultimately it is "owned" by the folks. Lastly, and this is quite important, Grady is designed for the very poor or indigent, and by its sheer size it services almost all of the poor folks in Fulton, Dekalb and frankly many other counties. Without it, all the nice hospitals that treat wealthy folks in the area would have to treat these poor folks as well.

Now, I won't argue that arrogance is a trait exhibited by several folks in this mess, however if this is what he is focused on, he really is out of touch. First of all, there are plenty of people out there that believe that Emory and Morehouse should be paying Grady for use of their hospital, not the other way around. (for a full summary on this story including an explanation why Emory and Morehouse should be paying please follow this link) Thus, by demanding that staff continue to work without payment, seems, to many, only fair. Second of all, Grady is near financial collapse and it may take up to half a billion dollars in order to save it. Given that staggering figure, is the important point really whether someone is asking or demanding that debts be forgiven. After all, if Grady needs half a billion dollars, Emory and Morehouse can get in line with a plethora of creditors.

Ah, but unlike most creditors, Grady expects, not asks, these two to continue providing services. Of course, they expect that Emory and Morehouse staff continue to work. Emory and Morehouse account for almost the entire staff. Without them there is no hospital. Without Grady, the poor in Fulton and Dekalb have no place to be treated. If Grady is no longer the whole entire medical system in Fulton, Dekalb and beyond is in serious crisis. (Without Grady some of the hospitals for the affluent would actually have to treat these folks and no one can have that now can they)

Second Emory and Morehouse need Grady a lot more than the other way around. First, Grady is a public hospital so it really belongs to the people. If the folks want it kept open, they WILL infuse it with cash one way or the other. On the other hand, Morehouse uses Grady for nearly all of its medical school and residency training. In other words, without Grady there is no Morehouse medical school. Emory maintains several for profit hospitals however the bulk of their training is also conducted at Grady. Furthermore, Grady is the main selling point to perspective Emory medical students. Grady is one of the biggest hospitals in the country and the world, and going to Emory medical school allows perspective medical students to train there. In other words, without Grady, there is not Morehouse medical school. While there is an Emory medical school, it goes from being an elite school, to the equivalent of EastWest Texas State Community College Medical School. (please, no one be offended, I made the school up but we all know that the more words before and after the State in question the worse the school is)

Thus, of course the powers that be at Grady expect that debt not only be forgiven but that staff continue to work. They hold all the power.Given all this we can see why they are so arrogant, but frankly this is all besides the main point anyway. King's piece is frankly most atrocious, in my opinion, because it focuses on side issues like demands over requests. King refuses to examine why Grady insists on going private and how that will impact the hospital and the tax payers. (Fortunately, you can count on this blogger to give you the straight scoop on all issues related to Grady and their plan for going private is just one of those issue. So for more info on the plan to go private please click here) By focusing on the arrogance of a group that has frankly shown nothing but arrogance for more than a decade, he really shows a total lack of understand of the issue.

The issue isn't whether or not some people are arrogant. They are and it matters very little, except to explain past, current and likely future behavior. The issue is what to do going forward. It appears obvious to me at least, that the reason the powers that be want to go private is so that their malfeasance can be even more easily hidden. Yet, that possibility isn't even mentioned. In fact, Mike King contributes absolutely nothing of substance to a debate that should be at the front of most Georgians' minds. It should be the AJC leading on this story. It isn't. In fact, if I am right, the AJC is actively participating in the corruption. That may explain why King's only contribution to this debate so far is well, so lame.

Finally, I have heard from the grapevine that Ron Marshall, of the Grady Coalition, wrote a piece that was supposed to counter King's in the AJC, and the AJC refused to publish it. No such refusals will be here. Here is Marshall's piece...

It does not surprise me that Grady voted to go private. This has been in the plan to privatize all major funding resources in America to control how money is being spent and who receives it. Look at Iraq, since when do we hire a private force to protect public interest? This has never happen in the history of war. Who benefits from privatization?

Grady changes have started the wheel of genocide. A whole community will parish (poor people and poor accident victims) in the name of profits. Not to mention the land deals that will be made. We have put a price on human life. Not only have we put a price on the life of an individual we allow the health care system to pick and choose who get’s treated and how much treatment they as humans receive. Animals get treated better than people. Throw a dog in the street and see what happens.

Our Governor had the nerve to pray for rain. The prayers should be for humanity as well as for the salvation of human life and for the protection of our planet. Now we have really fallen off the path of survival.What’s still hidden in all of this is how did this happen and who is responsible for what happen. This has never been asked. If it has there sure has been very little said about the accountability of the officials who oversee Grady and the official who appoint the board that put Grady in this position. Why is the public being deniedaccess to records that will show where all the money went or is going and who is receiving it? This is not new and it seems to happen like the migration of geese heading south every year.

Only one person was sent to prison for stealing from Grady, Charles Walker. Walker did not steal all that money by himself. He had to have help. Somebody signed the checks and somebody got paid to keep it quiet. Why wasn’t there an investigationconducted to find the accomplices. This is like a private (secret) Mafia, they sacrificed one to save the rest. I notice Walker has not turned on his accomplices. Is there money waiting for him when he is released?Is having cover-up money pay for a pass as Emory has shown. They have clearly had their way with Grady’s funding with a sweet heart contract. Does being a politician automatically give you a pass when crisis’s after crisis’s shock after shock that cost tax payers millions without having them be accountable time after time.

Now we had an explosion in south Georgia and Grady no other but Grady is in the front again. The needs are clear, human lives are at stake. Is there no other real time event that shows Grady at its best.So to feel anything is like watching killings and brutality between 6-11pm live on the news or a television program. You get use to it. The fight for justice and accountability has only hit a bump in the road, we must be protectors of justice and righteousness and we will accelerate ahead of corruption. Buckle-Up.

Many of the things he says have also been said here. It's too bad that Marshall needs my blog in order to get his message out. You can contact the AJC here about any of the plethora of issues I have raised.

(Update)I realize that anyone that tries to pick up the story of the crisis at Grady Hospital is likely to get lost in its many mazes. Thus, if this story is your first exposure to it, it is likely you have dumbfounded look on your face. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Then, the dumbfounded look will be removed. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

A Murder, A Suicide: Connecting More Dots in the Culture of Corruption (Updated)

Sheriff Elect Derwin Brown

The 2000 election for Sheriff of Dekalb County was bitter and difficult. It pitted incumbent Sheriff Sidney Dorsey against policeman Derwin Brown. Brown ran on a platform of cleaning up the corruption in the Sheriff's department. Many times the fingers of corruption were pointed directly at Dorsey himself. Dekalb County Sheriff's Department had a long history of corruption and Dorsey himself was no stranger to criminality.

Dorsey became the county's first black sheriff four years ago despite publicity about his arrests for domestic abuse and a manslaughter charge he once faced.

Reports also surfaced that Dorsey assigned inmates to work on houses of supporters of his wife, an Atlanta city councilwoman.

Other reports accused him of allowing deputies to work for his security company while on the clock. And a female deputy filed a lawsuit saying that she was denied a promotion because she ended an affair with Dorsey.

Brown's campaign message resonated and the voters voted him in overwhelmingly with him winning roughly two to one. Brown would never get a chance to fulfill any of his campaign promises. On December 15th, two days before he was to be sworn in, he was gunned down in his drive way.

Within months several people within the Sheriff's department or at least with strong ties to it were arrested. Those people included Paul Skyers, Devon Edwards, Patrick Cuffy (ultimately fingered as the shooter) and Melvin Walker. The man that authorities finally believed to be the ringleader and ultimately the person that gave the order was none other than the Sheriff at the time of the murder at least Sidney Dorsey.

Everyone eventually flipped on Dorsey and spent minimal or no time in jail. Most of their whereabouts are currently unknown, and Dorsey was ultimately convicted about five years later. He serves a sentence of 25 years.

Like with much of the corruption around it, this case leaves many more questions than answers. If a sheriff and several of his deputies and their contacts killed the incoming sheriff, then to me at least, that is the culture of corruption at its worst. Why then did the next Sheriff Thomas Brown (no relation) not clean house as Derwin Brown promised. (Thomas Brown, who was the former public safety officer of Dekalb County, was then selected by then Governor Roy Barnes to be the interim Sheriff)

Fellow candidates for sheriff and confidantes of Derwin Brown blasted the sheriff when he declined to fire all of those targeted for termination by the murdered sheriff-elect, or to hire those previously promised jobs. Although he has dismissed some personnel, Sheriff Brown has been criticized, both before and after the special election, for not fully embracing those changes.

When he came aboard, said Brown, the department was uneasy; he thinks his decisions have helped calm things.

"There may have been some concerns when I came in," said Brown. "I made very few staff changes. There were a few personnel changes -- we did let some people go -- but the heart and soul of the people who built this facility are still here."

Whatever doubts anyone had that the Dekalb County Sheriff's Department had a systemic culture of corruption were tragically erased when its Sheriff elect was gunned down in a conspiracy involving several members of the department itself, including the top person. If ever there was a reason for wholesale house cleaning it was this tragic event. Yet, that didn't happen.

There was other things that raised my eyebrows. There were rumors of a hitlist. In fact, the prosecutor on the case J. Tom Morgan wore a bullet proof vest for safety. I was told that reporter (and current candidate for U.S. Senate) Dale Cardwell had a member of the sheriff's department sleeping in his house for a month because they felt he was a target. The motive for the shooting was said to be revenge. If there was a hitlist and other targets that wouldn't make sense. Was Dorsey really the ringleader or was this murder really the work of someone and something much bigger? Only the powers that be know that answer.

There was some media that wondered if Dorsey really was the ringleader. His family doesn't believe that all the perpetraters have been caught. To this day, his death and the events surrounding it continue to have more questions than answers. Much like most of the corruption in and around Dekalb County, whether its Grady Hospital, Emory University, or the Sheriff's Department, it always seems as though investigations only go so far before somehow, some way they end.

On August 26th, 2004, Charles Hicks, Dekalb County Attorney was found dead. The death of Charles Hicks was eventually ruled a suicide however I believe that this was another case in which there are more questions than answers. Ron Marshall, head of the Grady Coalition, was an acquaintance of Hicks. He told me that on many occasions he told him that he (Hicks) was concerned about all of the corruption that he was procuring. The first officer on the scene was one Donald Frank, a wily character that Marshall says he would run into again (and one I will get back to in a minute). The most damning piece of evidence was that the gun was found laying next to Hicks' right hand. This seems peculiar since Hicks was in fact left handed.

If Hicks was in the middle of a culture of corruption, and he wanted to get out, it would stand to reason that the powers that be would want him eliminated. It also stands to reason that the powers to be would have enough power to then cover up this same murder and turn it into a suicide. Of course, that is all mere speculation. Let's not speculate but rather look for patterns.

The Sheriff's Department had a culture of corruption that went back decades. Several of its sheriffs wound up on the wrong end of the jail cell.

Former Sheriff Pat Jarvis last year was sentenced to 15 months in prison and fined $40,000 for fraud. Ray Bonner, a sheriff in the mid-1970s, pleaded self-defense and was acquitted in the fatal shooting of a 16-year-old boy in his front yard. And Lamar Martin, the sheriff in the late 1960s and early '70s, was convicted of bribery.

Of course after that, the next sheriff in line went in for murder.

While this was going on at the Sheriff's Department State Senator Charles Walker was fleecing Grady Hospital for millions of dollars. The State Senator committed so much crime that by the time he was done he was charged with 137 felonies and ultimately convicted on all but ten. Of course, he flipped on NO ONE. No one else was charged and he got ten years, or less than a month for each felony conviction. Then, we have the mysterious death Charles Hicks.

Who is running Dekalb County? That would be Vernon Jones. Jones is no stranger to trouble. His name has wound up on the police blotter roughly six times. It started in the mid eighties and the last known incident was this past December. The charges range from assault to rape. He's never been convicted of any of these crimes mind you. He's had more than a few questionable land deals including a prime piece of property (that he apparently bought for 500k in cash. Not bad for someone that makes a 100k per year) right next to a mall that he authorized the building of.

In fact, I only need to go to the same article where my research on Hicks began to find all sorts of malfeasance by Jones.

Jones' re-election campaign took its first hit, as one of his opponents, state Rep. Teresa Greene-Johnson, tried unsuccessfully to get a court protection order against him. Greene-Johnson alleged that Jones berated and threatened her on a campaign stop

....Within days of each other, Jones lost two political allies. Commissioner Lou Walker died from injuries sustained in a car accident and Jones' deputy chief of staff, Lance Robertson, was arrested and charged with the false imprisonment of a 19-year-old woman after a night of drinking at the W Hotel in Dunwoody.

It was revealed that Robertson had a criminal past, including a shoplifting conviction, that county officials did not investigate before Jones hired him. Robertson, who has been suspended without pay, denies any wrongdoing in the W Hotel incident.Also in August, a federal lawsuit accused Jones and other county officials of discriminating against white employees. County officials denied the allegations.

That article merely describes a few months in 2004.

By 2006, Ron Marshall was challenging Jones for Dekalb County CEO. Jones introduced Marshall to hardball politics, Dekalb County style. Marshall told me that he was constantly followed throughout the campaign. There was background checks done on him, and he and his wife mysteriously wound up on the Homeland Security Terror Watch List. Only the powers that be know how that happened, however the director of Homeland Security for Dekalb County by this point just happened to be Donald Franks (yes the exact same one that also happened to be the first police officer on the scene of the Hicks death).

There is a Latin phrase, Res Ipsa Loquitor, and it means the facts speak for themselves. There is no question that Vernon Jones is part of the problem. Between the murder of a Sheriff elect, the fleecing of Grady Hospital, the harrassment of a candidate, and many other scandals in between, Res Ipsa Loquitor. Nothing has changed within the Sheriff's Department that occupies the County he is CEO of. Grady is now in desperate need of an infusion of cash or they will cease to exist, so nothing has changed there either. The facts speak for themselves: either he was in on it, he was too incompetent or too scared to stop it, he was asleep at the wheel, or something else. It ultimately matters not because there is no excuse for that much corruption to go on on his watch, Res Ipsa Loquitor.

So, what was Vernon Jones up to in 2008? He's running for U.S. Senate. No, I am not kidding. If this sounds familiar just read this.

I believe that in order to create a culture of corruption, you need the police the politicians, and the media to be in on it or at least looking the other way. I think you can all see how the police are in on it. I think through this piece and in my entire series you can see how the politicians are in on it. How is the media in on it? Well, ask yourself this question. Why is a blogger from the Midwest asking questions the media in Atlanta should be asking? I will leave you with the words of a hero, Derwin Brown.

There have always been a few who have stood up for the many, often at times when the many would not stand for themselves. Whether out of fear, intimidation, or ignorance there have always been those who ride the victories and sacrifices of others, cheering and celebrating as if they dared to make a difference. Yes, even some who would minister to you about God's power and the armor and shield that "the word" provides seem to falter in their convictions when it's time to "step out on faith" and challenge the unrighteousness found in their workplace, community or government. What sacrifice are you willing to make for truth and righteousness? Are you leading a double life, speaking of injustices in whispers, while exclaiming all your faith in the creator? These are questions for self-examination. Are you willing to pick up the drum of justice? "THE TIME IS NOW!! PEACE"

Amen!!

UPDATE: This story speaks for itself and I believe that if this is your first exposure to the crisis at Grady Hospital and the dynamics that surround it, you should still have no trouble understanding this piece. That said, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Thus, if you want to see how Vernon Jones, Derwin Brown, et al fit into the mess at Grady Hospital please read the link I just provided. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

Epilogue: Since this was first published, I have come into possession of some documents that detail the shady land deal to end all shady land deals, by the shady politician to top all shady politicians, Vernon Jones. Here it is.

UPDATE: On August 5th 2008, Vernon Jones lost a run off election to Jim Martin. Ironically, though not coincidentally, Dale Cardwell, took third in the original Democratic primary. (in Georgia rules, a majority is required to win and so that's what caused the run off) His future political plans are still undetermined at this moment. Jones was then replaced as CEO of Dekalb County by Burrell Ellis.

Since losing the election, Jones has kept a relative low profile. He surfaced in Albany, Ga. to speak to a group of law enforcement officers. This fueled rumors that he might run for mayor of Albany in 2012 though that appears to be a step back for Jones. I don't expect him to stay in private life for too long.