COLUMBIA: CARE QUESTIONED AT NEVADA HOSPITAL

      "Reeling from a federal fraud probe and corporate shakeout,
 executives at the hospital giant Columbia/HCA have taken comfort
 from the fact that no one has impugned the quality of care at the
 company's empire of 342 hospitals."  However, USA Today reports
 that state health officials and officials at the Joint Commission
 on the Accreditation of Healthcare Organizations are now
 investigating allegations of staff shortages and substandard care
 at Columbia Sunrise in Las Vegas.  The review, which was spurred
 in part by the April death of a patient who received a
 transfusion of the wrong blood type, could result in the hospital
 being placed on "accreditation watch."  Additionally, the review
 could implicate other Columbia hospitals "that have adopted cost-
 cutting and efficiency measures similar to those under attack at
 Sunrise."  There are additional probes into staff shortages at
 two hospitals in Kentucky and one in California, according to USA
 Today.
      SEIU SAYS
      The allegations against Sunrise are the result of a year-
 long probe by the Service Employees International Union into
 staff concerns at the hospital.  The union relied on interviews
 with staff members and patients, and it reviewed internal
 hospital documents.  SEIU alleges that Sunrise had "inadequate
 staffing of nurses, lab technicians and physical therapists that
 resulted in delayed blood tests" and other treatments;
 "[i]nstances where treatment orders were not carried out";
 policies that prohibited emergency-room patients from being
 transferred to other hospitals, even if there were no beds
 available at Sunrise; a "pattern of failing to nurse staffing
 levels based on the condition of patients" and an over-reliance
 on temporary nursing staff.  The union also says that its review
 shows "a declining standard of care at Sunrise since the hospital
 was purchased by Columbia/HCA in 1993."  Mitch Mitchell,
 Sunrise's CEO, denies the SEIU allegations and says that the
 reports are based on "'misleading and unfounded allegations' and
 anecdotal reports."  JCAHO Director Dr. Dennis O'Leary said that
 although the "reliance on staff interviews 'may not rise to the
 level of scientific scrutiny we would want,' the reports are
 still valued and potentially accurate information" (Findlay,
 9/22).  
      OTHER NEWS
      The attorney for an indicted Columbia/HCA Healthcare Corp.
 executive said that "the government isn't playing fair in its
 probe into the company's Medicare billing practices," AP/USA
 Today reports.  In a letter to federal prosecutors, attorney
 Douglas Titus wrote that defense lawyers have had "access to only
 a fraction of the 3.5 million documents that investigators have
 seized."  According to Titus, who represents the former head of
 Columbia's southwest Florida division, the government has sent
 "only 1,682 pieces of paper ... to printers" for eventual
 dissemination to defense lawyers.  Titus also wrote that he was
 confused by the government's refusal to allow the defendant to
 review the documents for fear that fingerprints on the papers
 could disappear (9/22).