Clinic... Enough is Enough
Last updated 7/2/2020 at 10:07am
You know there’s a problem when….
The Borrego Sun began asking questions about operations of the Borrego Community Health Foundation (BCHF) with the firing of Jan Jones and Dr. Pam McEvoy, two high profile and respected medical providers at the Borrego Springs Clinic. At the same time, a previous investigation by the Sun was dusted off and has taken on new life and importance.
It’s almost impossible to unravel the Foundation’s reality through public documents, like the required IRS-990 filings for a federally-funded non-profit (FQHC). Looking from the outside, doesn’t get at the truth, or all the facts. However, the Sun has persisted in researching what is available and asked Borrego Health CEO Mikia Wallis, spokesperson, Vitor Coral, and others to explain, confirm or deny our information.
With the exception of one statement made public in April, the executive leadership has not been forthcoming. Instead, they have refused to comment. That’ a shame because there may be explanations for certain activities, or even justifications. Equally egregious, failure to come forward taints the work and reputations of hardworking employees in the clinics that are trying to live up to their responsibilities for the care and well-being of their patients. The community has also been denied the right to ask questions, and get answers, regarding operations at Borrego Springs clinic and the Foundation. This refusal by those in charge, who have a legal obligation to make details of their operations public, is in itself, a violation of their non-profit status.
So the Sun took a look inside BCHF, from the perspective of former employees and other sources. Many wish to remain anonymous for a variety of reasons. The most serious – the possibility of being complicit with fraud, or at least irregularities, or violations of state and federal regulations. The following comments from sources that reached out to the Sun have been verified through others in positions to know how BCHF conducts business. However, it’s up to the reader to decide the veracity of the information, and for BCHF to explain, confirm or deny.
Dr. Alfredo Ratniewski, Borrego Health’s Executive Chief Medical Director, has been a topic of interest, given his large salary compensations, plus identification as Executive Medical Director and provider at numerous clinics. In addition, there’s the issue of the State of California Department of Health’s lawsuit against the Foundation, charging that a payment of $3 million plus to buy two of the Doctor’s practices in Cathedral City and El Cajon, was not justified or legal. Whatever happened to the money for purchase, which was denied by the state, remains unknown. Surprisingly, Borrego Health owns and operates clinics in both sites in the suit – Cathedral City and El Cajon.
Did Borrego Health purchase these practices, despite an illegal finding by the state? And if so, how did they disclose, or reconcile the payment on state and federal filings?
Breaking news. Rumor has it that Dr. Ratniewski has resigned from his post. BCHF refused to deny or confirm. However, a confirmation appears to be found in the fact that where ever BCHF publicly discloses the executive team, the once proudly, displayed doctor is missing. He’s been wiped clean from Borrego Health webpages. An expert source explained that, “Yes, such an erasure from the web is possible, but very costly.” So now he’s wiped clean from the Foundation’s official history. We can only ask why?
Luckily, the Sun has copies of the original websites featuring Dr. Ratniewski.
Then there’s this – a former director with Borrego Health reports that BCHF actually bought seven of Dr. Ratniewski’s clinics, and paid $1 million for each. Research of the IRS filings do not identify any purchases of this kind. The question is: Are the purchases covered in the Doctor’s salary of $600,000 plus benefits shown in IRS-990 disclosures?
According to another source, formerly responsible for credentialing medical providers, “Dr. Ratniewski, went to a San Diego clinic periodically, and met with a couple of patients, so the Foundation could claim and pay him as a provider, as well as an executive.”
Two other executives, Nancy Pealing, Chief Quality Officer, and Gabriela Alavardo, Chief Compliance Officer, have also disappeared from the website, following rumors of their resignations. Why are so many members of the executive team resigning? Furthermore, why won’t the CEO and BCHF spokesperson, confirm or deny any resignations?
A director, fired, along with numerous long-time employees hired by Bruce Hebets, like Jones and Dr. McEvoy in April 2020, stated that while claiming loss of revenue due to COVID 19, as reasons for the layoffs, the foundation bought another clinic in Palm Springs, April – May of 2020.
Think about this – while claiming it was forced to lay off one-third of its employees, the Foundation was buying another clinic. An interesting fact: The first round of dismissals, according to the source, included a large percentage of Bruce Hebets’ hires, and loyal employees.
As conspiracy theories go, Dan Anderson, President of the BCHF Board of Trustees/Directors, has been instigating an administrative move from Borrego Springs to Riverside County, where he is the CEO of a registered healthcare non-profit, conveniently named, “Riverside Community Health Foundation.” Firing Borrego loyalists certainly cleared some obstacles for such a move. Add to this the fact that the BCHF board of trustees is now packed with a majority of Riverside individuals.
From insiders, the Sun has learned one trustee, a respected attorney, resigned his appointment to the board of trustees, rather hurriedly. The reason: “He was concerned with what he viewed as illegal activities, and did not want to put his professional or personal reputation at risk.”
Another view of from inside the foundation comes from a former, director of purchasing and employee of 14 and a 1/2 years, who was most recently reporting to Diana Thompson, Chief Financial Officer.
According to her account, Thompson must have a CPA license for her position. However, she has failed her CPA tests and remains identified as an accountant by trade. Thompson’s claim to fame, according to her BCHF biography, was previously working at La Casa Del Zorro in the Human Resources department, and formerly, serving as a trustee on the BCHF board.
Asking, “Is this the best person to be overseeing a reported, 2019, $300 million dollar plus operation?”
Then there’s the family connection. Diana Thompson’s brother is married to Bruce Hebets’ daughter. The former CEO had a history of keeping things in the family.
Also, according to this same source, Margaret (Peggy) Smith, the former disgraced and fired BCHF Chief Financial Officer, is still on the Foundation’s payroll, although she doesn’t report to work. Not only did Peggy take the fall for the attempted purchases of Dr. Ratniewski’s practices, “she knows where all the bodies are buried,” noted the source. The source, also believes the Board of Trustees is not aware of this fact, along with other interesting and questionable financial and purchasing activities.
For example, she explained that to avoid questions about employing relatives, wives often identify themselves by their maiden names for payroll purposes and husbands by their family name, making it difficult to identify who is related to whom.
“You didn’t want to question, criticize anyone, or bring up an irregularity because you never knew who was related to who and would snitch on you,” the source added.
More information she offered about Bruce Hebets, includes the habit of giving salaries of fired employees to spouses, who worked for the foundation. Hebets also kept questionable people employed, including a known felon on the job. According to an insider, who stated that, “When she tried to get the staff member fired because he was belligerent, on drugs while working, and stealing assets, she was told by Hebets to “leave it alone.” When the felon was eventually fired, his spouse was compensated with his salary.”
Hiring friends, creating titles and new job descriptions also seems to be a Foundation practice. A state assemblymember, who lost his re-election, was hired to oversee government affairs. He stayed, drawing a salary until elected to a local government post.
When it came to irregularities, the purchasing department did not go out to bid on purchases, and “was totally left out of the picture when it came to buying big things,” according to Rita Anderson, the former director of purchasing.
“When I would go to Mikia (CEO) or Diana (Chief Financial Officer) about a purchase and ask questions, they basically ignored or brushed me off, with statements like, “It’s business” or “Never mind.””
According to her account, members of executive management were “thick as thieves, and only shared information with certain people. The rest of the employees, even those holding, supposedly, important titles and responsibilities, were left in the dark.”
An example she gave was “mystery purchase orders” that would appear on her desk. When she inquired about the source of the revenue and authorization, she would be told, “It was a grant, and that was all.”
Former directors and managers shared similar experiences. According to the former director of credentials, “When trying to enforce protocols and policy, I brought issues I had with authenticating dental credentialing by outsourcing to Premier Healthcare Management to Mikia (Wallis). I was told to, “Find a way,” or “Don’t worry about it.”
Evidently, contract dentists are not audited. A major recruiter and Medi-Cal payroll manager for BCHF contract dentists is Premier HealthCare Management, a company located in El Cajon. The owner of Premier, and other key personnel do not come from a background in healthcare, but made their money in real estate, building and development. Considering that dental reimbursement is 65 percent the foundation’s revenue, contract dentistry involves big money.
It works for private dental providers too. Since they cannot collect Medi-Cal/Medicaid insurance, hooking up with a federal and state funded non-profit allows them to make money otherwise prohibited. It works like this, children come to one of the foundation’s 27 clinics, providing the government supported child preventive health initiative for low income families, for a wellness health check. The child is immediately referred to a contract dentist for a dental wellness check. That checkup and any follow-up services garner a paycheck from the federal government, all facilitated by BCHF. Dental wellness and preventive care are important federal and state comprehensive health strategies, unless used to manipulate the funding agencies, and using children to do it.
According to a former purchasing director, extravagant weekend parties at five-star resorts are regular events hosted by BCHF to thank vendors, contract dentists and to recruit. It’s impossible to find detailed dental information on IRS filings. However, Premier’s web page, proudly boasts of its relationship with Borrego Health, and how they manage the business of recruiting, and handling the payroll. This includes the complexities of meeting government regulations and requirements for payment. The best source of information on the BCHF Dental program, dental contract providers and policies is the foundation’s Chief Dental Officer, Timothy Martinez, but he’s not talking.
The general consensus among employees and former management about the Foundation’s operations and practices from sources reaching out to the Borrego Sun, appear to be:
“People who ask too many questions disappear,” “The left hand never knows what the right hand is doing, which may actually be a strategy to keep the good employees from knowing how they are being used,” “The way BCHF works is not right. They are able to manipulate the system and keep people, who know better, quiet,” “All about money, not what’s right,” “People that know better don’t want to lose their jobs, get their name in the paper, are bought out, or have relatives employed.”
It seems at the management level, people given important titles and job responsibilities find themselves blocked when questioning BCHF activities. “Over time, we burn out, realizing it doesn’t make any difference. And, at some point, most simply give up and collect their paychecks,” explains Rita Anderson.
There’s so much more the Sun has learned from insiders. Each story leads to another tentacle of questionable, and unverifiable partnerships and purchases, favoritism, money exchanges, contracts, and missing or misleading information on federal and state filings. Only the Borrego Community Health Foundation can clear up, justify or explain what’s going on.
Blaming COVID-19 for the current chaos at clinics and deterioration of services, doesn’t explain past behavior.
The Sun and the community are open to hearing from the Foundation, and need explanations from executive management. In addition to offering executives to confirm or deny information, the Sun also welcomes any clarifications or corrections of information the paper has printed. Borrego Health, it’s time to explain, or change.