Blog WSH

The Ever Increasing Danger of Western State Hospital

Western State Hospital continues to become a more and more dangerous location to work.  As employees who confront this issue with DSHS are banished by the current administration to “reassignment under investigation,” brave employees continue to communicate with Olympia for relief.  This is yet another call for our legislators for relief before more employees and patients are injured or killed.

Note:  I have received numerous requests for information resulting from this blog entry.  As a result, I have added an addendum to the end of this blog entry which answers many of the questions that have been asked.

As stated on my home page, the opinions I express are my own and CLEARLY do not reflect those of DSHS…  When this input is provided, often it results in direct retaliation…  Retaliation by WSH administration must remain consistent, so that others will not talk and leak this information.

Recent news is only the tip of the iceberg… 

Patients and staff remain at risk as DSHS expands Western State Hospital Administration and neglects the voluntary and mandatory overtime numbers that have now become unsustainable.   In a normal hospital this type of practice is illegal due to state law, but then Western State Hospital is NOT a “Hospital” under Washington law.  Western State Hospital is NOT licensed by the Department of Health (as are true hospitals).  As you have heard, Western State Hospital no longer meets the accreditation requirements of the Joint Commission of Hospital Accreditation…  In fact, WSH administration withdrew from the Joint Commission secretly this past year, not informing its employees of this action.  As they state…  they would never have passed accreditation…

Secret withdrawal from Joint Commission Accreditation is something that could NEVER have happened with a “hospital” that was licensed through the Department of Health, laws would have prevented this.  Western State Hospital operates under the same laws that applied in its old insane asylum days.  This is dangerous.  It is up to our legislators to correct this error.  Western State Hospital must become a “Hospital” under the law so that employee protections that apply to all other hospital employees within the State, also apply to Western State Hospital. 

If business practices within DSHS were audited, the level of corruption would become crystal clear.  DSHS does NOT keep permanent records of unscheduled absence.  DSHS does NOT keep permanent records of how many hours an employee works for a “completed shift.”  Should these records EVER be looked at, corruption up to (and including the Governor) will become readily apparent.  Who is the keeper of these falsified documents?  It is the Consolidated Institutional Business Services (CIBS).  It is this division that covers up and divides DSHS budgets so that tax payers do not know the basis of the staffing shortage at Western State Hospital.

In my past blog posts I have discussed the massive shortage of staffing at Western State Hospital as well as the “fifteen minute issue.”  I have outlined how the Office of State Auditor knows about the fraud (please read that document) and stated in 2014 that:

The Department shares your concerns. Since this needs to be resolved in the context of long-term labor practices and current labor law, it is one of the Department’s top concerns as we enter into collective bargaining discussions.

Since that whistleblower was filed in 2014, DSHS has taken no action to remedy the staffing shortage that results from this practice. Indeed, the issues have exacerbated as DSHS has continued to expand the size of administration at Western State Hospital.

In my last two blog entries, I have presented that regardless of “the hiring spree” that DSHS touts, the level of overtime continues to expand to the point of regular implementation of mandatory overtime, something that would be illegal in any “hospital” under Washington law…  As stated, WSH is not a “Hospital” under the law.

While it is a nice perk for over a thousand employees within WSH to work seven hours and forty five minutes per day to receive eight hours per day in wages (through falsified CIBS record keeping), it has directly impacted the safety of my peers as well as those that directly benefit from this perk.  Shift change periods are critical times in any hospital, one crew comes on and the other leaves.  Imagine a system where the Governor has created a union payoff where certain employees get to leave fifteen minutes early every day during this critical period of time.  This is exactly what is occurring at Western State Hospital as well as other DSHS facilities.

In 2017, Western State Hospital has broken all records with its level of overtime even after its “hiring spree.”  The numbers do the talking for me and are part of public records.

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Staffing for the same period one year ago…  

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What Western State Hospital requires is a full audit of CIBS and its timekeeping system for overtime-eligible employees.  A full audit of all DSHS Washington Management Services (WMS) expansions at Western State Hospital since January 1, 2017 is required.  From which budget does overtime come from?  From which budget does pay for work NOT rendered come from?  

Is there medicare fraud when DSHS receives $65 million per year claiming staff provided full care for a shift when the majority of staff do NOT work for a full eight hour shift (although they are compensated for it)? 

(I think this is possible most likely through use of CMS funding diversion)

We need to end the insanity of the current Administration.  Any external audit will show how deep the corruption within DSHS goes. 

I challenge reporters to delve into the wages of all new WMS administrator positions and compare them to direct patient care personnel wages.  Is the attendance record of administrators tracked as it is for nursing personnel displayed above?  As I have been told by administrators in the past…  “If I call in sick, I just have a bigger pile on my desk when I come in.”  True enough…  Although the pile is L&I injury paperwork…

Direct patient care providers put their life and license on the line every day they come to work under difficult conditions where employees often work two shifts per day, often through the implementation of mandatory overtime.  Often those persons manning the ward are overtime personnel who do not know the patients.  It is a little known fact that ALL of our direct patient care nursing staff members have certification or licensing.  If the license or certification is revoked by the Department of Health, the employee can no longer be employed.  The same is NOT true of administrators, as their influence on clinical practice is accountable to nobody. 

DSHS must be given directives to hire sufficient direct patient care personnel to null out overtime, I personally created the process through which this could be implemented.  All DSHS facilities need to be licensed by the Department of Health, to allow Western State to become a “Hospital” under the law.  Time worked must be measured identically for all overtime-eligible employees, it currently is not.  Western State Hospital administration must be de-layered to resemble a medical model where licensed care providers make ALL the clinical decisions, this is NOT currently the situation.  

To my Federation friends, I am sorry I continue to bring up the truth regarding the hours worked…  But continuing this practice endangers all of you the same as it endangers us.  We need to tell the truth about staffing.  All union and government corruption aside…  We have to look after ourselves, nobody else will do it for us.  The State Auditor has known about this and other illegal practices for years…  This union payoff and perk is endangering all of us.  Imagine how many more direct patient care employees could be paid for if timekeeping had not been falsified for so many years. 

Let’s lay truth on the table and make Western State Hospital safe for all of us.  In truth, many people should go to jail as a result of a full audit as taxpayers and the federal government have been defrauded billions of dollars over the years.  It could not have existed this long without complete government collusion and corruption.  

After all…  It is only the health of the direct care providers that suffered.



After posting this blog I have received a great deal of questions and input.  Rather than answer all the emails, I am updating this blog entry with answers to questions asked.

Many persons did not click to see the whistleblower response by the Office of State Auditor in 2014.  The following are key points in that document:

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It is exceptionally important to note that the Governor received a copy of the report and to understand that it is the Office of Governor that is responsible for negotiating employee contracts under our current collective bargaining process.  This is a VERY important point.

Next, review the following from that report:

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Please note that the Office of Auditor states 927 employees were impacted by this…  That figure is incorrect.  1149 employees at WSH were impacted, note that they did not mention how many employees were impacted in ALL DSHS facilities.  It is a substantial figure.  Also take particular note of the wording, “we obtained a list.”  From who?

The State Auditor found no reasonable cause to believe an improper governmental action had occurred, even though it was proven that the State was paying large numbers of overtime-eligible employees for work NOT rendered.  There was no statement of impact regarding assault events that occurred during shift change as a result of not having sufficient overlap of staffing at shift changes.  This is the situation  that WSH has now, there is grossly insufficient staff currently to maintain safe patient staffing levels under a budget shortfall without use of large volumes of voluntary and mandatory overtime and as a result, there is insufficient staff to safety allow the majority of direct patient care personnel to leave fifteen minutes early each day and STILL BE COMPENSATED FOR IT.  This is gross mismanagement.  But we have to dig deeper.  The Auditor come up with the following “resolution” which was sent to the Governor:

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So in 2014 the Governor gets this resolution and under current collective bargaining processes the resolution must be implemented in contract negotiations.  Negotiations after 2014 are concluded and the results are now before the Legislature for funding.

Did the Governor implement the “Department’s Plan of Resolution” during negotiations?  The answer is no, and this is the very reason why the Office of Governor must NEVER be involved in direct negotiations with labor unions.  

When I filed this whistleblower, I also filed complaints with other agencies pertaining to this issue.  At that time I was also voted in as the Chair of the RN union again.  I had ALSO filed a grievance pertaining to falsified timekeeping which directly related to this issue.  The RN union withdrew that grievance without my permission.  During this timeframe I filed an appeal with the RN Union District Hearing and Appeals Board which was responsible for such withdrawals under the union bylaws…  Only to find that the RN Union had NEVER elected a proper District Hearing & Appeals Board in its entire history.  So I appealed this issue to the SEIU International…  Who had never, either, done the same in order to hear my appeal.  The RN union overturned the last election which I won, and made it impossible for myself to run in another election as there was a pending hearing before an appointed body.  As a result, I can no longer participate in direct union activities for personal ethics reasons.  Union corruption is real.  The unions backed our current Governor, who was the head of the office that completed negotiations with all labor unions.  Is my friends know, I am a conservative and lifelong Republican…  Something which the union had a difficult time adjusting to, as I often presented them a different point of view than they were accustomed to.

This brings us back to the State Auditor “Department’s Plan of Resolution.”  The Office of Governor negotiates with the labor unions and would have been responsible for reconciling hours worked, for hours compensated.  The resolution was always simple, if a modern timekeeping system like KRONOS was initiated, there would be no way that time worked could be recorded differently for different employees.  Let me make this clear, the Office of Governor, in my opinion (as a political pay off), disregarded the “Department’s Plan of Resolution” and allowed the continuation of compensation for time NOT worked.  This is corruption at the highest level of State Government.  I personally view these actions to be criminal in nature.  The “top concern” of the “Department’s Plan of Resolution” was buried. Taxpayers pay the Governor’s payoff to the union. 

Should the Legislature approve contracts negotiated by a Governor that who financially benefitted from the labor unions that funded his reelection?  Not so fast…

Psychiatrists, physicians, psychologists, registered nurses, social workers, and licensed practical nurses are GROSSLY underpaid when compared to the private sector if wages are not adjusted at this time.  These positions cannot compete with the private sector and therefore should be provided wages that are real-world based. These positions should be reviewed with regard to public versus private sector wages and compensated accordingly taking into consideration the dangerous environment WSH represents.  If these key positions are lost, WSH will be thrown back into the insane asylum days as key clinical personnel (for safety of their own license) must leave State employment after June 30th when wages revert back to previous levels.  Wages must be competitive with the private sector or WSH dies.

I absolutely find it strange that I must argue for fair timekeeping practices, compensation for actual time worked.  But this is how corrupt Washington is at this time, it is an indisputable fact.

Also, I will encounter retaliation for providing this information to the public.  While I was addressing these issues in 2014 I was reassigned AWAY from timekeeping for almost a six month period (under investigation) because I received the only directive in DSHS to accurately record time in my timekeeping employee records.  I was not returned to my normal duties until all other timekeepers received directives to accurately record time worked.  DSHS had at that time created a process where CIBS took the timekeeper records and fraudulently recorded that 7.75 hour per day employees had worked eight hours…  Which is what continues to occur today.  Instead of having supervisors do the falsification of public records, DSHS has CIBS do it.

To the Legislature, please compile the cost of paying for work NOT rendered to taxpayers over the years.  Taxpayers must see the cost of corruption.  Also, research the number of labor and industries injury claims that occur near shift change times.  


Overtime Use at WSH

In the past years I have posted much data regarding Western State Hospital overtime use numbers.  In 2014 I was the co-chair of the Joint Nurse Staffing Committee and had created the first mathematical staffing model for Western State Hospital…  Using staffing data I created a method by which we could derive exact numbers of permanent positions that were required to provide base staffing and null out overtime taking all factors into consideration.  This data was provided to all levels of supervision within DSHS as well as to the office of Governor.  The numbers that were produced were staggering and remain posted in my blog history.  All of this data can be found on this website. 

My projections for staffing in 2014 turned out to be highly accurate based on current statistical data.  Recently Western State Hospital had only requested less the half the direct patient care staffing that was required to meet base staffing needs.  DSHS states that it has gone on a “hiring spree.”  The fact is that DSHS more than doubled the size of its administration while requesting less than half of the direct patient care personnel that were needed to provide safe care.  You can see the Joint Nursing Staffing Committee proposal here.  Here is a copy of my 2014 staffing model with projections for the need to hire an additional 178 full time direct patient care staff members.

Because of my mathematical projections, I have maintained a keen interest in overtime levels to determine the accuracy of my mathematical model projections.  My last blog did a similar review.  The information is compiled from a program called Scheduler, which tracks direct patient care attendance and overtime statistics.  

Below are actual screen results from Scheduler…  These are reports of the amount of overtime utilized from 1/1/16 to 5/21/16 compared to the amount of overtime utilized from the exact same period of time in 2017.

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In the above report you will note that from 1/1/16 to 5/21/16 WSH utilized 95,218.5 hours of overtime.  Although we cannot utilize the standard eight hour period to reflect a full shift worked for all WSH employees, as Washington Federation employees only work seven hours and forty five minutes per day while all other classifications work a full eight hours per day (see 15 minute issue), at least we can provide an idea of how many true full time employees are represented by the above numbers.  

95,218.5 hours divided by 8 (a full shift, except for WFSE employees) equals 11,902.3 full shifts worked by overtime (time and a half wages).  

A typical 8 hour employee (not a WFSE employee) works 52 weeks per year for 40 hours per week.  Thus a typical full time employee works 2080 hours per year.  If you divide 95,218.5 hours by 2080 you get the fact that for this period the state could have fully paid 45.8 full time full year employees with the amount of overtime used.

Now lets look at the level of overtime Western State Hospital utilized in 2017 for the same exact period of time as was calculated for 2016.

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In 2017 for the exact same period of time, Western State Hospital utilized 108,664.5 hours of overtime.  That is 13,446 hours MORE than was utilized for the exact same period in 2016 AFTER the “hiring spree.”  13,446 hours of overtime is the equivalent of paying an ADDITIONAL 6.5 full time full year employees.

  • In 2017 from 1/1 to 5/21 (not even a half a year) WSH paid the equivalent of 52 full time full year employees if you do not count the time and a half paid to those employees…  Just hours worked.

Western State Hospital cannot operate daily without voluntary and/or mandatory overtime.  Often minimum base staffing numbers are not maintained.  Administration does not currently provide fire check personnel, thus most wards operate with one staff member less per ward than is required to maintain safe patient care.

The key to reforming Western State Hospital is to provide adequate direct patient care staffing to meet patient needs.  Current statistics indicate the requirement of an additional 130 full time direct patient care employees IF the current need for overtime remains static…  It will NOT as we are now going into annual leave season.  Only after looking at the full year statistics can we make this projection.  My original 2014 projections indicated we needed 178 additional full time direct patient care staff members.  The final joint nurse staffing committee report indicated the need for 135.  DSHS asked for less than this for direct patient care.  

© Paul Vilja 2017