Juneau’s Bartlett Regional Hospital is the first, and so far the only, hospital in the state to be cited by workplace safety regulators for COVID-19 violations.
Hospital staff tipped off the state, leading investigators to find the city-owned hospital’s health and safety program inadequate. They issued more than a dozen citations.
Staff speaks out
The whistleblower was Laurie Bell. After years of pushing for a safer work environment at the hospital, she finally reached her breaking point over masks.
Bell used to work at the registration desk in Bartlett Regional Hospital’s Emergency Department. She and her coworkers were often the department’s first line of defense.
“We basically did all the grunt work before the patient would be seen by a nurse or doctor,” she said.
She said when the COVID-19 pandemic first spread into Alaska, they had a lot of exposure to the virus.
“There wasn’t enough [personal protective equipment] for everybody,” Bell said. “We were told that we were low risk and did not deserve personal protection.”
She said the hospital gave them one blue paper surgical mask per shift. She said that each time, she cited federal guidelines and asked for more protection.
“I was told that, in not-so-polite terms, that I didn’t know what I was talking about,” she said. “[That] I didn’t understand the science, even though everybody could go on the [Centers for Disease Control and Prevention] website and see what was recommended. And that I should just stick to what I know.”
But one day a COVID patient came in whose partner wasn’t consistently wearing a mask. Bell said he was unruly near her desk.
“He was aggressive and yelling,” she said. “He camped out in the hallway just outside of the ER. But he would come in and pace in front of my desk, yelling at me that he needed to be back there with her.”
Bell says a manager gave the man a rapid test and allowed him to stay. She says she found out later that he tested positive for COVID-19 — and that was only after another nurse called her to warn her that she had been exposed.
Bell complained to her supervisors. Then she filed a complaint internally. She told a union representative. But she says nothing changed.
“If you speak to anybody in the hospital, they will tell you the reporting system is a joke and most people don’t even bother using it,” she said. “But I did, because I felt like, at least I can say I went through the appropriate channels as I was instructed to do. And it did nothing for me.”
So Bell reported Bartlett to state health and labor department regulators in late 2020. She left the hospital that December.
Regulators cite the hospital
After Bell blew the whistle, inspectors from the state’s health department and the department of labor showed up to figure out what was going on at the hospital.
Then the violations and citations started rolling in.
First, they came from the health department. Those inspectors make sure the hospital is safe for patients.
They cited the hospital for six violations centered on infection control. They said patients and hospital staff weren’t being adequately screened for COVID-19.
They documented at least one incident where a staff member reported having COVID-19 symptoms but was told to keep working after they tested. That person reported having contact with a lot of patients before their test came back positive six days later.
Those COVID-19 violations had to be addressed pretty quickly because Bartlett’s Medicare and Medicaid funding was at risk.
The second team of inspectors who went through the hospital were from the state’s department of labor. They make sure the hospital is a safe place to work.
Employees were supposed to be self-screening for COVID-19 symptoms and logging them when they got to work, but inspectors said the hospital’s own records showed that less than 57% of them were actually doing it in December of 2020.
When they released their final report in June of 2021, along with more than a dozen violations and fines, it wasn’t just the hospital’s COVID-19 protocols that were called into question. They also fined the hospital for how it handled workplace violence. Inspectors said the hospital wasn’t recording injuries and illnesses among staff properly and also raised concerns that the hospital was under-recording its injuries.
They also wrote that employees were never properly trained on responding to hazardous spills. They documented more than 130 employees who never learned how to deal with blood-borne pathogens, despite being regularly exposed to them on the job. Others had not gotten medical clearance or been properly fitted for N95 masks and respirators.
Fit tests make sure hospital employees are wearing tight-fitting respirators that will seal properly and keep them from being exposed to airborne virus and bacteria.
“They got behind on their due dates,” said Bartlett Infection Preventionist Charlee Gribbon.
Employees are supposed to be checked yearly. State inspectors say more than two dozen people were overdue. The hospital instituted a new scheduling system to keep employee fit tests up to date.
Who is accountable for worker safety after top-level leadership shakeup?
Juneau didn’t get hit with COVID as hard as a lot of other communities.
The hospital took a lot of steps to improve and even hired a quality director to keep an eye on things. That safety team says the inspections helped the hospital.
“The importance of it and the safety aspect of it was reinforced for everybody,” Gribbon said. “So, you know, I was, like, grateful for the inspection because it makes us all better. You know, and if anybody is feeling unsafe, you know, we really need to dive into that.”
Gribbon says there’s more oversight now — that the learning curve was really high in the early days of the pandemic.
KTOO reached out to a number of current and former employees of Bartlett for this story. Gribbon was one of the few to take responsibility for failures in workplace safety.
The other person to take personal responsibility was former CEO Rose Lawhorne.
Lawhorne took over leadership of the hospital after the complaints had been filed, in April of 2021. She inherited this problem.
She told KTOO in 2021, “the buck stops with me.”
Lawhorne had worked at the hospital for decades, and she said she wasn’t surprised by the citations. Instead, she said she was ready to make changes.
“I have this gift of authority that I can empower them and say, ‘Yes, I approve. Yes, go ahead and provide additional training to the people who you feel need it,’” she said at the time.
Bell, the whistleblower, speaks highly of Lawhorne too. She says Lawhorne was one of the few leaders who checked in to make sure she felt safe.
But Lawhorne didn’t have a lot of time to address the issues at the hospital. After just six months on the job, she was fired by the hospital’s board of directors.
That first sign of instability turned into a landslide of resignations at the highest levels of the hospital. Since the beginning of the pandemic, all but one member of the senior leadership team left.
And it’s unclear why some of them left. One’s expense reports are part of an active criminal investigation. And the board hasn’t found permanent replacements for most of them — including the hospital’s interim CEO. He refused an interview for this story.
The hospital is managed like a business, so it answers to a board of directors. But there was no public board meeting to discuss the state’s final inspection report when it came out.
In the end, Bartlett was fined almost $150,000 by workplace safety inspectors, but the state labor commissioner reduced that by nearly 70%.
The hospital won’t pay that reduced fine either. It will take advantage of a state law that lets them use that money to improve workplace safety and submit those receipts to the state.
One of the things the hospital bought with the funds is respiratory protection — that is, the kind of PPE Laurie Bell wanted back in 2020.