NEWARK - The man in charge of a much maligned medical center has left on his accord, perhaps just before leaving by other means.
University Hospital President and CEO John Kastanis announced that he would resign from his position on Dec. 14. Kastanis came aboard in March 2016, but has not had much success during his tenure. Within the past few weeks, the hospital has come under fire for an outbreak of Acinetobacter baumannii bacteria, which resulted in the deaths of two premature infants.
The infants contracted the infection six weeks ago and, due to other medical conditions related to being born premature, the bacterial infection may not be the cause of death. No new NICU infections have been confirmed since October, when the NJ Department of Health ordered an external infection prevention expert to guide efforts in the NICU.
A DOH survey team came on-site Nov. 27 to investigate the hospital's internal notification policies, governance, and other factors that relate to reporting of deaths of cases during an ongoing outbreak. As of Nov. 26, the hospital's own infection control program was not aware of the deaths when contacted.
The DOH first became aware of this bacterial infection on October 1, when two cases of A. baumannii were confirmed in the NICU. Two additional cases were confirmed in lab tests later in October. Of these four confirmed cases, three of the infants have died. On October 25, the DOH reported in a press release that a premature infant who had been cared for at University Hospital and had the bacteria was transferred to another facility and passed away at the end of September, before the DOH was notified of infections in the NICU. The fourth infant was discharged at the end of last month.
The DOH ordered a Directed Plan of Correction on October 25 that required University Hospital to hire a full-time Certified Infection Control Practitioner to guide efforts.
University Hospital has also ranked poorly in recent Leapfrog surveys, receiving an “F” grade earlier this year on the grounds of failing to prevent infections, patient falls, surgical deficiencies, and medical errors and inadequate staff communication and responsiveness. That grade was recently upgraded to “D” status, with East Orange General Hospital now carrying the “F” mark.
In July, Fitch Ratings downgraded the hospital’s Bonds to “BB-,” citing pension liability, a “weak leverage profile,” and “thin operating performance.”
“My administration has repeatedly expressed its concern over the quality of care and leadership at University Hospital, seeking action. Both Governor Murphy’s appointment of a monitor for the hospital in July and the tragic deaths of three premature infants there in November speak to that institution’s many issues,” said Newark Mayor Ras Baraka in a statement.
“President and CEO John Kastanis’s decision to step down from his positions is a move in the right direction for the hospital and the residents of the city. We believe that the hospital requires new leadership, including a new board with adequate representation of Newark residents and a new President/CEO with a history of sensitivity to community.”
TRENTON - On July 27, Governor Phil Murphy signed an Executive Order directing the state Health Commissioner to install a monitor to review expenditures and assess the level of care provided at University Hospital in Newark in response to a series of concerns regarding the quality of care and the financial health of the institution.
The Hospital recently received a failing grade on quality of care from the Leapfrog Group, had its bond rating downgraded four notches due to financial difficulties, and attempted to reduce the number of pediatric beds without state approval.
“Given the scope of the problems found at University Hospital, these immediate actions are necessary to ensure the facility can continue providing the highest level of care to the community while it gets its fiscal house in order and improves its health care quality,” said Governor Murphy.
“I applaud Governor Murphy's swift and decisive action in appointing a monitor for University Hospital,” Newark Mayor Ras Baraka said. “University Hospital is central to providing health care to Newark residents and I have been very concerned about the quality of care at the hospital, their failure to live up to the Newark Agreement negotiated when the hospital was created, their attempt to reduce the number of pediatric beds without consulting myself or the Governor, and the failing grade they received on their level of care from the Leapfrog group. The appointment of a monitor will assure that University Hospital gets its house in order.”
“The medical care provided by University Hospital is vitally important to the health and welfare of our residents from Newark, Essex County and throughout the region,” said Essex County Executive Joseph N. DiVincenzo, Jr. “We applaud Gov. Murphy for taking a proactive approach and appointing a monitor to ensure patients receive the first-class care they deserve and their families expect.”
Health Commissioner Dr. Shereef Elnahal appointed veteran health care executive Judy Persichilli to serve as monitor, with broad authority to assess the level of care provided by the Hospital and to gain a deeper understanding of the financial affairs of the Hospital.
“University Hospital provides critical services for the residents of Newark,” Commissioner Elnahal said. “I look forward to working toward substantial improvements in the quality of care delivered, and in putting the hospital on a path to operational and financial stability.”
Earlier this year, University Hospital received an “F” grade in the national Leapfrog hospital patient safety report for failing to prevent infections, patient falls, surgical deficiencies, and medical errors and inadequate staff communication and responsiveness.
In July 2018, Fitch Ratings downgraded the Bonds to “BB-,” citing the Hospital’s pension liability, “weak leverage profile,” and “thin operating performance” as the basis for this lowered rating.
During the time period that University Hospital’s Certificate of Need application was pending with the state to close its Emergency Pediatric Unit (EPU) and Pediatric Intensive Care Unit (PICU), the hospital took steps to dramatically reduce the number of EPU beds on site and transfer those services to Newark Beth Israel Medical Center. These unauthorized steps jeopardized care for pediatric patients and threatened the hospital’s ability to provide essential health care services for surrounding communities.
Judith M. Persichilli is President Emerita, CHE Trinity Health and previously served as the interim president and chief executive officer of CHE Trinity Health. Prior to that, she was president and CEO of Catholic Health East and served for eight years as CEO at St. Francis Medical Center in Trenton. Mrs. Persichilli received her nursing diploma from the St. Francis Hospital School of Nursing in 1968, a bachelor of science in nursing summa cum laude from Rutgers University in 1976, and a master of arts in administration summa cum laude from Rider College in 1980. She has received an honorary doctor of health degree from Georgian Court University and an honorary doctor of humane letters from Sacred Heart University in Fairfield, Conn.
She is a member of various community agencies and is a member of several community boards, including the Health Care Administration Board of the State of New Jersey on appointment by the Governor. Mrs. Persichilli also serves on the Board of Directors of the New Jersey Health Care Quality Institute and the Audit and Compliance Committee of the Board of Bayada Nursing Agency. She was inducted into the New Jersey State Nurses Association Hall of Honor in 2006.
University Hospital is one of three Level I trauma centers in the state. In the FY19 budget, the hospital will receive more than $43.3 million based on the number of state funded staff, which is more than 2,900 employees. It receives another $10 million for a self-insurance Reserve Fund.