Judge places ‘dysfunctional’ RoxComp into receivership

Citing “severe dysfunction” with finances, administration and patient services at the Roxbury Comprehensive Health Center, state Attorney General Martha Coakley last week received authority to place the longstanding community center in receivership.

In addition, RoxComp has agreed to relinquish its state public health licenses by April 19, thus ending the center’s 45-year run as a provider of critical health services to a community most in need.

“Appointment of a receiver is necessary,” Coakley stated in court documents, “because the Center is incapable of taking steps necessary to preserve the health, safety and well-being of its patients; wind down its operations and conserve the center’s assets.”

Judge Garry Inge appointed Joseph Feaster, an attorney at McKenzie and Associates in Boston, as receiver. Feaster has previously served as interim president and CEO of the Dimock Community Health Center.

The blistering court documents detail a litany of serious deficiencies at RoxComp under the leadership of CEO Anita Crawford, who abruptly resigned earlier this year. Among the ongoing problems are failures to notify an estimated 4,000 patients about its closure and failure to pay its employees after they were effectively terminated on March 20, 2013.

The center terminated its clinical laboratory services in June 2012 because state public health regulators found “serious, unsafe patient care practices.”

Two months later, DPH suspended RoxComp’s dental services for similar unsafe patient care practices, including improper equipment sterilization and unsanitary conditions.

In all, federal regulators found that the center was not in compliance with 14 of 19 program requirements. They found “severe dysfunction with the Center’s administrative, financial and management functions, including the center’s board of directors.”

The problems continued this year. After a January 2013 site visit, state health regulators ordered the center to give up a drug treatment program as a result of “serious regulatory violations, including the lack of drug screening, the lack of random call-backs for persons on take home dosing regiments and low methadone stock.”

The problems were not limited to the center’s health care services. Regulators found that the financial systems were inadequate, forcing vendors to terminate services for the disposal of medical wastes. The center was also deficient in medical record-keeping, nursing supplies and site security.

Worse, the RoxComp Board Chairman Keith Crawford couldn’t devise an appropriate plan to solve its chronic problems.

“Dr. Crawford did not seem to be able to articulate any kind of plan that could revive that institution,” Coakley told the Boston Globe. “It became necessary to mitigate the damage, make sure the patients were cared for, and do what’s best for the building and the institution.”

Last summer, RoxComp was embroiled in controversy prompted by a series of letters by employees describing a woeful state of operation at the center. The problems included mislabeled lab samples, use of expired medical supplies and failure to comply with various Medicaid and Medicare regulations.

The damaging letters detailed financial problems ranging from the loss of “significant grants” that helped pay for medical and psychological programs, to an almost chronic shortage of medical equipment, paper towels and toilet paper. In some cases, the letters alleged, the center had no hot water.

At the time, Crawford questioned not only the validity of the unsigned, anonymous letters but also the timing. “None of the letters,” Crawford told the Bay State Banner, “accuse me of stealing money or running a center that is delivering poor health care.”

Without commenting on specific allegations, Crawford explained that RoxComp has undergone several routine surveys by both federal and state regulatory agencies. If there were deficiencies, Crawford said, they were fixed in a timely manner.

Crawford then said she believes the letters were sent “in retaliation” for her role as chairman of the board of Roxbury Community College. She did not explain the link between the two institutions or how her role in one affected her role in the other. Shortly after those comments were made last summer, Crawford was replaced as board chairman of Roxbury Community College.

It is unclear at this time whether the mismanagement at the Center will lead to any criminal charges. According to court records, the center received $1.9 million in federal funds but has shown an annual loss of about $400,000. Federal and state regulators caution that the Center’s financial statements have not been audited in several years in part because it still owes $35,000 to the firm that performed them in the past.

“It is my intention,” Feaster said in a statement, “to manage with appropriate diligence and respect the orderly disposition of patient transfer, employee pay and benefits, accounts receivables and payments, and the preservation of assets. I look forward to immediately assembling a team to address the task before me.”