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Virginia Mason Memorial is pictured on Saturday, June 20, 2020 in Yakima, Wash.

Two nurses at Virginia Mason Memorial filed a complaint with the state Department of Health, alleging that the hospital’s staffing, sanitation and personal protective equipment practices put patients and staff at risk during the COVID-19 pandemic.

Sylvia Keller and Alice Westphal alleged the hospital has been dangerously understaffed in its critical care unit.

As a result, they alleged in their early August complaint, nurses are working every day “in anticipation of a disaster.”

Kristen Maki, a public information officer with the state Department of Health, confirmed the agency had received the allegations but couldn’t go into detail about whether they were under investigation.

“If authorized, investigations are required to be unannounced,” she said. “That means we cannot confirm or deny whether we have opened an investigation at this time.”

Virginia Mason Memorial declined comment, per hospital protocol, saying, “Virginia Mason Memorial cannot comment on an ongoing investigation.”

The nurses’ union, SEIU Health care 1199NW, has been engaged in negotiations with Virginia Mason Memorial for safer working conditions during the COVID-19 pandemic.

Amy Clark, the communications director for SEIU Health care 1199NW, said via email Tuesday that the complaint is not related to contract negotiations.

“The two nurses who made the complaint are union members and so were able to get assistance from legal staff in navigating the Department of Health system, but the complaint is entirely their own experience and observation from their work at Virginia Mason Memorial hospital,” she said.

The complaint

The complaint alleges that while Virginia Mason Memorial staff have typically maintained a nurse-to-patient ratio in the Critical Care Unit of 1:1 or 1:2, the hospital has averaged one nurse per three patients since the pandemic.

The hospital’s expanding from 11 to 27 critical care beds without a similar increase in skilled nursing staff has meant that nurses not trained to care for or assess critical care patients are tending to them, according to the complaint. While the hospital has paired the lesser-trained nurses with more highly skilled nurses, the nurse to patient ratio still causes possibly dangerous care for patients, the complaint said.

“If a skilled nurse they are paired with needs to focus all attention on a patient who is coding, the other two patients under the pod’s care are left in critical danger,” the complaint says.

The complaint alleges that when the hospital admitted its first COVID-19 positive patients in April, cleaning staff were not provided with adequate personal protective equipment or taught how to properly disinfect rooms where positive patients stayed. Nurses were told to reuse N-95 masks and gowns, according to the complaint.

The complaint also alleges that hospital staff failed to inform employees about known exposures to COVID positive patients.

The complaint alleged the hospital had transferred patients who had not been tested for COVID-19 onto floors where no additional precautions had been taken, resulting in at least five staff members contracting the virus. The complaint did not specify when.

Clark said she had heard that Department of Health staff were spotted at the hospital the day after the two nurses filed their complaint in early August. An information request with the state returned several complaints filed against Virginia Mason Memorial this year, she added.

“From what I can tell it looks like a number of the complaints relate to patient care tied to staffing issues,” she said via email.

The process

The state Department of Health conducts facility oversight under state hospital licensing regulations, with a focus on ensuring hospitals have policies and procedures to keep patients safe and are adhering to them.

A case management team reviews all complaints to determine if an investigation is warranted. Allegations must amount to a possible violation of hospital licensing regulations that would endanger patient well-being, Maki said.

If the agency has legal authority to take action and believes a violation may have occurred, a probe results, involving investigators, staff attorneys and the Office of Attorney General, with findings forwarded to a board, according to the department’s Health Systems Quality Assurance complaint form.

Maki said investigations can involve unannounced on-site visits. Facilities not in compliance with regulations receive a written statement of deficiencies, which they must correct with a plan submitted to and approved by the Department of Health.

Additional on-site visits can occur as a follow-up. The state department’s complaint form notes that investigations can be lengthy due to legal and medical issues, with cases typically ranging from between a few weeks to two years.

The Yakima Herald-Republic has requested additional records related to the complaint.

Reach Lex Talamo at ltalamo@yakimaherald.com or on Twitter: @LexTalamo.