Health Care

Feds threaten to oust Mount Sinai from Medicare for placing patients in danger of sexual abuse

Mount Sinai Medical Center, 4300 Alton Rd., Miami Beach.
Mount Sinai Medical Center, 4300 Alton Rd., Miami Beach.

For six months after a patient accused a Mount Sinai Medical Center employee of sexually assaulting her in her room, hospital administrators allowed the worker, a mental health technician, to continue working directly with patients in the behavioral health unit while awaiting the results of a DNA test.

Christian Vidal, 42, was arrested by Miami Beach police in May and charged with sexual battery after the DNA test confirmed a match between Vidal and a sample taken from the patient, who was assaulted in November.

In June, acting on a complaint, state health regulators conducted an unannounced inspection of Mount Sinai and found what they called “an immediate jeopardy”: The hospital was failing to protect patients from sexual abuse.

As a result of the state’s findings, federal regulators threatened to terminate Mount Sinai from Medicare, the public health insurance program for elderly and disabled Americans, and the financial lifeblood of the hospital.

Mount Sinai CEO Steven Sonenreich said the hospital took the right steps after Vidal was arrested.

“We acted responsibly and notified the accrediting bodies,” Sonenreich said on Wednesday.

But a report from the state inspection in June said that although Mount Sinai administrators notified the Joint Commission, a nonprofit organization that accredits hospitals, they failed to tell the Florida Department of Children & Families, or DCF, as required. Hospital administrators never presented the incident to the hospital’s board of directors for review, either, the report states.

The woman who accused Vidal had been held at Mount Sinai under Florida’s Baker Act, a state law that allows people deemed a danger to themselves or others to be held against their will for up to 72 hours in a mental health treatment facility. She had been diagnosed with recurrent major depression and suicidal thoughts, according to the inspection report.

She was assaulted the day after being admitted to Mount Sinai’s behavioral health unit, where Vidal worked. The patient reported the assault to hospital staff, who then called police. The woman was then taken to the Roxcy Bolton Rape Treatment Center at Jackson Memorial Hospital, where she was examined.

Vidal told hospital administrators that he was in the room only minutes, according to the state inspection report. But because Vidal entered the patient’s room alone and the interaction took place in private with no camera to record the encounter — a violation of hospital protocol — police were called to investigate.

The woman told police that Vidal entered her room and started a conversation with her while eating his dinner. Some time during the conversation, the woman told police, Vidal approached her and caressed her breast.

She told police that Vidal then took her hand and forced her to touch his penis. Then he left the room and returned about 15 minutes later. According to the inspection report, he kissed and caressed the woman’s breast and then licked his hand and touched her vagina. Vidal allegedly took a picture of the patient while she was getting dressed and before he left the room.

Video footage of the hallway outside the patient’s room on the day she reported being assaulted showed that he entered and exited her room three times, staying several minutes on each occasion, over a 10-minute period, state inspectors reported.

Vidal then spoke with the patient in the hallway briefly and followed her into her room and left moments later. Vidal then walked down the hallway and the woman followed him briefly before returning to her room, according to the inspection report. Vidal entered her room seconds later, walked out after about 90 seconds, and then returned to her room for another 30 seconds.

Christian Vidal mug_fitted.jpeg
Christian Vidal, 42, of Miami was arrested and charged with sexual battery on May 22, 2019. Miami-Dade Corrections

About a minute after Vidal had left the patient’s room for the last time, the video footage showed the woman speaking with nurses at the nursing station. Vidal then was shown going in and out of her room multiple times and pacing the hallway for about 15 minutes, state inspectors reported.

Police arrived about an hour later. They interviewed Vidal, who denied any physical contact with the woman, and took a DNA sample from him. Mount Sinai administrators suspended Vidal for one day, without pay, and he returned to his regular work schedule the following day, according to the inspection report.

According to state inspectors, police initially said the patient’s allegations were unfounded, and that in their opinion Vidal was cleared pending the results of the DNA testing.

While awaiting the results of the DNA test over the next six months, Vidal had direct access to patients, working in the psychiatric intake area where he helped with patient admissions and transported patients from the emergency room to the behavioral health unit, state inspectors reported.

After Vidal’s DNA sample was matched to the DNA taken from the patient, he was fired on May 23. A week later, state regulators reported, they interviewed a nurse who was in the hallway and heard the patient yelling and saying that “the Spanish guy raped me.”

State inspectors said the DNA results were consistent with the incident described in the police report. They reported that other problems at Mount Sinai, including a lack of oversight of hospital employees and ineffective policies for improving performance and preventing sexual abuse, placed patients in danger.

Vidal’s criminal case remains open, according to Miami-Dade’s criminal justice online system. He remains out on bail and has a hearing scheduled on July 25.

Mount Sinai’s handling of the incident, including administrators’ failure to keep Vidal from patients, led to the threat of termination from Medicare. But Sonenreich, the hospital CEO, said that he does not expect the hospital to be terminated from the program because Mount Sinai has filed a corrective action plan that has been accepted and approved by state and federal regulators.

Patrick Manderfield, a spokesman for the Florida Agency for Health Care Administration, which regulates hospitals, said in an email that the agency has received Mount Sinai’s corrective action plan. “An on-site visit to review correction is in process,” he said.

The notice sent to Mount Sinai by CMS does not mean that termination from Medicare is certain. Federal regulators give a final notice of termination at least two days but not more than four days before the effective date, which means CMS would inform Mount Sinai on June 29 or July 1.

Hospitals rarely are terminated from the Medicare program, which covers about 464,000 people in Miami-Dade County. If Mount Sinai were excluded from Medicare, the effect would be devastating — cutting off the hospital from its primary source of payment for patient care.

About 62 percent of Mount Sinai’s total charges for inpatient care, or roughly $872 million in 2017, were billed to Medicare and Medicare HMOs, according to a state database. The hospital system reported about $1.4 billion in inpatient charges in 2017, the most recent year for which data is available.

Medicare beneficiaries made up 46 percent of the nearly 26,000 patients discharged from Mount Sinai in 2017.