Hospital Responds: ER Is Staffed at “Core” Levels of Two Nurses Per Shift, CEO Says
Eastland Memorial’s chief executive answered the Gazette’s questions about the emergency department, the resignation of its nurse manager, and a state complaint survey. Here is what he said.
By The Alliance Gazette
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EASTLAND, Texas — Eastland Memorial Hospital’s chief executive says the emergency department at Eastland County’s only hospital is operating at its established staffing levels, that no state investigation of the hospital is currently open, and that the practice of relieving department heads of their duties after they give notice is standard business practice rather than retaliation.
CEO Clay Taylor provided the responses in writing to questions submitted by The Alliance Gazette following the July 9 resignation of Emergency Department Nurse Manager Kaitlyn “Kat” Sanders, who left her position effective immediately.
The Gazette reported on Sanders’ resignation letter last week. Taylor’s responses address several of the concerns she raised, confirming some of the circumstances she described while offering a different characterization of what they mean.
A note on the letter. The Gazette has reported the substance of Sanders’ resignation letter but has not published it in full. One section of the letter contains an unverified allegation about a specific, identifiable hospital employee — an allegation the letter itself describes as unproven. The Gazette does not publish unproven accusations against private individuals. The letter has since been published in full elsewhere.
What “core staffing” means
In her letter, Sanders wrote that the emergency department faced 26 open shifts, a vacancy rate she said created “an imminent threat to safe patient-to-nurse ratios.” The Gazette reported at the time that it had not independently verified that figure.
Taylor did not dispute the number of open shifts. Instead, he said they represent coverage above the department’s baseline.
The emergency department “is currently staffed at its established core staffing levels, and all core staffing shifts are filled,” Taylor wrote. “The open shifts referenced are for additional coverage above core staffing.” The hospital, he said, “continuously monitors staffing needs and adjusts resources as necessary to ensure safe, uninterrupted patient care.”
Asked what those core staffing levels are, Taylor gave a specific answer. The hospital, he said, “considers two registered nurses, and a registration clerk core staffing per shift.”
Coverage beyond that baseline is conditional. “When available, the hospital staffs an emergency technician and an additional shift during peak hours that includes an additional registered nurse,” Taylor wrote. He added that “when the position is filled,” the ER nurse manager is also a registered nurse who can float to any shift.
That position is currently vacant.
The two accounts are not necessarily in conflict. Sanders wrote that at the moment of her departure there were two registered nurses and two patients in the department — which matches the hospital’s stated core level. Where the accounts differ is on whether that baseline is sufficient. Taylor’s answer indicates the department is meeting the standard the hospital has set for itself.
Texas does not set mandatory nurse-to-patient ratios for hospitals, leaving staffing levels largely to each facility.
Leadership vacancies
Sanders wrote that the hospital was operating without a quality manager and would soon be without an infection control and employee health manager, following what she described as the termination of the previous chief nursing officer.
Taylor confirmed both positions are vacant and said the hospital is “working to recruit highly qualified candidates” for them.
In the meantime, he said, “the responsibilities associated with these positions continue to be performed by qualified leadership and staff,” with infection prevention and control overseen by the chief nursing officer. He characterized the vacant roles as “administrative in nature,” adding that they “do not provide direct patient care.”
The hospital does currently have a chief nursing officer in place, Taylor said. Sanders’ letter stated that responsibility for ER operations would pass to Interim Chief Nursing Officer Brandi Riley. Taylor said the chief nursing officer is providing clinical leadership of the emergency department “while the hospital works to secure an interim Emergency Department manager.”
A complaint-driven state survey
Sanders’ letter referenced an “ongoing state Health and Human Services investigation.” The Gazette reported that it had not independently confirmed the status of any state investigation.
Asked directly, Taylor said none is open.
“The hospital is not currently the subject of any open or pending state regulatory investigation or complaint investigation,” he wrote.
Taylor said the hospital was surveyed by the Texas Health and Human Services Commission on June 15 and 16, and that the survey was complaint-driven — meaning a complaint prompted the state to examine the facility. The survey found no deficiencies, he said, and its findings were accepted by both HHSC and the federal Centers for Medicare & Medicaid Services.
Taylor’s account and Sanders’ letter differ on this point. It is possible both descriptions refer to the same complaint survey, viewed at different stages.
The Gazette has a pending public information request with HHSC for the hospital’s survey and complaint-investigation records, and will report what those records show.
The shared folder
Sanders wrote that her access to a shared folder containing emergency department operational and trauma data was abruptly revoked, and that the loss crippled her ability to manage state trauma-designation requirements and follow-up reporting.
Taylor confirmed that access to the folder was restricted. He said it was done so the contents could be reviewed “to ensure potentially sensitive information could be accessed only by the appropriate personnel.” During the review, he said, trauma and compliance files remained available to staff who notified the hospital’s IT director that they needed access.
“The hospital’s ER trauma and compliance data has been maintained appropriately throughout this process,” Taylor wrote, adding that the hospital is meeting regulatory requirements for its trauma designation and patient communications.
Department heads and resignations
Sanders described the practice of escorting department heads from the building after they give notice — as she said happened to the quality manager — as evidence of a pattern of retaliation.
Taylor did not dispute that the practice occurs. He said employees “in leadership or other positions with access to confidential, proprietary, or sensitive information may be relieved of their work responsibilities after providing notice of their resignation,” and that in those cases the employee may continue to receive pay for the notice period, accrued PTO, and other earned benefits.
The practice, he wrote, “is intended to protect confidential information and ensure a smooth operational transition and should not be interpreted as disciplinary or retaliatory.”
On the broader retaliation concerns, Taylor repeated the hospital’s position that it does not discuss specific personnel actions publicly, that “employment decisions are based on documented performance and adherence to hospital policy and applicable law,” and that the hospital does “not tolerate retaliation against employees who report issues in good faith.”
What comes next
The Gazette has followed developments at Eastland Memorial since anonymous employee complaints surfaced earlier this year. The publication is continuing to review public records related to the hospital’s operations and leadership, including its survey and complaint history with state and federal regulators, and will report further as that work develops.
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The Alliance Gazette distinguishes between allegations and confirmed facts. Statements attributed to Kaitlyn Sanders reflect her written account and have not been independently substantiated. The hospital has not been found by any court or agency to have violated the law in connection with the matters described above. The Gazette submitted written questions to CEO Clay Taylor and has presented his responses above.
