(November 15)  Patrick Petre, whose tenure as the top administrator of the county hospital was marred by accusations of irregularities in the running of the facility over the last several years, is leaving his position at the hospital today. His resignation was announced November 11.
Known as Arrowhead Regional Medical Center, the county hospital made several strides during Petre’s time as director, which began in 2007. Those included an 83 medical/surgical bed expansion on the sixth floor and the addition of a three-story, 68,000-square-foot medical office building. Petre was also on hand when the medical center was designated as a stroke center and incorporated a palliative care program and an enhanced cancer care program.
By February 2010 and perhaps earlier, however, California state and federal investigators began looking into alleged irregularities at the institution, including faulty diagnoses that led to the deaths or permanent injuries of patients; billing fraud with regard to descriptions of services rendered; a fiduciary conflict of interest in which the hospital’s former medical director, Dr. Dev GnanaDev, owned the medical corporation, Arrowhead Regional Surgical Group, Inc., which had an exclusive contract for the provision of certain surgical procedures at the hospital; the hospital’s alleged free provision of off-the-books medical care to individuals, including members of the board of supervisors and high ranking county officials; inadequate supervision and oversight of the emergency room; violations of law with regard to the use of physical restraints on patients in the hospital’s behavioral health ward; together with inadequate peer review of the hospital’s policies and practices.
The county initiated the first of a series of internal audits shortly after the state and federal probes were revealed as being under way.
In May 2010, the Centers for Medicare and Medicaid Services threatened to suspend Medicare and Medi-Cal payments to  Arrowhead Regional Medical Center if the county hospital did not show improvement in operations and patient care.
On November 4, 2010  a team of more than 20 investigators, including FBI agents, members of the U.S. Attorney’s office and district attorney’s office employees, served search warrants at Arrowhead Regional Medical Center, hauling away thousands of documents and computer files. No criminal charges were ever filed, but the county’s internal examinations of its operations intensified.
Last January, GnanaDev, who had been the hospital’s medical director since 2000 and had come under continuous criticism because of the perceptions of the conflict involving his dual roles as the hospital’s medical director and as owner and head of the surgery group with a hospital contract, departed as medical director and was replaced by Dr. Emily Ebert, who has served the last eight months as the acting medical director of the county hospital.
Doctors and other medical professionals who work at the hospital reported that Petre was unwilling or unable to assert his overarching management authority at the hospital to hold GnanaDev in check, and had shrunk from providing recommendations to the board of supervisors that would have curtailed GnanaDev’s domination of hospital operations and the promotion of his surgical group’s financial interests, even in the face of indications this created a circumstance that was contrary to the interests of some of the hospital’s patients.  Petre’s reluctance could be at least partially explicated by the consideration that some of the members of the board of supervisors had been the recipients of the off-the-books care rendered at the hospital.
In September, Dr. Richard Pitts succeeded Ebert as Arrowhead Regional’s medical director.
Petre reportedly was offered a management post with a private sector medical provider in Los Angeles County, and will move into that position shortly.
Petre will be temporarily replaced by Pitts while a nationwide search is conducted to replace him.