The original version of the following article was published in this blog in early 2013, in relation to an official annual status report prepared and disseminated in August, 2012, specific to the operation of Arizona's sole long term public mental health facility, The Arizona State Hospital, by then ASH Supervisor Cory Nelson. Since that time, Cory Nelson has been repeatedly exposed via major Phoenix area media outlets, in terms of grossly mischaracterizing the substandard medical-mental health care and conditions at ASH, and there is arguably no stronger evidence in the context of this man's patent untruthfulness than this 2012 "State of the Hospital" report, evidence that most definitely includes clear data to the effect that Nelson is very unqualified, ethically and experientially, for the positions that he has filled in Arizona's behavioral health system. For which, Nelson was promoted within the Arizona health care construct by the Director of the Arizona Health Department, Will Humble. All aspects of this recent history are occurring in graphic defiance of established health care law and policy, and yet to date, no accountability has been provided to the citizens of Arizona, including the patient community at ASH, who are being continually subjected to the clinical and administrative ineptitude that I became aware of while hospitalized at ASH in 2011-2012.
Why Do We Care? Herein, a consideration of Cory "meathead" Nelson's 2012 Arizona State Hospital Annual Update, aka, "The State of the Hospital."
Topic: 2012 "State of the Hospital" presentation(s), facilitated by the Arizona Department of Health Services/Behavioral Health Services, sometime in late August, 2012.
Arizona State Hospital
Annual Update. August 2012. Cory D. Nelson, MPA. Administrator/CEO
(to see a full copy of the document itself, go to www.adhs.gov, and from there just go to the Arizona State Hospital page, and follow the prompt to where you should find it at the top of the page).
Excerpt from the document itself(pp 18). Cory Nelson: "Why Do We Care?" (as in, the staff, about the patients at The Arizona State Hospital) "Because If We Don't..." (care about the patients at at ASH), "They Will Find Someone Who Does" (as in, we will lose business).
It is interesting to consider why a supervisor of a major public hospital, with less than one year of experience at that facility, would pose so inane a question to a staff that possesses far more actual experience in behavioral health care than he does (even now, in 2013-14); and consistent with the flagrant exhibition of arrogance, it is worth contemplating what Nelson's primary objective is in the context of maintaining reasonably decent care and treatment at ASH is, in fact. Not as a matter of ensuring that ASH's seriously mentally ill and disabled patients are provided with fundamentally established standards of care, but rather to preserve the state of fiscal stability, as though ASH patients are in a position to take their business elsewhere at the drop of a hat. As illustrated herein, Cory "crazycorycorner" Nelson, in conjunction with the Arizona Department of Health Services (ADHS), convened a "State of the Hospital" presentation to his staff at ASH, wherein he facilitated a carefully planned dissemination of misinformation specific to the affairs of ASH, as they stood at the time (fiscal year 2011-12). In order to do this, Nelson relied on a 32 (or so) page power point document, entitled Arizona State Hospital Annual Update that he presumably presented to an audience including ADHS officials and staff, ASH staff, and maybe even members of the public, including ASH patient family members. It is stretch of the imagination to suppose that any former patients, such as myself, were there, but I would have been there, without a doubt, were I to have known in advance about the event. As it is, I did not hear anything about it until approximately 14-21 days after it occurred, which is when ADHS Director Will Humble published this very, very brief mention of the presentation on his official blog site:
State of the Hospital
September 12th, 2012 by Will Humble, Director ADHS.
A few weeks ago Cory Nelson did his in-person “State of the Hospital” presentations. Many of you were able to attend one and we really appreciate the dialogue and feedback we got. It’s impressive to see how much work our hospital team has accomplished in the past year. (UPDATE, December 2013: as illustrated by numerous deep investigations into ASH's operational history over the last 6-18 months and related news reports aired by Phoenix area ABC affiliate Ch. 15, as well as the AZ Family Ch. 12 news source, Cory Nelson is directly responsible for creating a clear and irrefutable crisis at ASH that virtually began as soon as he was hired, wherein ASH patients and ASH staff have been subjected to an utter decimation of safety standards that arose via Nelson's graphic ineptitude as a hospital administrator. The fact is, this crisis was furthered [as it evolved in 2011-12] by the complicity of ADHS Director Will Humble, (as illustrated in the above ADHS "Director's Blog" post), who has willfully engaged in distorting hard data that today has been revealed in this context; misbehavior and patent untruthfulness that both of these men have maintained in blatant defiance of the pubic trust, in spite of the emergence of such data. I know that I am not alone in declaring this issue as unacceptable in every sense of the word.)
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I was disappointed, as usual, to see so little information about the event, particularly given that ASH maintains the full responsibility of caring for close to 300 seriously mentally ill and disabled patients. However, my attention was immediately drawn to (the) sentence #2 (out of three) reference to "dialogue and feedback," because I am hopeful that at least a few of the ASH staff who have, in recent months, been expressing their outrage and disbelief about the river of misinformation that's been flowing out of Humble's office with direct respect for the state of affairs at ASH were in attendance, and that they had the courage to speak up and voice their concerns when they had the chance. But I have no way of knowing that, or who all may have actually been in attendance, because beyond Will Humble's three sentence article about this event, all I have been able to garner about what all exactly went on that day comes in the form of a 23 or so so page power point document that Cory "meathead" Nelson utilized in disseminating an arguably questionable body of information about the Hospital's last 12 months of existence as Arizona's only long term public mental health facility. Sadly, there is no information that I am aware of specific to the "feedback and dialogue," but I am in a process of seeking that information.
In lieu of such information, I did take the time to review the power point document that Cory "meathead" Nelson apparently used during his presentation about the state of affairs at ASH. (to view this document, visit www.adhs.gov and then go to the Arizona State Hospital page). It is not a particularly impressive document when one considers it's purpose and function; it is more like what one see at the annual staffing of a fast food restaurant, in my opinion, with an assorted body of poorly constructed references to improvements in facility (including at least one full color photo of a door knob, and two or three very grainy photos of a building roof) and at least 16 primary staffing changes (described under the heading Leadership Changes, and none of which apply to the obviously need to remove ethically challenged executive staff such as Donna "You are so Busted" Noriega (see "News Flash: Donna Noriega- Busted!" April 17, 2012), and other like critical details about ASH, which Nelson variously paraphrased in categories such as: "What else happened?", as follows:
"Really?", "Still more?" (this is where the door knob appears on pp. 8 of the document), followed by "You've got to be kidding?" (and two really crappy photos of said roof on pp. 10-11), and "So when does it stop?" (pp.12). It is embarrassing as a reasonably educated/intelligent adult to have to accept the line of rhetoric presented by Nelson , and then it only gets worse, with continued photo imagery that was obviously, oh so cleverly, downloaded from the internet, much like an 8th grade student might go to the trouble of, including an image of Albert Einstein and the words "Why do I have to change?" (and the quote "The world as we have created it is a process of our thinking. It cannot be changed without changing our thinking" pp 16), and finally a plagiarized comic strip image that challenges any belief that Nelson) actually eared a legitimate undergraduate level college education, much less an advanced degree in the context). All of it, juvenile tidbits of flash, at best, designed to create an impression of creative thinking; but very sadly, nothing meant to meaningfully effect or improve the substandard conditions at ASH, as I know them to be.
Not until page 18 of the Annual Update, does the supervisor of ASH begin discussing anything at all related to the experiences of ASH patients. It is (or was) by all appearances, a perfunctory and far from reassuring discussion in this context (to I, a recently discharged former patient of ASH), and short of having been there at the presentation of this crap personally, I can only speculate as to how Nelson specifically carried forth during this portion of his presentation. On its face, however, as per the materials included in the power point document that I reviewed, I honestly have to say, I am more than a little bit worried.
FOR EXAMPLE:
Take a look at this, if you will. It is a verbatim section of Nelson's power point document (pp. 19). Herein, with immediate respect for the needs and expectations of ASH patients and their families, the supervisor of Arizona's sole long term public mental hospital offers his grossly distorted interpretation of what it means to be a health care professional in the 21st century:
Why do we care?
Because if we don't care, they will find
someone who does.
This section of Nelson's presentation is both confusing to me (for in referring to the possibility that "they will find someone who does [care]", I am stumped, in the first place, as to whether he means the Arizona state court system, because "they" are the sole source/reference point of each and every patient that is ever admitted to ASH, or if he is referring to the patients themselves); as well as horrifying to me, (as a former patient, human being, and tax payer), for herein, the person in whom all citizens of Arizona have granted their trust in terms of meaningfully tending to the critically vital needs of the state's most vulnerable and at risk citizens equates caring with commercially oriented profit incentives, and the retention of open market customers. This is what it means to care in Cory "meathead" Nelson's way of seeing things: Either care about retaining our patients, lest the patients be lost to competitors. This specific illustration of Nelson's frame of thinking highlights the significance of his record in South Dakota, pre-ASH and Arizona, circa 2009-10), as reported in the following article, published in a Yankton, SD, newspaper : HSC Pay Raise Sparks Questions: Administrator Receives $10,000 Pay Increase, Nathan Johnson nathan.johnson@yankton.net Published: Wednesday, July 7, 2010 1:17 PM CDT). This is a man who very accepted an under-the-table $10,000 pay raise that had not been approved by the citizens for whom he worked in South Dakota, which created a a still unresolved cloud of suspicion about Nelson's conduct in that state, which he left behind before being hired to work as ASH's highest ranking employee. Clearly , Nelson only sees dollar signs and margins of predictable loss/gain in his perspective(s) on caring. And given his behavior in South Dakota, as it relates to Arizona's agreeably corrupt public resources network at this time, I fell safe in presuming that he is fully aware of the shortsightedness of his "vision." Not a good recipe, if you ask me (and all that that implies), for ensuring that Arizona's seriously mentally ill and disabled ASH patients are cared for in a manner consistent with established health care standards; a condition of ripeness, more like, in terms of holding open the doors that at this time allow for the presence of overtly sanctioned patient abuse, clinical negligence and discrimination, and directly related administrative malfeasance.
(UPDATE 2013-14: Or, as one of my associates put it less than 8 weeks ago: "The Arizona State Hospital is a powder keg of illegal conduct now on the verge of explosion."
And although I'd typically believe that such history (the South Dakota scandal) would suffice in disqualifying someone like HIM from caring for Arizona's common citizens (this, based on the other 5 states I have lived in at length), it just don't seem to matter in Arizona. But myself aside, all this crap also signifies the the fact that the crisis at ASH still exists, in terms of every person still needing to be there; so it is painful to me, too, as a one time patient, therein, as a man who feels the pain of the ones still in there. I can, today, literally sense the tension, fear, and sickness that arises when patient abuse occurs at ASH, for I was emotionally effected by it at the time, and such effects linger beyond any other like negative events that one might experience. As does the emotional and psychological abuse that someone like I suffered as a child: Indeed, the ruthless personalities of ASH's most depraved staff members, be it the old war horse nurses who have become overly accustomed to care standards that went out of practice 25-40 years ago, or the socio-psychopathic doctors who have no problem with stomping all over the lawful protections and rights of their patients as a matter of standard practice, emerged in my dreams (nightmares) as I slept at ASH, because their graphic misbehavior triggered such memories for the first time, in my case, in over many, many years. This, the state of affairs at ASH, as I see it.
It is readily apparent to me, as a person who has been studying the actions of this yahoo, Cory "overpaid" Nelson, ever since he stepped in as the new Supervisor at ASH in August, 2011, that the "man" is very out of touch with what it means to take responsibility for hospital patients of any kind, particularly such as those being treated at ASH. And from what we can see here, through the materials he relied upon in presenting his 2012 "State of the Hospital," I think it is pretty obvious how this man views the topic(s) of care, health care, the quality of care given to hospital patients, ASH patients. CARE, as Cory "meathead" Nelson sees it, is not relative to the actual quality of care that his patients experience, but rather to the falsehood described by his gaping disconnect from ASH, as a hospital, and the ASH patients, as follows:
WE CARE BECAUSE WE NEED THE BUSINESS. END OF STORY.
As a matter of practicality, I will pose one question: "What does it mean to care when it comes to health professions?" And it seems reasonable, doesn't it, for any hospital patient to presume that our care givers care because we are human beings; and that they care because they are human beings; and that they care because they are health care professionals, dedicated to working in a field, as such, where caring for the welfare of the patient is founded on universal tenets of compassion, trust, and kindness.
Trust, as I have discussed in the past, is the centerpiece of any successful psychiatric objective specific to the needs of mentally ill patients, and the need for this extends beyond the basic psychiatrist to patient relationship; trust, indeed, that these people care (isn't this something that any reasonable person today expects of their health care providers?); trust that is afforded the patient on the basis of any patients' need to believe that our care provider is competent; trust that has a whole lot to do with caring for a patients' comfort, health, well being, safety, and any other number of like sentiments?
I began paying close attention to Cory Nelson within six weeks of his August, 2011, arrival at ASH. At the time, I directly reported concerns to Cory Nelson about definably criminal misconduct in the form of clinical retaliation that was being imparted on me by the senior psychiatric staff, who had full control over my assigned inpatient treatment and discharge planning team at ASH, retaliation for me having lawfully filed a well founded grievance with the support of the department of health's own Office of Human Rights, (see my previous articles specific to case #2012c-BHS-0338-DHS) and in response to my communications with him about the matter, this is what he told me, in writing:
"Patrick I would encourage you to work with your treatment team to address all aspects of your treatment plan while you are still a resident at the hospital. Since your legal status at the hospital is voluntary you may certainly request discharge from your treatment team if you believe that the treatment that you are receiving is ineffective, unnecessary or otherwise not meeting your needs." (ADHS/ASH letter, Cory Nelson to ------- (PJ Reed), September 30, 2011)
And there it was. The danger posed by a man who did not realize that I, an ASH patient, was, at that time:
A) clinically unstable- as in, still suicidal to some marked degree-
and as such, far from ready for safe discharge from ASH;
B) in no position to request discharge because there are no other
long term public mental health facilities in Arizona besides ASH;
C) not requesting his consideration of matters relating to the
effectiveness (per se'), necessity, or fulfillment of my
needs as a patient.
Specific to the last of these three factors, for about 95% of the time that I was hospitalized at The Arizona State Hospital, I maintained good faith and well intentioned expectations flowing from my recognition of ASH's explicit role in my life at that time; these expectations extended to my understanding of patient rights, health care ethics, and common law and policy; and in terms of the concerns that I had shared with Nelson at the time, my reports related to documented misconduct and misbehavior of ASH staff, violations of law and policy, and abridgments of my rights as a patient, citizen-consumer, and human being. I was not coming to him with any concerns about the ineffectiveness or lack of necessity of my treatment, per se' (although the misconduct that I reported clearly contributes to such concerns, not just in my case, but in terms of the mismanaged care provided to all ASH patients); and my perspective in this context was distinctly stated in the documents that I forwarded to Nelson in relation to this specific matter. My concerns about these issues flowed from my concern not just in the context of my experiences, but in that of my peers, as well, for it was overwhelmingly evident to me that the clinicians and administrators at ASH impart their grossly unlawful misconduct on all 0f the patients at ASH with little if any discretion or reservation. With these issues in mind (not specifically tied into any concerns I had about ineffectiveness, etc.), I fully expected that the supervisor of ASH would have the capacity to realize the full context of my expressed concerns at that time. I communicated with him through well detailed and carefully written correspondence, documents that I of course have full copies of, and even today, I am shocked at how graphically disconnected Cory "crazycorycorner" Nelson is from the basic realities of ASH the facility, and the ASH patients, such as myself.
Even Nelson's reference to my status as voluntary is misguided. There are any number of patients at ASH who agree to accept their hospitalization at ASH on a voluntary basis. At the same time, initial admission to ASH only occurs following a civil or criminal court order for involuntary treatment, but many patients remain at ASH voluntarily if they have been advised by their doctors to remain at ASH beyond the terms of court ordered involuntary treatment while their respective therapy, drug regimen, and general treatment continues. Such was my case at the time. But the fact of the matter is- and as proven by the details surrounding the May, 2011, escape of Jesus Rincon Murietta (wherein, ASH administrators altered the facts underlying the escape in order to avoid accountability, relying on Murietta's status as a voluntary patient in order to justify their patent refusal to release any information about the escape at the time that it happened, thus leading to the brutal slaying of April Mott in late August, 2011; [see "Victim's Family Questions Why Man Was Free", by JJ Hensley, AZ Republic, Sept. 29, 2011])- the administrators and clinicians and ASH, and even assistant attorney general Joel "the mortician" Rudd, arbitrarily manipulate the actual, legal provisions underlying voluntary status at ASH in order to avoid both accountability (in terms of the public trust), as well as in terms of their well established responsibilities and obligations to their patient-customers (as in, specific to my experiences in this context). This is precisely what Nelson was doing when he drafted the Sept. 30, 2011, letter discussed above. (Talking out of his ass, in effect.)
Cory "crazycorycorner.weebly.com" Nelson's words, as quoted above when he responded to my reports of patient abuse and staff misconduct, pretty clearly proves that he interprets The Arizona State Hospital as being something like a motel, and in stating this to me in this manner, I was felt as though my psychological condition at the time was of no concern to him, whatsoever, a statement along the lines of:
"So far as I am concerned, Patrick, if you don't agree with the way we do business here at ASH, then you might as well just head out the door and go kill yourself, or whatever. I don't give a shit about you, or your allegations about abuse. I am the supervisor at ASH, and you are nothing to me."
From what I have thus far seen about this goddamn "State of the Hospital" presentation as it related to quality of patient care concerns at ASH, Nelson's
primary intent was to suppress the truth(s) about clearly substandard conditions
at ASH that even staff have been vocal about reporting to his office (as per comments posted directly to Nelson on his personal web page; see "News Flash", July 20, 2012 and "Hot Off The Goddamn Presses" August 22, 2012), while simultaneously furthering the ongoing out of control situation at ASH. The utilization of the expression "State of the Hospital", being as it clearly is a rip off of the "State of the Nation" presidential addresses that citizens of our country are so well familiar with, is nearly blasphemous in its communicative presentation, because Cory "meathead" Nelson and his cadre of grossly inept executive staff harbor nothing but selfishly grounded sentiments about the state of affairs at ASH in terms of the one's residing there. As such, this rat bastard was not seeking to address anything along the lines of improving or even ensuring patient specific quality of care at ASH. In fact, by posing the question "Why do we care?", Nelson unmistakably acknowledged his own lack of understanding of what it means to be a health care professional. He is so far out in left field (because he has a background not in health care, but in corrections) that I can almost imagine him tossing ideas around his head as he prepared his power point Annual Report document, unable-in essence- to wrap his mind around what it is, in fact, to be a caring person. " 'Why would I care... if I did…..?' No, that clearly won't work. 'Why should I care…..?' Ah, no, not that either, too open ended….'What if I cared….' Darn, this is harder that I thought…. Wait, here it comes… 'Why do I care? Yes!' That's the one! Why do we care?…. 'Because if anyone knows how much we don't care, we will lose business….' Not not quite….", and so on.
It is impossible for me to fully understand how in the hell "Meathead" Nelson pulled this off, presuming that he did (?). Again, I have no way of knowing who all was there, or what the reactions of his audience were. Whatever the case, it is stark ravingly clear to me that this man is operating via the presumption that his staff don't care in the first place (and least not in a way that is good for business) and need to be taught how to care. Taught, as such, by a man trained in facilities management entirely unrelated to heath care facilities, that sales and profit are what matters most, and to hell with the patient experience, in fact. This is doubly upsetting, too, because there are a number of very well intentioned, caring and ethical individuals working at ASH, and for Nelson to get up there in front of such people and ask so ridiculously inane a question as this is preposterous and demeaning. By all appearances with this presentation in mind, the South Dakota wing-nut entrusted with running The Arizona State Hospital has yet again put one of his size 12 suede loafers smack dab into the thick of his awesomely clean teeth.
In my humble opinion at this time, in terms of ensuring a reasonable quality of patient care at The Arizona State Hospital, the supervisor of The Arizona State Hospital (the states' only long term public mental hospital), and his superiors in the Arizona Department of Health, have all the vision of a management team from Panda Express.
In Closing: Cory "meathead" Nelson may be qualified to discuss administrative business matters in an open market context (emphasis: may), but when it comes to a public hospital facility such at ASH, he is clearly out of his realm. His disconnect from the role that The Arizona State Hospital fills, as a critically needed public health care entity which does not operate on a basis of commercial enterprise, the very presence of which represents the inability of our culture and society to meaningfully attend to the needs of the seriously mentally ill persons in our midst (persons such as I, for I am here today), and his obliviousness from the needs of the patients themselves (persons such as I, for I know these things about this rat bastard from first hand experience) dictates something not all unlike professional depravity and base level ineptitude. We, the mentally ill, are not trading our disabilities and needs in the way that other people may be able to. We are struggling our illnesses simply to exist. The only reason anybody is in ASH has to do with serious mental illness, and the only assured way that anybody in ASH today is going to regain their sanity lies in cleaning up the substandard and abusive conduct of ASH staff.
I hope that you, my readers, will take the time to visit the Arizona Department of Health Services on-line resources in your own right, where you will be able, amongst other things, to review the Arizona State Hospital Annual Update 2012, post your comments to ADHS Will Humble's official blog, and generally peruse the propaganda presented therein. I hope that you do this, because I do not want you to rely soloed upon me and my interpretations of these matters. I am well qualified, and the only one in fact, who can directly speak about my experiences while hospitalized at ASH, but things like the 2012 "State of the Hospital" event are ongoing, and the public has the right to play a role in any such activities. At a minimum, we have the express right to be fully apprised about the conditions at ASH, but in my opinion, this is not happening (as evidenced by the document I discussed today). Please, find it in your heart to do your part in helping me address the patient abuse at ASH. ASH is operating at a level of graphically substandard mental-medical care, and they are getting away with it.
paoloreed@gmail.com
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