IV. The Confluence Effect
These 3 prongs of the Goodbye Columbia campaign fork were fine-tined to produce a resonance designated as the "confluence effect".
" Each piece added to the pressure of the others. The press coverage of
the violations of Whitehall, for example, put enormous pressure on Public
Health. It raised questions about why Columbia had ever been given a license in
the first place. So...the Department of Public Health would generate still more
pressure on Columbia. There really was a confluence of factors."
( Fedosiuk & Pastreich, op. cit.)
The outcome seems to have been decided as early as September of 1986, when the Cape Cod Times began publishing the excellent set of survey articles by Wendy Williams, These are a paradigm of good investigative journalism. Not only did she draw up the tally sheet of Columbia's dreadful performance in Massachusetts and other places around the country, she also contacted financial analysts, economists, officials involved in the monitoring of nursing homes ( such as Sheldon Goldberg, the director of the American Association of Homes for the Aging, and Jerry Aron of the Division of Aging of the Harvard Medical School), to paint a global picture of the take-over of the nursing home population of America, ( never at any time in the best of hands), by giant chains such as Beverly Enterprises, Columbia and others, and the consequent degradation of elderly care and the environment in which it is carried out.
These articles combined:
( 1) Anecdotes about neglected patients, lying for hours on urine -soaked
sheets, hanging out of beds, breaking limbs, being swaddled in garbage bags, ,
etc.
(2) Facts and figures on staff reductions, untrained staff and equipment failures.
(3) Columbia's terrible record in other states around the country
(4) Statistics on expenditures for food, equipment, personnel, etc., in Columbia';s facilities.
( 5) An overview of the growth of the corporate elderly warehousing industry since the mid 70's
(6) The dramatic rise of the fortunes of George P. Van through the 80's.
(7) The fish anecdote,
Retold to virtual death in every feature article
about Columbia, yet inexhaustibly plunderable, it appears that George Van
kept a wood-carving on his desk, a rendition in teak of the food chain, with a
giant fish swallowing a medium fish swallowing a small fish swallowing a
minnow. Evidence exists to show that this was, perhaps still is, his business
philosophy. It is somewhat gratifying for me to find that in fact it doesn't
work.
Yet George P. Van, still believing that all that mattered in a crisis was that one put up, or seemed to put up, a tough fight, managed to hold off the union, the relatives, the community, and even the Department of Public Health, for fully another year, before selling out to the Cape Cod Hospital in September of 1987.
I find this rather astonishing, since the DPH denied permanent licenses to Columbia in January. In their ruling against Columbia, one finds statements such as these: " Department surveys... find that since Columbia assumed control of these...facilities.. [they].. have provided substandard care to their residents."
Despite this unequivocal description of their situation, these residents were subject to another 9 months of substandard care. One is reminded once again, of the eloquent phrase of William Butler Yeats, so appropriate to this America of ours :