The scenario is not unheard of.

Internal state complaints obtained by POLITICO through records requests describe RWJUH Hamilton — which was contracted to do worker medical exams, testing and other services across multiple state agencies — as slow-moving on exams for DOH employees to determine whether they were fit to continue working, an issue cited as early as 2019.

In many instances, the records said, RWJUH Hamilton outright ignored the state.

The slow response from the hospital resulted in DOH employees being put on leave much longer than expected — sometimes paid, sometimes not — draining the state of resources and thousands of dollars in salaries, according to the complaints.

The scenarios were the subject of two complaints sent to the Contract Compliance Audit Unit, a department within the Treasury that deals with contract disputes between the state and their vendors. The CCAU determined in Feb. 2020 and March 2023 that RWJUH Hamilton violated the terms of its contract.

The state renewed the contract multiple times after the initial violation. Darryl Isherwood, a spokesperson for the Treasury, said the 2019 complaint filed did not rise “to the level of requesting cancellation of the contract” and the contract was extended to “provide continuity of services to State Agencies.” After the first complaint, RWJUH Hamilton promised corrective action —although state officials later said that changes were “short-lived.”

The exact scope of how many employees were impacted by the delays is unclear; between the two complaints, the DOH detailed five examples of employees kept out of work for months.

“[Office of Employee Relations] staff remains concerned, as they did in 2019, that our continued use of RWJ’s services may jeopardize management’s ability to maintain effective operations,” the 2022 DOH memo said. “Their failure to adhere to the contract and overall lack of communication and responsiveness is unacceptable.”

Sherry Smith, a spokesperson for RWJUH Hamilton, said that factors outside of the hospital’s control contributed to delays, saying that state employees were not responsive throughout the exam process.

RWJBarnabas Health — one of the state’s largest players in health care with twelve acute care hospitals across the state — claimed to conduct 40,000 corporate care visits in 2022 “with much success.” Smith noted that the state extended the contract, which started in 2012, for years past its initial expiration.

“Regrettably, RWJUH Hamilton staff turnover, operational restructuring and employee error did contribute to delays in these two cases following which, corrective actions were taken,” Smith said in a statement.

“However, and more notably, the vast majority of the delays documented in the complaints are the result of the need to obtain medical records or specialist evaluations from providers outside of our control. This process is further frustrated by uncontrollable situations including State employees who fail to provide executed authorizations, fail to attend or complete appointments, or fail to obtain proper clearance by a primary care or specialty physician.”

RWJUH Hamilton no longer holds the state contract which was the subject of the complaints. The contract went out to bid in the start of 2022; according to Isherwood, “existing procurement workloads” and prioritizing the state’s response to Covid-19 were factors that could impact how fast a contract goes out to bid.

Smith said the hospital chose not to pursue the new contract “due to operational restructuring.” As of April 1, Penn Medicine Princeton Health is the new vendor for the state.

While the CCAU found RWJUH Hamilton violated the terms of its contract, it does not have the statutory authority to dole out financial penalties, according to Isherwood. The CCAU’s findings may lead to a vendor being passed up for future state business, although it is not mandated, according to Treasury spokesperson Melinda Caliendo.

Isherwood said that steps to take legal action against RWJUH Hamilton for contract violations would typically be initiated through the DOH, since that was the agency interacting with the hospital. Isherwood said the state has not moved to suspend or debar RWJUH Hamilton from future contracts — another option the state can take for vendors who show “failure” to perform, according to state regulations.

Nancy Kearney, a spokesperson for the DOH, declined to comment on what steps, if any, the department has taken to bring penalties against RWJUH Hamilton.

‘Continued to be ignored’

DOH officials filed a CCAU complaint against RWJUH Hamilton in November 2019, alleging that the hospital wasn’t being timely in conducting exams to determine whether employees were fit to continue working. According to DOH spokesperson Dalya Ewais, employees go through such an exam in instances including but not limited to “performance concerns and workers’ compensation cases.”

In the 2019 complaint, the DOH used as an example of employee LW, who was verbally cleared by RWJUH Hamilton to return to work on April 30, 2019. However, the hospital didn’t send paperwork to the state verifying the verbal return to work approval, leaving LW on unpaid leave for over a month until RWJUH Hamilton sent confirming documentation. During that time LW still had to pay for health insurance despite having no income, according to the complaint.

Issues for LW persisted after they returned to work. The DOH wrote that LW was showing “concerning behaviors in the workplace” and was put on paid leave June 25, 2019, pending the results of a psychological exam.

But as of the complaint’s filing on Nov. 7, 2019, LW remained on paid leave and RWJUH Hamilton did not complete an exam. Multiple inquiries into LW’s status and reminders to the hospital that LW was on paid leave went unanswered, according to the complaint.

In a response to the state, a representative for RWJUH Hamilton wrote that the delays were due to only having one neuropsychiatrist who was “very part-time” and trying to retire. The hospital also said a new electronic medical records system contributed to delays. The RWJUH Hamilton representative acknowledged that there was “no excuse” for the five week delay between LW’s verbal approval and written notice allowing return to work.

RWJUH Hamilton’s letter said that changes were underway to ameliorate delays — but the promises were “short-lived,” according to state officials. The DOH filed another complaint against RWJUH Hamilton in fall of 2022.

“[T]hese complaints are similar to those filed back in 2019,” a DOH staffer wrote in a November 2022 email. “Those same issues were not disputed either. At that time, RWJ acknowledged the department’s concerns however, their increase in communication was short-lived. As the same issues continue three years later, I am not hopeful there would be any long-lasting improvements.”

A DOH memo attached to the complaint had three examples of anonymous employees put on paid leave pending the results of fitness for duty exams that dragged on for months.

S.A. was put on paid leave in February 2022 pending the outcome of their exam, although they were still on leave as of the letter’s writing in Sept. 2022, according to the memo. It listed at least six instances where RWJUH Hamilton did not respond to the state’s inquiries, which ranged from scheduling an appointment, questioning whether S.A. could return to work with accommodations or if S.A. was even showing up to appointments.

S.A. received $17,000 in salary despite not working, according to the memo.

Another employee, R.F, was put on paid leave in May 2022 but was still on leave as of the memo’s writing. RWJUH Hamilton did not respond to at least seven of the state’s inquiries, according to the memo. R.F. still received $18,000 in salary despite not working.

In the case of J.M. — the employee put on paid leave over a year at a cost of approximately $80,000 — the state counted at least 10 times their inquiries to RWJUH Hamilton went unanswered.

“I do not think the amount of money the [DOH] has been forced to incur due to RWJ’s failure to adhere to the contract should be overlooked,” the DOH staffer wrote in the November email. “While the cost of services may be less than others have quoted, it has cost the department significantly more by retaining their services. ... Our multiple written inquiries regarding other employees continued to be ignored.”

RWJ analysis acknowledged errors

According to Isherwood, the Treasury spokesperson, the DOH spent approximately $228,600 over the approximately 10-year period that RWJUH Hamilton held the contract, out of $1,130,026 spent across all state agencies to RWJUH Hamilton for exams and testing.

Kearney, the DOH spokesperson, declined to comment on how many DOH workers have been put on leave or how many fitness for duty exams the DOH requests.

RWJUH Hamiltonresponded to the second complaint several days past the deadline Treasury set to respond, according to email correspondence. The hospital created a “root cause analysis” document; a letter from the CCAU, dated March 21 2023, said RWJUH Hamilton’s response “basically acknowledge[s] the delays and lack of communication.”

The CCAU concluded that the examples from the DOH “demonstrate that the vendor has failed to provide timely and adequate services as required, despite its attempts to remedy the underlying issues.”

In a letter provided to POLITICO from RWJBarnabas that was sent to the DOH, as of March 21, 2023, two workers cited in the complaint were not cleared to return to work; J.M. needed clearance from a specialist and their primary care provider and S.A. walked out of a physical in April, according to the letter.

R.F. was cleared to return to work in mid-October, according to the RWJUH Hamilton letter. While DOH staffers did not reference that employee directly, an email from a DOH staffer said that RWJUH Hamilton provided a return to work date for an employee referenced in the complaint that already passed, meaning that the DOH “continued to pay the employee’s salary beyond the date it should have.”