The Auditor Put My Old Register Under A New Seal

I did not move the register.

I put the disposal order in a clear sleeve and walked to compliance at seven the next morning. That office was near the old north entrance, where the windows still had handles people could turn.

Eileen Cho opened the door with a mug in her hand.

"I have a record problem," I said.

"Come sit down."

She was forty-one, Korean American, and new enough that I still wore my badge facing out when we spoke. Her patient manner made people talk too much. I had watched her wait through a full minute of silence without looking away.

She read the order twice.

"Where are these records now?"

"In the chamber archive cabinet."

"Who has keys?"

"Me, the archive clerk, and facilities. Facilities keeps its key in a signed-out box."

"Did you take anything home?"

"My demotion notice. No patient or service records."

She nodded and wrote that down.

"Good. We need an unbroken line from where the records belong to whoever examines them. No kitchen tables. No car trunks."

"They're hospital property."

"Yes. And we need to keep them that way."

She asked what the register could show. I told her about the shut valve, the capped supply, the red tag, and strips 4418 and 4419.

"A flat line alone could mean a bad recorder," she said.

"That's why I kept the register too."

For the first time that morning, she smiled.

We went downstairs with an archive clerk named Paul Harker. Eileen brought a camera, a transfer form, and two empty evidence boxes. She called them record boxes until Paul wrote the seal numbers on her form.

"Now they're evidence boxes," she said.

We photographed the cabinet before I opened it. Paul checked my key against the access sheet. Eileen photographed the register's closing seal without breaking it.

Seal 8062. My name crossed the tape in blue ink.

The pressure strips were in sleeves in a separate folder. Eileen counted the sleeves while Paul read their numbers aloud. Neither opened one.

"Do you want me to explain them?" I asked.

"After we record what we received."

She put custody before the story. I began to trust her.

Voss arrived while we were signing the transfer.

"Eileen, a word."

"Certainly. We're preserving records covered by a billing concern."

"Those are old copies."

"The disposal order calls them duplicates. Where are the originals?"

Voss glanced at me.

"The clinical system is the official record."

"It may be the official clinical record," Eileen said. "These are original equipment records. They answer a different question."

"You're letting a maintenance complaint turn into an audit."

"You signed an order to destroy material named in a complaint. I have paused that order."

Voss pressed her lips together.

"You report to this hospital, Ms. Cho."

"I do. My policy also gives the board's audit chair notice when a complaint involves an executive. I've sent that notice."

She said it as gently as she might have told someone the elevator was full.

Voss left without touching the forms.

Paul and Eileen carried the sealed boxes to the compliance archive. I watched Paul sign the receiving line. Then Eileen gave me a copy with patient names covered.

"That proves the transfer," she said. "It doesn't settle the billing question."

"I know."

"And until we check the full list, neither of us knows how many charges are involved."

Monday, I reported to maintenance in a gray shirt with HELPER printed above the pocket. My supervisor, Luis, handed me a cart of ceiling tiles.

"I didn't request this transfer," he said.

"I know that too."

He gave me work I could do and left the jokes to other people. Nobody made many.

On Wednesday, I changed a stained tile above a clinic hall. Beneath me, a woman at the billing window held an itemized statement.

"Two chamber visits," she said. "That's $3,700. I had my foot dressed in a chair."

The clerk lowered her voice. I climbed down and rolled my cart away. I did not ask the woman her name. I wrote the time and place in a note to Eileen.

That afternoon, Eileen called me back to her office.

She had asked billing for every chamber charge from February 3 through March 16. There were 126, spread across nineteen patients. Each was billed at $1,850.

"That's $233,100," she said.

I looked at the calculator between us.

"Did she sign all of them?"

"The records show her approval on each charge. We're verifying the signature history."

A printer behind her began to run.

She collected the page, read it, and set it in front of me.

Cedar Basin Health Plan had received a patient dispute. Its audit unit wanted the original pressure-test strips, the sealed service register, and the complete record of who had held them.