Bad Medicine

Has the St. Louis College of Health Careers failed to deliver on promises of a good education and rewarding jobs?

A young woman can get plenty tired of slinging belly bombers day after day at a White Castle. This was not the life Latisha Tally envisioned after graduating with honors from East St. Louis High School. She had dreams. Dreams of college, dreams of a challenging career in physical therapy -- dreams of a good life.

One night four years ago, after coming home from another long day of sliders and fries, Latisha found herself sitting on the couch, letting the dream play out in her head again. Staring at the TV, she saw a commercial for the St. Louis College of Health Careers. She remembers thinking: This could be my ticket out. Just seven and a half months, and I'll be a medical assistant.

Latisha, now 24, figured the $12-an-hour job would give her valuable experience in healthcare and help her save money for college. She even convinced her older sister, Arlisa, to sign up for the program, which cost nearly $7,000.

Like the vast majority of students attending the St. Louis College of Health Careers, Latisha and Arlisa qualified for federal financial aid, both getting $3,000 in Pell grants and $4,000 in Stafford loans to pay for tuition. Because she had a new baby at home, Arlisa borrowed extra money for living expenses, while Latisha continued grinding out the four-to-midnight shift at White Castle.

"We'd get up at 4:30 to get my sister's baby to the babysitter, and get out of here to beat traffic and get to class," recalls Latisha. "I thought once we graduated, we'd have a good job."

In a classroom submerged in the cold basement of an old Central West End mansion on West Pine Boulevard, the sisters soon realized they'd made a huge mistake. Two months after classes started, they still didn't have books. The classrooms and bathrooms were dirty, the furniture and carpet old and tattered.

Meanwhile, teachers seemed to disappear in droves. In two classes, Latisha and Arlisa didn't have instructors at all. There were times when the Tally sisters sat alongside classmates, all of them huddled in their coats because the furnace didn't work, waiting for a teacher to arrive.

"All that stress -- and all we got out of it was a certificate," Latisha says. "I graduated in 2001, and I still don't have a job in the medical field."

The Tally sisters are not alone in voicing bitter criticism of the vocational-training school, which has one campus on Highway 40 just east of Kingshighway and another in south county on Butler Hill Road.

In the last two years, nearly 1,000 students have paid between $7,000 and $24,000 for programs that supposedly will train them to work as medical assistants, practical nurses, massage therapists, nurses' aides, medical record keepers, pharmacy technicians, ophthalmic medical assistants and echocardiogram technicians.

In interviews with the Riverfront Times, and in documents obtained by the newspaper, more than twenty former students, teachers and administrators -- some of whom asked not to be identified -- offered a scathing indictment of the college.

They cited the alarming rate of teacher turnover, the outdated equipment, the long delays in getting textbooks and supplies. Some students even claimed to have paid thousands of dollars for classes that were cancelled midway through the school year.

There are also allegations that college officials gave answers to prospective pupils on entrance exams and enrolled high school dropouts who couldn't read or write. Former teachers say they were told to pass failing students so the college would not lose federal financial aid.

A number of the allegations surfaced two and three years ago and may not be indicative of the present-day administrative climate at the college. No formal investigations are underway.

Darryl Spencer, a placement director at the college for twelve years, says despite the problems, many students succeeded because instructors genuinely cared about them. "We had some success stories where people got hired and moved on from there," says Spencer.

Nonetheless, many of those interviewed recalled a series of administrative abuses they claim to have taken place at the college. Another stinging accusation alleges that staff members faked grade transcripts, high school diplomas, General Equivalency Diploma (GED) certificates, admission agreements, internship records and physical exams prior to audits by the Missouri Department of Higher Education in 2001 and the Accrediting Bureau of Health Education Schools in 2002.

Several of the alleged falsified forms were entered as evidence in a wrongful-termination lawsuit filed in March 2002 in St. Louis City Circuit Court by Lori Nichols, a former student-services representative at the college. Nichols, who declined interview requests for this story, claimed she was canned for refusing to forge documents.

In an August 2002 deposition, Nichols stated, "Enrollment agreements that could not be located were created, and signatures were forged, and dates were backdated. Any high school diplomas or GED certificates that could not be accounted for, or found in the files, were created as well by cut and paste methods to make it look as though the student had met that eligibility requirement."

A former employee, who asked not to be identified, admits to forging diplomas that were missing from students' files while state auditors were at the college in September 2001. The diplomas were forged, the employee says, because school officials discovered that some students had not actually graduated from high school or passed the GED exam -- a requirement for federal financial-aid recipients.

"I had a blank City of St. Louis high school diploma, and I had checked and found out what kind of font they had used, and I printed out their names onto a piece of paper and then [copied] it onto the diploma," the employee explains.

Scott Tapp, a former anatomy and physiology instructor, says he saw employees create school transcripts for former students when their grades were missing from their files.

"Transcripts from our school were just made up because they couldn't find them," he says. "They'd just give them all A's."

Cindy Ness, director of nursing and allied health at the college from 2000 to 2001, confirms she saw an employee falsifying diplomas and other documents.

"It seemed matter-of-fact, like this needs to be done," Ness explains. "Lori [Nichols] came and told me what was happening, and she and I decided we weren't going to have any part of it."

One of the documents in question is a physical-examination form for Arlisa Tally. Students who interned at medical offices, like Arlisa, were required to visit a doctor for a physical exam, which included a test for tuberculosis and immunization for hepatitis.

The doctor's form, entered as evidence in the Nichols' lawsuit, noted Arlisa's height at five-foot-one and weight at one hundred pounds. No serious medical problems were listed, and the doctor wrote that Arlisa had been tested in 2001 for tuberculosis and immunized for hepatitis. The doctor's name is illegible.

But Arlisa says the exam never took place.

Her actual height is five-foot-three; her weight at the time was eighty-five pounds. She says she was never immunized or tested for tuberculosis before interning at St. Mary's Hospital in East St. Louis, where one of her jobs was drawing blood.

The jagged signature at the bottom of the physical exam looks nothing like Arlisa's right-slanting, bubbly cursive. "I never wrote like that in my life," she says.

Scott Tapp says employees found names of doctors in the phone book and forged their signatures, as well as student signatures on bogus physical exams.

"I observed a campus director forging physicals and instructing admission representatives on how to do it," he says.

Steve Barsam of Kirkwood and Rush Robinson of Maryland Heights founded the St. Louis College of Health Careers in 1981. The men worked together at Maryville University where Robinson was a biology instructor. Barsam managed the science lab.

The college's mission is to train students for healthcare jobs that pay between $8 and $16 an hour. Ninety percent of the students are women. Many of them are trying to escape minimum-wage jobs. Others are welfare moms whose checks will stop if they don't seek job training.

Last year the college collected $3.6 million from tuition, books and fees, up from $2.8 million the previous year, according to financial statements filed with the U.S. Department of Education. The lion's share of that money comes from federal financial aid. In 2001, 97 percent of the students at the nearly all-black St. Louis city campus received federal grants, and 88 percent also received federal loans.

Many former employees claim students aren't getting what they paid for because Barsam and Robinson run the school on the cheap.

"They would drive up in their BMWs, and the students didn't have heat in their classrooms," says a former program director who also spoke on the condition of anonymity.

Described by former employees as "arrogant" and "aloof," Barsam and Robinson are unaffectionately referred to as "the boys" by their numerous detractors.

"Barsam and Robinson wouldn't even speak to students," says Carol Worth, a former medical-billing instructor. "Half the time they wouldn't even speak to [the teachers]."

Lark Riehn, a former business officer at the college, says the owners are being unfairly criticized. "They really did have the students' best interests at heart -- to take people without much of an education and give them a career in the healthcare industry," says Riehn. "It was incredible to see the stories after nine or ten months from students who started with nothing."

Citing "confidentiality" issues, both Robinson and Barsam declined to comment on the allegations.

The college's attorney, Daniel Wilke, last week issued the following statement: "St. Louis College of Health Careers does believe it is delivering its educational promises to students. That is its mission, and it feels that it is living up to that mission, and will strive to maintain the quality of the school experience it provides to its students."

Former instructors, meanwhile, say they constantly filled in for teachers who either quit or were fired. The teacher turnover rate from 2001 to 2002 was an astonishing 76 percent, according to notes by a state employee of the Department of Higher Education who visited the school in 2002.

"Steve [Barsam]'s motto was, 'Change is good,'" says the former program director. "Change in staff is not good. How can you keep a quality staff if they don't provide you with the supplies you need for class?"

Students routinely received their books weeks -- even months -- late. Worth says she taught a medical-billing class where twenty students shared five books. "The class started in September, [and students] didn't get books until mid-November," she says.

Not true, counters Lark Riehn. "I would actually drive out to [the publisher] and get the books," she remembers. "I had a check, and I'd physically put the books into my vehicle."

Several former instructors say the college didn't provide even the most basic supplies, such as chalk. "We'd go across the street to Walgreens and buy paper ourselves to make copies for our tests," says a former teacher.

Also, much of the medical laboratory equipment was old and broken. Says former director of nursing and allied health Cindy Ness: "Getting the equipment you needed was a problem."

Former instructor Tapp recalls trying to teach students how to sterilize medical instruments in a broken autoclave machine.

"The ultrasound machine simply did not work," Tapp says. "The microscopes -- the majority of them did not work. There was no audio-visual equipment except for one TV, and we were in a three-story building without an elevator so it had to be carried up the stairs."

Tapp notes that poorly trained students can eventually endanger patient's lives. "There is a serious risk of false results," he explains. For example, a technician who doesn't know how to use the electrocardiogram (EKG) properly "could lead to the doctor misinterpreting the EKG results and medicating inappropriately."

From Highway 40, the St. Louis College of Health Careers looks impressive. A footbridge across the freeway connects the three-story building to the Barnes-Jewish medical complex in the Central West End.

The college moved last year from its cramped quarters on West Pine to the building at 909 South Taylor Avenue, which Barsam and Robinson bought from the Central Institute for the Deaf for at least $2 million, according to city real-estate records.

Inside, framed occupancy permits and sales-tax certificates hang on the powder-blue walls of the school's lobby. A few metal folding chairs surround a large conference table where a perky admissions representative explains all the college has to offer to a prospective student.

On glossy, full-color brochures are photographs of beautiful women wearing stethoscopes and scrubs as they comfort the sick or look thoughtfully at a patient's chart.

Lynn Mareschal of St. Ann visited the city campus in 2002 to enroll in the echocardiogram-technician program. She was told she first needed to complete a patient-care technician program, which cost $8,000.

"The teachers missed class on a regular basis. I only got half the clinical hours I needed, and the classes were three hours, but they usually only kept us for an hour," she wrote in a September 2002 complaint to the Better Business Bureau. "Now I found out that the [echocardiogram] program has been cancelled."

Thirteen students filed complaints with the Better Business Bureau between August 2001 and June 2004.

Former instructor Carol Worth says college officials enrolled pharmacy-technician students even though the school did not have a pharmacy teacher on staff. When it was time to take pharmacy classes in the second semester, adds Worth, "They would tell them, 'Go ahead and go into the coding and billing class -- and you can always come back and take pharmacy for free.'"

Carol Bennett of Lemay says college recruiters told her she'd be a certified medical coder when she graduated. But in complaints to the Better Business Bureau, Bennett and other students claim coding was never taught during the one-year, ten-thousand-dollar program.

"I can't find a job, and I have a huge loan to pay off," Bennett says. "I feel manipulated, lied to and cheated."

When Bennett visited the south-county campus in 2002, a recruiter told her she would need to take an entrance exam to evaluate her reading, writing and math skills. Bennett conceded she was terrible at math.

"He took the math part of the test for me," she admits. "I knew it was wrong, but I wanted to go to school so bad. I wanted to make a better life for me and my family."

Sandy Kaup, the former director of college admissions, denies that prospective students were given answers. But two former administrators say they found exam booklets with the answers written on them.

"The pre-test was supposed to be in the [student] file," explains an ex-campus director. "I would find the pre-test in the trash with the answers on it. Then I went to their file, and there was the same exact test. That's why I left."

Another former instructor says, "I had a student who couldn't read. How did she get in?" Five other ex-teachers confirm that students in their classes couldn't read or write.

Staff members felt pressured to enlist students because those who failed to meet their enrollment goals were fired. Says a former admissions representative: "It is a sales environment."

Dr. David Goldberg, who taught physiology at the college for five months in 2003, says those charges are simply not true. "I was never pressured to pass anyone."

Recruiters may have been fired for "not working," says Sandy Kaup. But he insists the college never required employees to make quotas -- a practice outlawed by the U.S. Department of Education.

Darryl Spencer, the former director of placement, says he battled for years with the admissions department "because they would bring in people who couldn't succeed in the program. I'd tell them, 'Don't fill their heads with dreams.'"

Cindy Ness went to work at the St. Louis College of Health Careers in 2000, a year after the school reluctantly promised the Missouri Board of Nursing that it would shutter its practical nursing program at both campuses.

For years graduates of the nursing program failed the state nursing exam at staggering rates. In 1998 only 47 percent of graduates managed to pass the test, a requirement to be a nurse in Missouri.

Under Ness' tutelage, 90 percent of nursing graduates in the 2000-2001 class aced the state exam. But Ness says she left in disgust after only one year when a school owner ordered her to pass five nursing students who had failed classes.

"We were told to let them into the second semester," explains Ness. "I wouldn't let them in, and that's when they got really upset with me. They went to [an instructor] and told her to do it."

Another instructor confirms that Barsam and Robinson ordered her to re-test students who had failed classes. "In order to get a passing grade in the class, they had to retake tests," the teacher says. "If they failed a class, they would get kicked out, and [the school] didn't want to lose the money -- the financial aid."

Scott Tapp says that when he asked a supervisor how an illiterate student was supposed to pass his anatomy class, he was told, "Shut up. This is what we do."

The college's own catalog states that students with grade-point averages below 2.0 will be suspended and their financial aid will be terminated. Nursing students must maintain a 3.0 GPA. Schools are required by law to adhere to the academic-progress policies outlined in their catalogs, confirms Dennis Mertes, team leader of the Kansas City region of the U.S. Department of Education. However, Mertes declined to comment on specific allegations pertaining to the St. Louis College of Health Careers.

When graduates of the practical nursing program took the state nursing exam this year, only 65 percent passed. That's a far cry from the 80-percent pass rate required by the state Board of Nursing for a school to maintain accreditation. In 2003 only 73 percent of the school's alumni made the grade, and in 2002 only 66 percent passed.

In December the nursing board will consider whether to revoke the college's accreditation, confirms Lori Scheidt, the board's executive director. But despite its past performance, college officials can still reopen a nursing program, just as they did in 2000, she says.

"It is true that they could close one day and reopen the next, and the board would not have the grounds to deny them unless there is something wrong with their proposal," Scheidt explains.

In the months after Latisha and Arlisa Tally graduated, the sisters returned to the campus, trying to avail themselves of placement services they were promised.

They never found a job, but on one visit, the sisters noticed some big changes at the school. "They were painting rooms and putting in new carpet," Arlisa says.

Before a scheduled visit by the Accrediting Bureau of Health Education Schools (ABHES) in the fall of 2002, both campuses got a facelift, plus thousands of dollars worth of new medical laboratory equipment. The college also borrowed $70,000 to buy new computers, according to Uniform Commercial Code records filed with the Missouri Secretary of State's office.

"We did buy -- right before ABHES came -- a bunch of new equipment: new microscopes, new centrifuges, new incubators," says a school employee.

Despite that, the ABHES visit "was a total disaster," the employee says. "We got a huge report back on all the things that were screwed up."

ABHES is a national organization that gives its seal of approval to more than 200 vocational-health schools that meet its standards. Executive director Carol Moneymaker confirms that her organization placed the school on conditional approval in 2002 but refuses to discuss any details of the on-site visit.

"It's not public information," Moneymaker explains. "The institution would have to approve the release of that information."

But according to one employee, the accreditation team found fault with the school's internship practices, among other things. ABHES requires allied health students to intern at a medical facility such as a doctor's office or a hospital.

Each student's internship file should have included the dates and hours a student worked and a supervisor's signature. But on many of the work logs, the hours were incomplete and there were no signatures, even though the students graduated, the employee says.

"We used a lot of the same clinical sites, so we'd pull a [student] file from the same site where [there was a supervisor's signature]," the employee says. "We had to go back and do a lot of cutting and pasting of signatures."

Former student Lynn Mareschal says that when she and her classmates interned at a nursing home, the instructor told students to lie about their hours. "[The teacher] would tell you to just go home. We'd leave at noon or one o' clock, and we'd sign out and say we left at three," she says. "They wanted it to appear we had done all the clinical hours we were required to do, but we weren't doing them."

Finding internship sites for students was difficult because of the school's reputation, says instructor Worth. Another former employee says that when she tried to set up clinical opportunities for students, employers said, "Your school is nothing more than a diploma pusher."

After nearly a year of scrutiny by ABHES, the organization finally granted accreditation to the college in July 2003. But one former college director says ABHES is letting the school off too easy.

"The accreditors are allowing them to meet the minimum requirements," the administrator says. "They get a slap on the wrist and a write-up. They need to be shut down."

Frustrated by her futile job search and living in public housing with a new baby, an exasperated Latisha Tally sent a letter to the Missouri Department of Higher Education a year ago outlining the school's shortcomings.

Latisha was shocked and angry when a response arrived from the state's proprietary-school certification program. "The department has determined that the school acted in accordance with certification standards and school policy, and no further action is required," wrote Leroy Wade, director of the office that oversees proprietary schools.

The department is supposed to verify that for-profit schools in the state meet minimum educational, safety and financial standards. In the last three years, the office received three other complaints about the St. Louis College of Health Careers.

Wade concedes that the allegations raised by Latisha Tally and others could violate state standards. But with a staff of two people to regulate more than 140 for-profit schools around the state, Wade says, the department's ability to investigate complaints is limited.

"We contact the school and ask for their response, then we review and make a determination about whether a standard has been violated," he explains. "The problem is verifying what actually occurred. Even if we don't like what was done, there's nothing more we can do if we see they have not violated the letter of the requirements."

But Wade concedes, "The kind of questions that are coming up point to the need for [an investigation]."

Latisha and Arlisa Tally couldn't agree more. On a recent afternoon, Latisha -- dressed smartly in a brilliant pink shirt and black slacks -- holds her sleeping son after returning home from another job interview. Arlisa styles a friend's hair and watches a Lifetime movie.

Thumbing through student loan papers, they wonder if they will ever find jobs or be able to repay their college debts, which total $15,000 between them.

"We thought we were going to be working somewhere," says Latisha. "Months went by. Then years went by. Now we're in debt, and we still don't have a job."

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