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Investors were also shaken by the resignations this month of two senior Tenet executives, including the chief financial officer.
And then at a budget meeting with senior Tenet officials, the order came down: Do better next year.
The doctors also received particular attention from senior Tenet executives, particularly Thomas Mackey and Neil Sorrentino, according to former Redding executives, doctors and documents obtained by investigators.
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While participants were in agreement about the importance of hand hygiene as a patient safety issue: if you're not washing your hands, you're flouting a very basic patient safety tenet (Senior Manager, Clinical Services), there were differences in views about whether hand hygiene non-compliance should be defined as a health care error.
Those scandals -- which began to emerge last year -- have resulted in the replacement of much of the company's senior management, including Jeffrey C. Barbakow, Tenet's former chief executive.
But although Dr. Kay provides regular updates by videoconference to Mr. Tenet, a senior United States official said Dr. Kay did not plan to issue any further update to Congress soon.
Carries as baggage: As a senior adviser to Mr. Tenet in 2002, Mr. Brennan was present at the creation of the C.I.A.'s controversial detention and interrogation program, which Mr. Obama has strongly criticized.
(from "The Conundrum of Iran: Strengthening Moderates Without Acquiescing to Belligerence," in The Annals of the American Academy of Political and Social Science, July 2008) Carries as baggage: As a senior adviser to Mr. Tenet in 2002, Mr. Brennan was present at the creation of the C.I.A.'s controversial detention and interrogation program, which Mr. Obama has strongly criticized.
Mr. Tenet and other senior C.I.A. officials did not immediately report Mr. Deutch's possible security lapses to the White House or Congressional oversight committees.
We have been so unable to provide quality of care because we are told 'We have budget constraints, we have budget constraints.' " Tenet said its new senior vice president for clinical quality is Dr. Jennifer Daley, who had senior positions in quality-related functions at Beth Israel Deaconess Medical Center and Massachusetts General Hospital.
"There was no comprehensive estimate of the enemy," the report said, contradicting statements by senior intelligence officials close to Mr. Tenet who have depicted the C.I.A. as being at war against terrorism from the moment that Mr. Tenet issued the memorandum they have portrayed as a watershed event.
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