Tuesday, November 24, 2015

Former St. Thomas CEO Got Top Salary


By Walter F. Roche Jr.

The former CEO at Nashville's Saint Thomas health care companies drew the largest salary for the second year in a row, according to tax returns for the organizations.
The tax return, known as a 990, showed Michael Schatzlein, drew salary, bonuses and other benefits totaling just under $2 million. He also drew a supplemental retirement payment valued at $179,379.
Schatzlein moved on to an executive post at Saint Thomas' parent company, Ascension Health, in July of last year.
Schatzlein's successor, Karen Springer, drew pay and benefits totaling $588,581 in the year before her promotion.
In the prior fiscal year Schatzlein earned salary, benefits and bonuses totaling just over $2 million.
The tax return covers the fiscal year ending June 30, 2014.
Other top earners at Saint Thomas include physicians James Baker 2nd, Joseph Boyd and Vafa Mansouri, all of whom collected salaries and benefits for more than $1 million.
Former executive vice president Wesley Littrell was paid $570,266, including a $480,256 severance payment. He also got $71,292 in supplemental retirement payments.
Former executive vice president Alan Strauss collected $745,241 in salary and benefits plus $8,236 in supplemental retirement.
Others topping $1 million in salary and benefits, according to the return, were physicians Mark Koenig and Stephen Fahrig.
The returns show revenue for the fiscal year dropped from $462.3 million to $434 million at Saint Thomas West and from $421.2 million to $407.8 million at Saint Thomas Midtown.
Revenues at Saint Thomas Rutherford were $249 million, down from $252  million the year before.

Thursday, November 19, 2015

Appeal Filed in Vanderbilt Malpractice Case


By Walter F. Roche Jr.

A notice of appeal has been filed in the case of an accident victim who had charged that he was prematurely discharged from the Vanderbilt University Medical Center and lost his leg as a result.
The notice was filed in behalf of Patrick Miller, a Robertson County resident who was severely injured in a 2010 motorcycle accident and airlifted to Vanderbilt for treatment.
Circuit Court Judge Thomas Brothers recently issued a directed verdict in favor of Vanderbilt on all Miller's claims including medical malpractice and punitive damages.
Miller's lawyers said in the notice that they also were appealing Brother's decision to bar them from presenting evidence that Miller was prematurely discharged "because of his lack of health insurance."
Miller, then 33, underwent multiple surgeries between Oct. 22 and Nov. 5, 2010 when he was discharged to his home.
Two days later he returned and was found to have a massive infection leading to the amputation of his right leg, according to court records.
The directed verdict came after Vanderbilt's attorneys asked for dismissal on the grounds that the complaint did not properly identify the treating physician.
Court records show multiple physicians were involved in Miller's care.
Vanderbilt, in its filings, said those physicians "complied with the applicable standard of care."
"His (Miller's) injuries were severe and nothing the Vanderbilt surgeons did or failed to do caused the injury to Patrick Miller that otherwise would not have occurred," the hospital attorneys stated.
Miller's lawyers argued that Vanderbilt should have delayed the discharge due to a rising white blood cell count. They also charged that plans to discharge Miller to another health facility rather than to his home were abandoned once they learned he had no insurance.
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Wednesday, July 29, 2015

St Christophers's Cited By State For Excessive ER Delays


By Walter F. Roche Jr.

Pennsylvania Health Department inspectors have cited Philadelphia's Saint Christopher's Hospital for Children for excessive delays in providing care to patients who came for emergency care.
In a report recently made public, the state found that one patient who showed up at 9:29 p.m. wasn't seen by a doctor until 1:16 a.m. the following day.
In fact the inspectors found that there were excessive delays for emergency room patients to get basic triage.
In the report dated June 6, the inspectors stated "it was determined that the facility failed to ensure prompt examination for 5 of 10 patients presenting at the emergency room for treatment.
Cited by the state was a requirement that hospitals with emergency departments "shall provide prompt examination or treatment, or both, to all persons who come or are brought into the hospital in need of such treatment, irrespective of ability to pay.
 "Such treatment shall be of the highest type consistent with the facilities available and with the standards established in the medical community of which the hospital is a part," the report adds.
Patients, inspectors found, waited from 40 minutes to an hour and 11 minutes before getting initial triage.
Some patients, they found, apparently gave up and left.
The waits to get actual treatment and be reassessed were even longer, with seven of 10 emergency room patients facing extensive delays. Those included the patient who didn't see a physician until 1:16 a.m. the next day.
 Officials of the hospital filed a plan of correction with the state in which it promised to take several steps to speed up the process. The plan includes increased monitoring of any backups and the assignment of additional nurses when needed.
Saint Christopher's spokeswoman Kelsey Jacobsen said the corrective action plan has been accepted by the state and "includes the methods by which the hospital will be measuring the effectiveness of our corrective actions."
 She said state inspectors have not yet shown up for a followup visit to the facility, which is part of the Tenet Healthcare Corp..
 The corrective action plan includes increased monitoring of any ER backups and the assignment of additional nurses when needed.
"If any patients are found to be waiting more than 10 minutes for a registered nurse assessment, an additional nurse (RN) with triage training will be deployed to the waiting area to perform an assessment of those patients and assign a preliminary acuity (ESI) level," the plan states.
Also included are new procedures to improve "patient flow."
The hospital promised to conduct audits of records to ensure that the problems were not repeated.
The inspection was based on a review of record of patients who showed up at the hospital's emergency room on the evening of May 2.
The report was completed on June 5, but, by standard department policy, was not released to the public until 41 days later.

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Tuesday, July 28, 2015

Nashville Patients Had Records Exposed


By Walter F. Roche Jr.

Two unnamed dental patients from the Nashville area inadvertently had personal health information posted on the web site of a Minnesota testing company for some 18 months.
In a legal notice published last week in a Nashville based newspaper, OralDNA Labs/Access Genetics disclosed that the names of the two patients, the names of their dentists and the tests performed were posted on the internet.
Curt Tokach, chief financial officer for the company, said that the patient data was posted inadvertently in a screen shot on a Frequently Asked Questions page on the company web site.
He said the legal notice was published because the company no longer had current contact information for the two patients.
He stressed that no test results or other personal data, such as social security numbers, were disclosed.
"Upon discovery of the breach," the legal notice states, "we immediately removed the PHI (protected health information) to protect the patients from any further unauthorized access."
According to the notice the two patients underwent periodontal  testing between Jan. 1, 2013 and Jan. 15, 2013.
The data was "available for viewing" on the company website from Nov. 15, 2013 to May 26, 2015 when it was discovered.
Calling the incident unfortunate, Tokach stressed that only the two patients' data was disclosed.
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Tuesday, June 30, 2015

Lebanon Home Cited For Causing Actual Harm


By Walter F. Roche Jr.


A Lebanon, Tenn. nursing home has been cited by state inspectors for causing actual harm to several patients due to the improper care of pressure sores.
In a 50-page report posted recently on the Tennessee Health Department website, the Lebanon Health and Rehabilitation Center was also cited for failing to administer drugs prescribed by a physician and for failing to update care plans for some patients.
Daniel Richmond, acting administrator at the 60-bed facility said that subsequent to the inspection on March 31, the nursing home developed and implemented a corrective action plan.
He said state inspectors later revisited the home and approved the plan of correction.
According to the inspection report a female patient who already had pressure sores had them worsen while she was a patient. That same patient, inspectors found, did not receive her prescribed medications on four days in August and September of 2014.
Two other patients, according to the report, got pressure sores after they had been admitted and "suffered actual harm" as a result.
Yet another patient did not get needed treatment for pressure sores which worsened as a result.
The nursing home, which is located at 731 Castle Heights Court in Lebanon has an overall rating of 2 out of five stars under the federal Medicare rating system, nursing home compare. A "2" rating is classified as "below average."
In the individual category of quality of care, the home got a 1 star rating, which is listed as "much below average.
The home is part of the Sava SeniorCare nursing home chain.
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Wednesday, June 24, 2015

Drug Giant Charged With Illegally Blocking Generic Cancer Drug

By Walter F. Roche Jr.


Two labor affiliated organizations have filed suit in U.S. District Court in Boston, Mass. charging Novartis Pharmaceuticals with illegally blocking the entry of  a cheaper generic cancer drug in order to increase its revenues by hundreds of millions of dollars.
In the 89-page complaint filed this week, the United Food and Commercial Workers Union Midwest Health Benefits Fund charges that Novartis "illegally extracted an additional seven months of exclusivity from generic maker Sun Pharma."
According to the complaint, Novartis' patent on Gleevec is due to expire on July 4, but under a settlement agreement between the two firms, the exclusivity will extend to February of next year.
The suit states that Gleevec "radically improves the lives of patients suffering from chronic myeloid leukemia."
But the monthly cost for a patient is $9,000 and the drug has generated $13.5 billion in revenues in the United States alone.
Novartis officials called the claims unsubstantiated and promised a vigorous defense against the suit.
"The patents covering Gleevec remain legally in force and are covered by a statutory presumption of validity. The patents are clearly directed to our marketed product and are properly listed in the FDA’s Orange Book and the settlement with Sun is a lawful settlement agreement resolving the declaratory judgement action filed by Sun challenging the validity of one of the Gleevec patents," the company said in a statement.
Filed for the food workers and the Laborers Health and Welfare Trust Fund for Northern California, the class action suit charges that Novartis first made  illegal add-on amendments to its existing filings for Gleevec with the U.S. Food and Drug administration and then used that filing to sue Sun Pharma charging it with infringing on its patent.
The suit was settled in May of last year with the agreement that Sun Pharma would delay its introduction of the generic form of the cancer drug until February 2016.
"But for the anticompetitive, illegal and ongoing conduct alleged in this complaint, plaintiff and members of the class would begin paying less for their imatinib mesylate as of July 5," the suit states, adding that the resulting overcharges could potentially total hundreds of millions of dollars."
Filing the suit were Massachusetts attorneys Thomas Sobol and Kristen Johnson.
They are asking the court to invalidate the May 14 settlement between Novartis and Sun Pharma.

Friday, June 12, 2015

Nursing Home Residents Reeked of Urine, Inspection States

By Walter F. Roche Jr.


Residents at a Nashville nursing home were left lying in urine soaked clothing due to understaffing and multiple other problems at the 124 bed facility, according to a blistering 55-page report.
Seven instances of abuse and neglect were reported between April 1 and Mid-May, state officials reported.
The inspection report, based on a May 19 to May 22 visit to the Donelson Place Care and Rehabilitation Center, comes as federal officials have served notice that the home's participation in the Medicare and Medicaid programs will be terminated effective at the end of this month.
The report by state Health Department inspection staffers also cites multiple violations of rules governing patient discharges.
In one case a resident was improperly discharged following allegations that he sexually assaulted another resident.
Charges of rape, the report states, proved unfounded.
The inspection came following the issuance of a notice on May 12 by the U.S. Centers for Medicare and Medicaid services that the Donelson Place's participation in the two federal programs would be terminated effective July. The notice was published in a Nashville newspaper.
Earlier this week state Health Commissioner John Dreyhzehner announced that on June 4 he had imposed a freeze on new admissions to the nursing home.
The state inspectors found that needed incontinence care was not provided to five residents. They also found that one resident was placed in an environment that was "detrimental to his or her safety and welfare."
According to the report, there were multiple reports of patients being found with their bedding and clothing saturated with urine and feces. As the inspectors noted, new cases of neglect and abuse occurred even as the facility was supposed to be implementing a corrective action plan for the same violations in the past.
The new violations were reported by other staff members and relatives of the patients.
When one patient was lifted from the bed, urine dripped from the patient's pants, the report states. A visitor reported that her mother was "extremely saturated with urine."
Another relative complained that a patient "reeked of urine two days in a row."
In another case cited, a patient "yelled all night" seeking assistance.
Some staffers were terminated or suspended, the report states, as a result of the neglect.
The inspectors also found that the number of staffers was insufficient
Several cases were cited in which patients were discharged without being informed of their rights. One patient ended up in a motel with no provision for providing needed care.
Another involved a patient who had been accused of kissing another patient, who eventually charged that she was nearly raped.
The alleged offender was forced to leave the facility, but the inspectors found that it was not done properly.
Donelson Place is owned by the Kentucky based Signature Healthcare corporation.
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Wednesday, June 10, 2015

Admissions Frozen At Nashville Nursing Home, Closing Likely

By Walter F. Roche Jr.


New admissions have been barred at a 124-bed Nashville nursing home, with a long history of citations for violations of state and federal requirements and a closing may be imminent.
The freeze, which went into effect June 4, was made public today by state Health Commissioner John Dreyzehner. A $3,001 fine was also imposed on the Donelson Place Care and Rehabilitation Center which is owned by Signature Healthcare, a Kentucky based nursing home chain.
Though the announcement contained no details on the reasons for the action, state health inspection records show numerous citations over the past year with the latest available issued in March.
Although the announcement made no mention of patient transfers, some residents at the nursing home have been told they must find a new residence within 30 days. The 30 day notice is a signal that federal funding is about to be cutoff forcing a closure.
In the March report inspectors cited the home for subjecting a patient to verbal abuse.
Inspectors also found that a patient who needed toileting assistance was told by an aide that she only could respond to emergencies.
"I'm very busy right now. We only take emergencies," the patient was told.
Federal records show that the U.S. Centers for Medicare and Medicaid Services issued a termination notice to Donnelson Place late last year. The notice was rescinded, however, early this year.
The state also announced it was appointing a special monitor to oversee operations of the care home.

Thursday, April 9, 2015

Philadelphia Psychiatric Hospital Cited in Patient Suicide

By Walter F. Roche Jr.


A West Philadelphia psychiatric facility has been cited in a federal investigation for failing to properly monitor a patient who was able to commit suicide while under inpatient care.
In a seven-page report just issued by the state Health Department, investigators found that despite a recent history of attempted suicide the patient was able to drown himself in a pail of water while taking a shower.
Cited for failure to comply with federal requirements was the 245 bed Kirkbride Center in University City.
According to the report, the unnamed patient was supposed to be under constant monitoring with much of the time being confined to a lobby, where his or her actions could be observed.
Inspectors found from examining hospital records that the care plan was not properly implemented despite the fact that the patient had attempted suicide just two days earlier on Jan. 18.
"There was no documented evidence that appropriate and adequate interventions were developed and implemented to address this patient's risk for suicide," the report states.
The report states that the patient had asked for shampoo to take a shower at 4:30 p.m. on Jan. 20.
At 4:45 p.m. he was found "with head in trash can full of water. Limbs limp."
Attempts at resuscitation were unsuccessful.
The surveyors found that despite an order for the patient to be confined to the lounge area, that order was not implemented.
While state inspectors were at the facility in early February, they found that yet another patient who was supposed to be confined to the lounge area was alone in a bedroom "without staff supervision."
Yet another patient was kept in the lounge area overnight and had to sleep on a chair or couch.
The facility also was cited for having items in a patient's room that could have been used to commit suicide.
Officials of Kirkbride subsequently filed a plan of correction including a new "plain sight"policy under which high risk suicidal patients will be kept under observation in a lounge area during the day but will be allowed to return to their bedrooms at night with a staff member observing the patient from the doorway.
"We are creating colored risk bands for those individuals who are placed on Plain Sight or One to One observation in order to increase staff awareness of those patients on the unit  who are deemed at high risk of self harm," the corrective action plan states.
Victoria Johnson, an attorney for the Kirkbride Center, said that due to federal privacy laws, center officials could not comment on the care provided to any patients.

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Tuesday, January 6, 2015

TN Facility for Disabled to Close

By Walter F. Roche Jr

A state run facility for those with developmental and intellectual disabilities will close its doors next year under a plan to be submitted for federal court approval later this month.
The plan, which would move some 96 residents to other facilities, would permanently close the Greene Valley Developmental Center in Greeneville, one of the last such facilities in the state.
 Cara Kumari, spokeswoman for the state Department of Intellectual and Developmental Disabilities said that the closure plans had been worked out in lengthy negotiations with the plaintiffs in a federal lawsuit dating back more than a decade.
She said that the current residents will have the option of moving to newer and smaller facilities or to receive care in their family homes. The proposed closure date is June 30, 2016.
She said that transition plans for individual residents will be reviewed by a quality monitoring panel and the residents will continue to be monitored after relocation.
She stressed that the plan will not become binding unless it is approved by a federal judge.
"The goal is always to ensure people are being transitioned in the safest manner possible," Kumari wrote in an email response to questions, adding that the monitoring program will "ensure that people's needs are being met within their new homes.
Some 600 employees at the facility will lose their jobs. Kumari said efforts will be made to find other employment for those being displaced.
The state is also moving to close the Clover Bottom Developmental Center in Nashville.
Kumari said that if the plan is approved the only remaining such facility will be the 12 bed Harold Jordan Center in Nashville.
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