KentuckyOne under state investigation for critical staff cuts

U of L Hospital   (Photo from WDRB-TV)

The state is investigating whether patient care is unsafe at University of Louisville Hospital because of staff cuts, particularly in nursing, made by KentuckyOne Health.

The Courier-Journal reported June 9 that Dr. J. David Richardson, a prominent surgeon and current president of the American College of Surgeons, said cuts in nursing and other staff had caused a “major patient safety issue” and were “destroying the hospital.”

Richardson said in an email to university officials that Intensive Care Unit patients often cannot be moved to a more appropriate setting because there are “no available beds,” even though there are dozens of empty beds around “but they are simply not staffed,” The C-J's Andrew Wolfson reported. Richardson also said the hospital is poorly staffed at night, requiring patients to be held in the emergency room until 9 or 10 the next morning, when more nurses are available.

Beth Fisher, a spokeswoman for the Cabinet for Health and Family Services, confirmed Friday that its Office of Inspector General has an open investigation of the hospital. The office investigates hospitals in the state for the Centers for Medicare and Medicaid Services, which can terminate a hospital’s federal reimbursements in case of serious offenses.

KentuckyOne spokesman David McArthur said the company is awaiting the inspector general's report and has already assembled a group that will "evaluate and address any specific points and recommendations as soon as they are received," Wolfson reports. McArthur said the company is committed to quality and safety and has been investing “significant resources to continually improve key areas of hospital performance.” He also noted that staff reductions occurred more than two years ago.

Nevertheless, other physicians and hospital officials have confirmed Richardson’s assertions, including Dr. Susan Galandiuk, who told Wolfson that layoffs and cuts have forced the hospital to hire temporary “traveling nurses” unfamiliar with procedures.

“You are in the operating room with nurses who have no idea what equipment you are using or what they are supposed to be doing,” said Galandiuk, a colorectal surgeon who is editor-in-chief of a leading scientific journal in that specialty. “It is sad to see the deterioration.”

McArthur insisted that traveling nurses are trained on equipment and procedures unique to U of L Hospital.

The investigation is the latest problem for the hospital and KentuckyOne Health, whose parent company, Catholic Health Initiatives, lost $125.9 million in the last quarter of 2015 and has run up $9 billion in debt.

The Joint Commission, which accredits U.S. hospitals, found 31 deficient areas at U of L Hospital in January. They include problems with infection prevention and transfusion errors, as well as in broader categories. The hospital was accredited, but with the requirement of a follow-up survey. McArthur told Wolfson that none of the problems were considered serious and all have been addressed and corrected.

The hospital received a “D” grade in April from the Leapfrog Group, an independent organization founded by employers and medical experts. Two of KentuckyOne’s other hospitals in Louisville – Jewish and Sts. Mary & Elizabeth Hospital – got the same marks. The organization, which assigns letter grades to more than 2,500 U.S. hospitals based on medical errors, accidents, injuries and infections, says selecting the right hospital can reduce a patient’s risk of avoidable death by 50 percent.

KentuckyOne partnered with the University of Louisville in 2012. Former Gov. Steve Beshear blocked a full merger partly because of concerns about applying the Roman Catholic Church's Ethical and Religious Directives for Catholic Health Services at a public hospital, Maria Castellucci reported in Modern Healthcare.