Showing posts with label patients. Show all posts
Showing posts with label patients. Show all posts

Friday, September 30, 2022

Two Kentucky hospitals, in Lexington and Prestonsburg, each lose $2.4 million in very different lawsuits over 'patient dumping'

Baptist Health Lexington (Photo for The Courier Journal by Jack Weaver)
Highlands ARH Medical Center, Prestonsburg
Two Kentucky hospitals have recently lost lawsuits that charged them with “patient dumping,” generally defined as discharging patients who are uninsured or unable to pay – or refusing to admit them in the first place, reports Andrew Wolfson of the Louisville Courier Journal.

The judgments were virtually the same, but the cases were very different.

On Aug. 31, a Floyd County jury awarded $2.4 million to Ashley Shepherd, "who claimed Highlands ARH Medical Center retaliated against her after she refused to go along with an alleged scheme to boot out suicidal, psychotic and homicidal patents when their insurance coverage expired, usually after three days," Wolfson reports. "Shepherd, a behavioral therapist, said she was directed by supervisors at the hospital in Prestonsburg to persuade patients they were no longer psychotic, suicidal or homicidal so they could be discharged when they could no longer pay or their insurance coverage ran out."

Shepherd, a 36-year-old single mother, testified in a deposition, “I was told this is not a hotel.” ARH denied the charges, but the jury said it should pay $2 million in punitive damages.

On Sept. 13, a federal jury in Louisville "awarded $2,395,000 to tow-truck operator William “Tully” Williams, 65, whom Baptist Hospital Lexington turned away when he was transported there by EMS suffering from a dangerous type of heart attack" on Final Four weekend in April 2015, Wolfson reports. "The hospital said it had to 'divert' heart-attack patients because it didn’t have any cardiothoracic surgeons on call. . . . He had to be loaded back into an ambulance and taken to another hospital down the road. . . . His lawyer, Hans Poppe, said the hospital committed a 'reckless comedy of errors,' including failing to advise local ambulance services of its plans."

Williams sued Baptist Health after the federal government found that the hospital violated the Emergency Medical Treatment and Labor Act by failing to screen and stabilize Williams before sending him to the University of Kentucky hospital a mile away, Wolfson reports. The law allows fines of up to $100,000, or lets patients sue for more.

Baptist Health attorneys argued that the delay was "only a few minutes, but its own medical expert conceded it didn’t meet the standard of care," Wolfson reports. The jury's verdict included $1.85 million in punitive damages, which are designed to discourage similar conduct by the defendant and others. The case was tried by District Judge Claria Horn Boom.

Shepherd's attorney, Jerry Patton of Prestonsburg, told Wolfson that his client's award “sends a message to health-care providers who bear tremendous responsibility for the treatment and care of psychiatric patients that the law must be followed, and above all patient safety and care is paramount to any and all other considerations, including profit.”

Appalachian Regional Healthcare's chief legal officer, Cristi R. Lee, gave Wolfson a statement: “Patient care is always the top priority in all ARH locations, regardless of that patient's ability to pay. Additionally, processes are in place to encourage all staff to make their voices heard should they want to suggest opportunities for improvement or have any concerns while working in our facilities.”

"She noted the case, tried before Judge Thomas Smith, involved one claim related solely to Shepherd’s employment and there were no claims of medical negligence," Wolfson reports. "She said ARH was disappointed with how the law was applied and has asked Smith to overturn the verdict."

In the other case, Baptist Health spokeswoman Kit Fullenlove Barry told Wolfson that the diversion of Williams said was a “rare and unusual occurrence. . . . While we are surprised and disappointed with the verdict, we are pleased that Mr. Williams received the care he needed and is doing well.” Baptist "said it later hired a consultant to train employees how to comply with the law," Wolfson reports.

Friday, August 26, 2022

Lexington nurse accused of killing patient worked at 2 hospitals

A Lexington nurse who was indicted Monday on charges of murdering a patient at Baptist Health Lexington had worked at the University of Kentucky's main hospital until the charge was filed, the Lexington Herald-Leader reports.

Eyvette Hunter (Fayette County Detention Center photo)
"Eyvette Hunter, 52, was charged with murder for allegedly committing intentional medical maltreatment, causing a 97-year-old patient’s death on May 5," Christopher Leach reports. "The patient, James Morris, died as 'a direct result' of Hunter’s actions on April 30, Lexington police said in a news release Tuesday. Hunter was arrested on Tuesday and is being held at the Fayette County Detention Center on a $100,000 bond, according to jail records."

UK spokesman Jay Blanton confirmed to Leach that Hunter was also working at the Albert B. Chandler Hospital as a traveling nurse, placed by an outside agency, from November 2021 to the date of her arrest. Blanton said she was immediately released from her duties after UK HealthCare learned of her suspension by the Kentucky Board of Nursing and the indictment Tuesday. 

Those records show that Hunter previously held nursing licenses in other states, but did not face discipline from boards in those states, Leach reports. Blanton and a Baptist Health spokesperson told Leach that Hunter had no maltreatment incidents before the one alleged. She was licensed as a registered nurse in Kentucky in 2018 and as a licensed practical nurse in 2007, state records say.

According to Hunter's suspension order, Morris, who was admitted to the hospital "after a slip and fall injury," was aggressive and agitated while in the hospital, Leach reports. Hunter requested medication to calm him down on April 30, which was denied. Hunter then allegedly withdrew a vial of lorazepam meant for another patient and appeared in Morris's room several minutes later with a syringe and "proceeded to administer something intravenously," the order says. 

Lorazepam is in a group of drugs called benzodiazepines, used to treat anxiety.

The Board of Nursing order suspending Hunter said another hospital employee saw what happened, asked Hunter what she gave Morris, and Hunter answered "something special." The order said his oxygen saturation equipment had been turned off and he aspirated food or medicine, developed pneumonia and was admitted May 3 to hospice care , where he died two days later. 

Leach reports the order says Hunter later admitted that she had given Ativan, the brand name for lorazepam, to Morris without an order "as well as subsequently feeding him."

Wednesday, May 11, 2022

Most Kentucky hospitals in national safety ratings got Cs again; state's percentage of A grades is 35th in nation, down from 30th

By Melissa Patrick
Kentucky Health News

A nonprofit group that gives letter grades twice a year to hospitals for patient safety has again given grades of C to most Kentucky hospitals on its list. 

The Leapfrog Group, based in Washington, D.C., rated nearly 3,000 general acute-care hospitals. Most of Kentucky's 126 hospitals were not rated. 

The group does not grade small hospitals with "critical access" status because they don't have to report quality measures to the federal government; nor does it grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data.

Lepfrog gave A ratings to 11 Kentucky hospitals, 20% of the 55 it graded; Kentucky ranked 35th among states in A grades, down from 30th in the last report. It gave Bs to 14 Kentucky hospitals, Cs to 25 and Ds to five. 

The grades are based on more than 30 measures that indicate how well hospitals protect patients from preventable errors, injuries, accidents and infections. A Leapfrog news release says the latest grades reflect the impact of the pandemic on patient safety, with several measures showing a significant decline. The latest Hospital Safety Grades are published alongside a new report titled, "Patient Experience During the Pandemic: Adult Inpatient Care." 

The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation, Leapfrog says.

The Leapfrog site offers details on a number of  measures, under headings titled Infections, Problems with Surgery, Practices to Prevent Errors, Safety Problems, and Doctors, Nurses and Hospital Staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.
Screenshot of Leapfrog page for St. Claire Regional Medical Center in Morehead, which fell to a
D rating in the latest six-month report after getting seven Cs in a row. To enlarge an image, click on it. 
High Scores

Hospitals getting As were: Baptist Health in Corbin, Lexington and Richmond; Deaconess Henderson Hospital; Tompkinsville's Monroe County Medical Center; Louisville's Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital, and Norton Women's & Children's Hospital; Mercy Health Lourdes in Paducah; and St. Elizabeth Healthcare-Ft. Thomas

Of these, Baptist Health Corbin, Mercy Health Lourdes and St. Elizabeth moved up from a B rating in the last report. The rest maintained their A grade. 

This is the sixth straight grading period that all four Norton Healthcare adult-service hospitals in Louisville have received an A. 

Shifts up and down

After receiving Cs and one D since spring 2016, Ephraim McDowell Regional Medical Center in Danville rose to a B on the latest report. 

The Albert B. Chandler Hospital at the University of Kentucky also moved up to a B after receiving Cs and one D since fall 2018. 

Three others also moved up to a B, after getting a C last time: Baptist Health Deaconess Madisonville; Glasgow's T.J. Samson Community Hospital; and Leitchfield's Twin Lakes Regional Medical Center, which has joined the Owensboro Health system. 

Owensboro Health's main hospital fell moved from A to B, as did three others: Baptist Health Paducah; Bowling Green's TriStar Greenview Regional Hospital and Middlesboro ARH Hospital.  

Other hospitals with B grades are Baptist Health Louisville; Winchester's Clark Regional Medical Center; Frankfort Regional Medical Center; Lexington's Saint Joseph East; and St. Elizabeth Heatlhcare-Edgewood. 

Almost half the 55 Kentucky hospitals graded by Leapfrog got Cs on the latest report. Of those, most of them also got a C on the last report; nine moved down from a higher grade. 

After getting seven and three As in a row, respectively, St. Elizabeth Healthcare-Florence and Flaget Memorial Hospital in Bardstown fell to the C level. 

Seven hospitals dropped to a C after having Bs last time: Advent Health Manchester; Baptist Health La Grange; Lake Cumberland Regional Hospital in Somerset; St. Joseph Mount Sterling; St. Joseph-London; Tug Valley ARH Regional Medical Center in South Williamson; and U of L Health-Sts. Mary and Elizabeth Hospital in Louisville.

After receiving seven Cs in a row, St. Claire Regional Medical Center in Morehead fell to a D. The other four hospitals with Ds got the same grade on the last report: Murray-Calloway County Hospital; Hopkinsville's Jennie Stuart HealthPikeville Medical Center and Taylor Regional Hospital in Campbellsville.

Friday, November 12, 2021

Most Ky. hospitals in national patient safety ratings got Cs again

By Melissa Patrick
Kentucky Health News

A nonprofit group that grades hospitals for patient safety was able to provide scores for nine more Kentucky hospitals in its latest report, and again gave Cs to most of those it graded. 

The Leapfrog Group, based in Washington, D.C., rated more than 2,900 general acute-care hospitals, the most ever. Most of Kentucky's 126 hospitals were not rated, but those that were have most of the state's hospital beds.

The group does not grade small hospitals with "critical access" status because they don't have to report quality measures to the federal government, nor does it grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data.

Leapfrog gave A ratings to 15 Kentucky hospitals, or about 25% of those it graded, up from 24% in the last report. Kentucky ranked 30th in A grades, up from 33rd in the last report, issued in May 2021.  Leapfrog gave Bs to 17 Kentucky hospitals, Cs to 23, and Ds to four. 

The twice-yearly grades are based on more than 30 performance measures of patient safety that indicate how well hospitals protect patients from errors, injuries, accidents and infections. For the first time, the report includes performance grades for post-operative sepsis, blood leakage and kidney injury. 

The news release notes that post-operative sepsis can result in "suffering, disability and sometimes death for an estimated 160,000 people a year in the United States. It adds that sepsis in all settings kills over 270,000 people a year and is the costliest condition in U.S. hospitals. Further, it says that Black people are twice as likely as white people to be diagnosed with sepsis

The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey, and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation, Leapfrog says.

The Leapfrog site offers details on each measures, under headings titled Infections, Problems with Surgery, Practices to Prevent Errors, Safety Problems, and Doctors, Nurses and Hospital Staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.

Screenshot of Leapfrog page for Hazard ARH Regional Medical Center,
which moved to a C rating after getting five Ds in a row. 

High scorers

Hospitals getting As were: Baptist Health in Lexington, Paducah, and Richmond; Deaconess Henderson Hospital; Flaget Memorial Hospital in Bardstown; Logan Memorial Hospital in Russellville; Middlesboro ARH Hospital; Monroe County Medical Center in Tompkinsville; Louisville's Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital, and Norton Women's & Children Hospital; Owensboro Health; St. Elizabeth Healthcare-Florence; and Tristar Greenview Regional Hospital in Bowling Green. 

Of these, Baptist Health Paducah, Deaconess, Owensboro and Greenview moved up from a B rating in the last report. Logan Memorial, Middlesboro ARH, and Monroe County were not scored in the last report. The rest maintained their A grade. 

Shifts up and down

After receiving Cs and Ds since the Spring of 2016, U of L Health - Mary and Elizabeth Hospital got a B on the latest report.

Four others moved up to a B, after getting Cs in the last report. They were Frankfort Regional Medical Center; Lake Cumberland Regional Medical Center in Somerset and Saint Joseph-East in Lexington.

Four moved down to a B, after getting an A on the last report: Baptist Health LaGrange; Clark Regional Medical Center in Winchester; St. Elizabeth Healthcare-Ft Thomas; and St Elizabeth Healthcare-Edgewood. 

Other hospitals with B grades are Advent Health Manchester; Baptist Health in Corbin and Louisville; Mercy Health Lourdes in Paducah; Paul B. Hall Regional Medical Center in Paintsville; Saint Joseph-London; Saint Joseph Mount Sterling; Three Rivers Medical Center in Louisa; and Tug Valley ARH Regional Medical Center in South Williamson. 

Again, most of the hospitals got Cs, and most on this list got a C on the last report. 

After getting five Ds in a row, Hazard ARH Regional Medical Center moved up to a C. 

Three hospitals dropped to a C, after having Bs on the last report: Baptist Health Madisonville; King's Daughters Medical Center in Ashland; and T.J. Sampson Community Hospital in Glasgow.

Three that got Cs on the last report moved down to a D. They are Jennie Stuart Health in Hopkinsville; Murray-Calloway County Hospital; and Taylor Regional Hospital in Campbellsville. Pikeville Medical Center got its second D in a row after a string of Cs. Only two Kentucky hospitals got a D score in the Spring report.

Sunday, May 2, 2021

Most Ky. hospitals in patient-safety survey for national nonprofit's twice-a-year report card again get grade of C; fewer got As

By Melissa Patrick
Kentucky Health News

A nonprofit group that grades hospitals for patient safety gave fewer As in Kentucky than the last time, and again gave Cs to most of the 50 Kentucky hospitals that it evaluates. 

The Leapfrog Group, based in Washington, D.C., rated more than 2,700 general acute-care hospitals. Most of Kentucky's 126 hospitals were not rated, but those that were have most of the hospital beds in the state. 

The group does not grade small hospitals with "critical access" status because they don't have to report quality measures to the federal government, nor does it grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data. 

Leapfrog gave As to 12 Kentucky hospitals, or about 24 percent of those it graded, down from about 36% on the last report. Kentucky ranked 33rd in A grades, down from 21st in the last report, issued in fall 2020. Leapfrog gave Bs to 12 hospitals, Cs to 24, and Ds to two. 

The twice-yearly grades are based on 27 performance measures of patient safety that indicate how well hospitals protect patients from errors, injuries, accidents and infections. The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey, and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation, Leapfrog says.

The Leapfrog site offers details on each measures, under headings titled Infections, Problems with surgery, Practices to Prevent Errors, Safety Problems, Doctors, Nurses and Hospital Staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.
Screenshot of Leapfrog page for Harrison Memorial Hospital in Cynthiana, which moved to a C from 
an A, shows detail for infection issues and tabs for other issues. For a larger version, click on it.
 
The report notes that the data from the report does not yet reflect the impacts of the coronavirus pandemic. 

Leah Binder, president and CEO of the group. added that the scores in this report should serve as a proxy for the safety of care provided to Covid-19 patients in many ways, noting that hospitals with strong infection control policies in place are better equipped to protect their patients and workers.

"As we emerge from the pandemic, hospitals need to double down on safety, so they save lives, strengthen their organizations, and position themselves to withstand the next crisis. Putting safety first should be the priority of every hospital CEO," she said in a news release

High scorers

St. Elizabeth Healthcare-Edgewood has received As on every Leapfrog report card since spring 2014, the first year it was graded.

Other hospitals on the A list are: Baptist Health in La Grange, Lexington, and Richmond; Clark Regional Medical Center in Winchester; Flaget Memorial Hospital in Bardstown; Louisville's Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital, and Norton Women's & Children Hospital; St. Elizabeth Healthcare-Ft. Thomas; and St. Elizabeth Hospital-Florence.

All of the hospitals that got As in this report also got an A on the last report. 

Shifts up and down

Baptist Health Madisonville moved down to a B, after moving up to an A in the last following a string of Cs since fall 2017. 

After two As in a row, Mercy Health Lourdes in Paducah moved down to a B and Saint Joseph London moved back to a B, after moving up to an A in the last report. 

Two hospitals got Bs after not getting a score in the fall of 2020: King's Daughters Medical Center in Ashland and Tug Valley ARH Regional Medical Center in South Williamson. After having no scores reported in the fall, both hospitals had received Cs since fall 2018. 

Other hospitals on the B list are Baptist Health hospitals in Corbin, Louisville and Paducah; Deaconess Henderson Hospital (formerly Methodist Hospital of Henderson); Owensboro Health; T.J. Samson Community Hospital in Glasgow; and TriStar Greenview Regional Hospital in Bowling Green. 

Most of the hospitals got Cs, and most of the hospitals on this list got a C on the last report. 

Georgetown Community Hospital moved down to a C after getting a B in the last report and As since spring 2018. 

Harrison Memorial Hospital in Cynthiana dropped to a C, after getting all As and only one B in the spring 2020 report since fall 2018. 

Highlands Regional Medical Center in Prestonsburg moved up to a C after getting a D in the last report. Since spring 2016, this hospital has received either a C or a D on each report. 

After not being graded since fall 2018, both Jennie Stuart Health in Hopkinsville and Twin Lakes Regional Medical Center (now part of Owensboro Health) in Leitchfield got Cs. 

After getting six Cs in a row, Pikeville Medical Center moved down to a D.  Hazard ARH Regional Medical Center also got a D, its fifth in a row. 

Click here for a list of Kentucky hospitals and their Leapfrog safety grades. Click here for a list of frequently asked questions about the report.

Wednesday, September 30, 2020

Former Kentuckian recovering from serious health challenges offers hope and advice for others in similar situations

Written as "an open letter to friends and colleagues," this essay offers hope and insight for people and families facing serious health challenges.

By Wes Irvin

Over the last seven years, I have been on a medical journey that has unfortunately taken me away from many folks who I still miss working with on a daily basis in Washington, D.C.

I’m sure many of you have wondered if I just fell off the face of the earth. Well, I have fallen along the way many times, and this journey has been a rollercoaster in every sense of the word, but I remain thankful to still be here every day.

Wes Irvin
Here’s my story: In September 2012, my life took an unexpected turn. Since then, I have undergone 60 surgeries and survived abdominal flesh-eating bacteria, five septic episodes, and multiple pulmonary embolisms. I also lost my spleen and gallbladder. I’ve been treated (and my life saved, more than once) in hospitals in Baltimore, Cleveland, Houston, and Rochester. I could go on, but you get the picture. It’s an understatement to say that there is no playbook for what my family and I have undergone. Thankfully, my underlying health was strong and it’s a big part of my story of survival.

I write not to seek sympathy, but to share some reflections born from this journey of compounded trauma, emotional healing and wellness, patience, perseverance, faith, and forgiveness—and also to thank some of the people closest to me who have been so supportive.

1. Yes, it is the journey, not the destination. As Robert Hastings writes in The Station, life really is about the journey. If you look out over the horizon, and try to figure out everything in your life, you’ll simply outrun yourself and miss living the gift of today. We exhaust ourselves by overreaching for the future—becoming less and less aware of what’s directly in front of us.

2. Today is the real deal. We all get excited about opening a Christmas present, a wedding present, or a birthday present. Right? There is so much anticipation and enthusiasm around a new gift. I have learned after losing hundreds of days since 2012—and from coming in and out of the woods—that I needed to open my “daily present” a bit more mindfully. I’ve realized that yesterday is in the rear-view mirror, tomorrow is uncertain, but today is for real: it’s a gift; it’s here. We should open today with excitement, surprise, and thanksgiving. Grab on and enjoy! As Eleanor Roosevelt wisely said, Tomorrow is a mystery. Today is a gift. That is why it is called the present.

3. Find the pony in the pile. It sounds crass, but I’ll say it anyway: Find the pony in whatever pile of crap you unexpectedly wander into—and work tirelessly to find it. When horrible things happen to us, believe it or not, there is good we can find. I encourage you to hone in on that. If you can approach adversity with this mindset—and it isn’t easy—then you can ride that pony to the finish line. What I’m saying is find the positive, that morsel of goodness inside what may seem the deepest, darkest place in the issue you are facing.

4. Love is not just for “loved ones.” It is so important not only to love yourself, and your family, but to love people from all walks of life, every day, because I assure you that one day it may take all walks of life to save yours. Since day one of my ordeal, I have reminded the very kind folks who cleaned my rooms from the ICU to the ER in every hospital where I’ve stayed, how critical their jobs are. They, too, are busy with the work of saving lives. I hope you will look around for individuals working to ensure we can open the gift of today and tomorrow—folks working tirelessly to keep us safe, get us where we’re going, to ensure we get food. The list is endless. . . .

5. Forget politics—we’re all people. The America in 2012 when I fell sick is not the America I recognize today, in terms of the rhetoric. As politicized and divided as the country is today, I have seen up close the incredible professionalism, courage and skill of medical teams whose only concern is the care of their patients. My caregivers have been from all walks and stations of life and from countries around the world. I have been blessed that they call America their home. It’s because of the microsurgeon from Turkey, the nurse from India, and so many others who treated and helped me, that I am here. All of them worked and continue to work to find ways to put Humpty Dumpty back together. And I remain grateful to all of them.

6. Giving thanks, with gratitude. Finally, I want to thank the people who have accompanied me on this journey: First, my wife Tricia and our children, Ashby, Jack, and Mary Rose. Trish has navigated the unimaginable with grace and forgiveness—and our children have done so as well. I also want to add that Trish did all this while serving our community in multiple roles over the years. They have all been a blessing and extremely understanding during rough times and managed to pick themselves up—and often me as well—every day while moving forward.

I also want to thank my former bosses who helped me along the way. They have either sat by my bedside or helped to keep my focus balanced and strong. And speaking of bedsides, Secretary Norman Mineta was also an inspiration to me as I watched him, too, bravely navigate a serious illness while managing his leadership duties from a hospital bed. So thank you: Secretary Mineta, Ernie Fletcher, Frank Wolf, Jay Timmons and the National Association of Manufacturers, Jim Simpson, Mike DeWine, Bill Schubert, and Dave Camp. You were there for me, and it has meant the world.

I have been enveloped by a spiritual guiding light and have felt all the prayers and positive thoughts over the years from so many of you reading this. My heartfelt thanks to you all. As I like to say, “Thankful is simply every day.” The S.S. Irvin remains afloat, and we are working hard to mindfully navigate it every single day. Our family, knowing we are all survivors from this journey, has so much to celebrate and to continue to be thankful for.

Wes Irvin is a former Lexington resident who was congressional, campaign and gubernatorial press secretary for Ernie Fletcher. He lives in Annapolis, Md., and says he is an evolving survivor who advocates for the disabled and focuses his volunteer time on emotional wellness issues, due to a multi-year health journey.

Friday, May 8, 2020

Most Kentucky hospitals get a 'C' on a twice-a-year safety report card, including Jewish, which got a rare 'F' on the last report

By Melissa Patrick
Kentucky Health News

For the fourth grading period in a row, a nonprofit group that rates patient safety in hospitals has given Cs to most of the 49 Kentucky hospitals it rated.

The Leapfrog Group, based in Washington, D.C., rates more than 2,600 hospitals. Most of Kentucky's 126 hospitals were not rated,. The group does not grade hospitals with  "critical access" status because they don't have to report quality measures to the federal government, nor does it grade hospitals for which there aren't enough publicly reported data or specialty or government hospitals.

Leapfrog gave As to 12 Kentucky hospitals, or about 24 percent of those graded. It gave Bs to 10, Cs to 24, and Ds to 3. Most of the changes from the last report, in November, came from hospitals in the two lowest grades moving into the C category, with only a few swaps in the upper grades.

The only hospital to get a failing grade last fall, Jewish Hospital in Louisville, jumped to a C grade in this one, after having received a string of Ds since the spring of 2016 before getting a failing grade in the last report.

The University of Louisville acquired Jewish Hospital and other facilities from KentuckyOne Health last fall. David McArthur, public relations director for U of L Health, told Chris Larson of Louisville Business First that the system continually strives for patient safety improvements.

"The Leapfrog grade increase for Jewish Hospital reflects improvement by U of L Health for the self-reporting of process data," McArthur told Larson in an e-mail. "U of L Hospital was already meeting the self-reporting standard." That hospital again got a D, as did Sts. Mary & Elizabeth Hospital, which was one of the facilities bought from KentuckyOne.

McArthur said Leapfrog is using the same federal outcome data from fall 2019, so "With no new data, no score improvement was expected there." Because of the coronavirus pandemic, hospitals were allowed to use their survey responses from 2019 in 2020, unless they chose to update it, Leapfrog said.

Hazard ARH Regional Medical Center got a D for the third time in a row, after getting Bs and Cs in prior reports.
Screenshot of Hazard ARH scores shows detail for infection issues and tabs for other issues.
The twice-yearly grades are calculated using 28 performance measures of patient safety that indicate how well hospitals protect patients from errors, injuries, accidents and infections. The report uses data from the federal Centers for Medicare and Medicaid Services, Leapfrog's own survey, and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation.

The Leapfrog site offers details on each of the measures under headings titled infections, problems with surgery, practices to prevent errors, safety problems, doctors, nurses and hospital staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing. For example, as shown in the graph above, Hazard ARH performed below average in three infection-control categories, but above average on two.

"While many hospitals are good at keeping their patients safe, some hospitals aren't," says Leapfrog. "As many as 440,000 people die every year from preventable errors in hospitals."

High scorers

St. Elizabeth Healthcare-Edgewood
has received As on every Leapfrog report card since spring 2014, the first year it was graded.

Other hospitals on the A list are: Baptist Health Lexington; Clark Regional Medical Center in Winchester; Georgetown Community Hospital; Louisville's Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital and Norton Women's & Children's Hospital; St. Elizabeth Heatlhcare-Ft. Thomas; St. Elizabeth Hospital-Florence; Mercy Health Lourdes in Paducah and Whitesburg ARH Hospital.

Mercy Health Lourdes and Whitesburg ARH were the only two on this list to change their status since the last grading period, both moving up from a B.

Saluting the repeated As for all his adult-service hospitals, Norton Healthcare President and CEO Russell Cox called it "a testament to the hard work of our dedicated providers and employees, who consistently strive to deliver safe, high-quality care to our patients. Never has this been more apparent than during the current public health crisis with the covid-19 pandemic.”

Shifts up and down

Flaget Memorial Hospital in Bardstown fell to a B after getting its first-ever A in last fall's report, after getting four Cs in a row. Harrison Memorial Hospital in Cynthiana also dropped to a B, after receiving three As in a row.

Baptist Health Richmond moved up to a B, after getting three Cs in a row, and Frankfort Regional Medical Center regained its B status after a C in the last report.

Other hospitals on the B list are Owensboro Health, Saint Joseph East and Saint Joseph Hospital in Lexington, Saint Joseph-London and Glasgow's T.J. Sampson Community Hospital.

Most of the hospitals got Cs, and most of the changes were to that status.

Hardin Memorial Hospital in Elizabethtown moved to a C after getting a B in the last report; Baptist Health Paducah dropped to a C, after getting three Bs in a row.

Highlands Regional Medical Center in Prestonsburg moved up to a C, after four Ds in a row.

And after getting their first Ds since the spring of 2016, the University of Kentucky Albert B. Chandler Hospital and UK HealthCare Good Samaritan Hospital and moved back up to a C status.

Only a few Kentucky hospitals have ever received a failing grade from Leapfrog. Other than Jewish Hospital last fall, they have been Lexington's Saint Joseph East in fall 2015 (it got a B this time); Methodist Hospital of Henderson, spring 2019; and Campbellsville's Taylor Regional Hospital in spring 2013. Both got Cs this time.

Click here for a list of Kentucky hospitals and their Leapfrog safety grades. Click here for a list of frequently asked questions about the report.

Wednesday, November 13, 2019

More action needed to protect patients from antibiotic-resistant infections, which kill an American every 15 minutes, CDC says

Cover of CDC report; to download it, click here.
More action is needed to protect Americans from antibiotic-resistant infections, 2.8 million of which occur in the U.S. each year, killing more than 35,000 people, one about every 15 minutes, says the federal Centers for Disease Control and Prevention.

On top of that, 12,800 people died from an infection that is not drug-resistant but is "caused by the same factors that drive antibiotic resistance—antibiotic use and the spread of germs," the CDC said in its report, Antibiotic Resistance Threats in the United States, 2019. "The number of people facing antibiotic resistance is still too high. More action is needed to fully protect people."

Hospitals are a main battleground in the fight. The word "hospital" appears 188 times in the 148-page report, which was issued days after the Leapfrog Group's latest rankings of patient safety at hospitals nationwide, including 50 in Kentucky. The most common grade, on an A-to-F scale, was a C, and the report showed that many hospitals had difficulty dealing with resistant infections.
The University of Louisville Hospital got a D overall in the Leapfrog Group's patient-safety ratings and was rated poorly in dealing with one of the major antibiotic-resistant infections, Methicillin-resistant staphlycoccus areus (MRSA), and C. diff, an infection related to the use of antibiotics. Click to enlarge.
The report's foreword, by CDC Director Robert Redfield, sums up the history of antibiotics in personal terms: "In March 1942, Mrs. Anne Miller of New Haven, Connecticut, was near death. Infectious germs had made their way into her bloodstream. Desperate to save her, doctors administered an experimental drug: penicillin, which Alexander Fleming discovered 14 years earlier. In just hours, she recovered, becoming the first person in the world to be saved by an antibiotic. Rather than dying in her thirties, Mrs. Miller lived to be 90 years old.

"Today, decades later, germs like the one that infected Mrs. Miller are becoming resistant to antibiotics. You could have one in or on your body right now—a resistant germ that, in the right circumstances, could also infect you. But—unlike the bacteria that threatened Mrs. Miller—the bacteria may be able to avoid the effects of the antibiotics designed to kill them. Unfortunately, like nearly 3 million people across the United States, you or a loved one may face an antibiotic-resistant infection."

The use of antibiotics has a self-defeating element: the growth of genetically different bacteria and fungi that have mutated into forms that are resistant to the antibiotics or picked up resistance traits from other germs through mobile genetic elements. Also, antibiotic use encourages development of Clostridioides difficile, or C. diff., a bacterium "that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon," says the Mayo Clinic. The CDC report says 223,900 cases of C. diff. occurred in 2017, killing at least 12,800 Americans.

"Dedicated prevention and infection control efforts in the U.S. are working to reduce the number of infections and deaths caused by antibiotic-resistant germs, but . . . CDC is concerned about rising resistant infections in the community, which can put more people at risk, make spread more difficult to identify and contain, and threaten the progress made to protect patients," the CDC said in announcing the report. "The emergence and spread of new forms of resistance remains a concern."

What is to be done? "Public-health prevention programs targeting resistant germs can and have worked to slow spread and save lives, but more needs to be done," the report says. "The U.S. and global community must scale up these effective strategies and develop new strategies to prevent infections and save lives. In the United States, infection prevention activities have proven effective in slowing the spread of resistant germs. This includes:
  • Strategies to decrease spread within healthcare settings (e.g., implementing hand hygiene)
  • Vaccinations
  • Implementing biosecurity measures on farms
  • Responding rapidly to unusual genes and germs when they first appear, keeping new threats from spreading

Sunday, November 10, 2019

50 Kentucky hospitals get semi-annual ratings on how well they protect patients from infections, injuries and other safety issues

More Kentucky hospitals are doing better at protecting patients from infections, injuries and other in-hospital threats, according to the latest national rankings, on an A-to-F scale. The ratings improved slightly from the spring; two additional hospitals got As, and fewer got Cs and Ds.

However, two of the University of Kentucky's hospitals dropped to a D, as did Sts. Mary & Elizabeth Hospital in Louisville, which is being renamed U of L Health – Mary & Elizabeth Hospital after its purchase by the University of Louisville.

Louisville's Jewish Hospital, which will also get a U of L prefix as part of the university's purchase of some KentuckyOneHealth units, got an F on patient safety in the latest rankings by the Leapfrog Group, a nonprofit watchdog organization.

Other Kentucky hospitals with Ds were the Hazard ARH Regional Medical Center and Highlands Regional Medical Center in Prestonsburg.

Methodist Hospital of Henderson, which got an F in the spring, got a C, the most common grade for the 50 Kentucky hospitals rated. Most of Kentucky's 125 hospitals were not rated, since rural hospitals with "critical access" status don't have to report quality measures to the federal government.

Leapfrog bases its grades on data about "infections; surgery and safety problems; error-prevention practices; and metrics on doctors, nurses and staff to determine its rankings and grades twice a year," the Lexington Herald-Leader notes. Leapfrog says its data come from the Centers for Medicare & Medicaid Services (CMS), its own surveys and other sources.

One tab rating The Medical Center at Bowling Green,
which got a C overall, breaks down how it did on infections.
(For a larger version of the chart, click on the image.)
The Leapfrog site offers details on each of the measures under headings titled infections, problems with surgery, practices to prevent errors, safety problems, doctors, nurses & hospital staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.

UK's Albert B. Chandler Hospital and Good Samaritan Hospital got Ds this fall after Cs in the spring. "In other rankings, UK does very well," the Herald-Leader notes. "Chandler Hospital was ranked as the No. 1 regional facility in Kentucky by U.S. News and World Report and has been for four years.

Dr. Mark Newman, UK’s executive vice president for health affairs, told the Herald-Leader, “Like many academic medical centers, UK HealthCare serves a disproportionate number of patients with complex medical needs, which is not accurately represented by Leapfrog. . . .The quality of care and safety of our patients is of utmost importance at UK HealthCare and we continue to invest in substantial resources to continually improve in these areas.”

Chandler Hospital's rating cited surgery problems such as objects left in patients' bodies; surgical wounds that split open; death from serious treatable complications; collapsed lungs; serious breathing problems; and dangerous blood clots. It also got lower marks for antibiotic-resistant infections and surgical-site infection after colon surgery. "Dangerous bedsores and patient falls/injuries also were issues," the Herald-Leader notes. "Good Samaritan received below-average scores in many of the same areas."

The Centers for Disease Control and Prevention reports that the U.S. has about 35,000 deaths a year from drug-resistant infections. That's one about every 15 minutes, CNN notes.

Jewish Hospital also had problems with infections, surgery, bedsores patient falls and injuries, and communication with patients. U of L Health told the Courier Journal that the ratings of some of its hospitals (U of L Hospital got a D, as usual) didn't reflect "the complex nature of the patient cases they handled or the high-risk population they serve," CJ reporter Morgan Watkins writes.

U of L "noted that some of the information Leapfrog took into account dates back to early 2016," when its hospital was managed by KentuckyOne Health. "The university resumed control of U of L Hospital in mid-2017 and officially acquired Jewish and other Louisville-based KentuckyOne facilities on Nov. 1."

Chief Medical Officer Jason Smith said, "Since 2018, U of L Hospital has reported almost perfect compliance with the Leapfrog Safe Practices. We have reviewed our publicly reported data since July 2017, and utilizing the Leapfrog Group’s own calculator for scoring with that data, our calculated grade would have been a C."
On the positive side, two Kentucky hospitals earned As for the first time: Flaget Memorial Hospital near Bardstown and Jewish Hospital-Shelbyville. The other As went to Baptist Health Lexington, Clark Regional Medical Center in Winchester, Georgetown Community Hospital, Cynthiana's Harrison Memorial Hospital, Louisville's four Norton Healthcare hospitals, and the St. Elizabeth Healthcare hospitals in Edgewood, Florence and Fort Thomas.

The most common grade was a C, given to 20 hospitals. The 10 with B grades are Owensboro Health, Glasgow's T.J. Samson Community Hospital, the three CHI Saint Joseph Health hospitals in Lexington and London, Baptist Health Paducah and Mercy Health Lourdes in Paducah, and Whitesburg ARH Hospital.

Friday, June 7, 2019

1 in 5 hospital patients need care after discharge, but can have limited choices unless they know their options, columnist advises

Health columnist Trudy Lieberman
"One in five patients across the country needs further care after discharge from a hospital," Rural Health News Service columnist Trudy Lieberman writes. "Many times their families don’t know where to turn for help." The hospital can be a weak link, she warns: "Discharge planning is deficient, can be harmful, and sometimes results in a patient’s decline."

Discharging hospitals can limit patients' options, Lieberman writes: "If hospitals are hitting the limits of what Medicare will pay for a patient’s care, they have a great incentive for moving people out. To them it doesn’t matter if a patient is moved to another state, as I was, or to another town. Either one can make it difficult for family to visit and keep an eye on the care, which is all-important."

Patients and their families may not be aware of just what sub-acute-care facilities, home-care agencies or rehabilitation centers can do, and may not even know about a relatively new type of hospital, the long-term acute care facility (LTAC), which "treats sicker patients for an average of at least 25 days for recovery," Lieberman writes. "Neither had I, when I found myself transferred to one early in 2018 after a long hospital stay."

Kentucky has one freestanding LTAC, Kindred Hospital in Louisville, and eight that are inside or adjacent to another hospital: in the Baptist Health hospitals in Corbin, Madisonville and Paducah; St. Joseph Hospital in Lexington; UK HealthCare in Lexington; St. Elizabeth Fort Thomas; a Kindred facility in Jewish Hospital in Louisville; and the Commonwealth Regional Specialty Hospital in The Medical Center at Bowling Green.

The 32-bed ContinueCARE facility in the 273-bed Corbin hospital recently won a Respiratory Center of Excellence designation from the Center for Improvement in Healthcare Quality, making it "the first facility in the country to receive this specific CIHQ designation for respiratory therapy," Baptist Health said in a news release.

Lieberman has suggestions for dealing with care after discharge: "Medicare requires a discharge notice, which sets out a patient’s appeal rights and procedures, to be given no later than two days after a person is admitted to a hospital. Some are given at admission, usually a time of confusion, and the explanation of rights is likely to be overlooked. Be aware of it, though, and read it carefully. You may need to rely on it if you think a relative needs to stay longer in the hospital. And for all families who need more care after a hospital stay, the website of the Center for Medicare Advocacy has loads of information."

For Lieberman's full column, and her previous columns, click here.

Sunday, October 7, 2018

Need for improved staffing in nursing homes and hospitals was among timely topics at annual Health Watch USA conference

By Melissa Patrick
Kentucky Health News

Several speakers at the Oct. 4 Health Watch USA Healthcare Transparency and Patient Safety Conference in Lexington talked about the importance of adequate staffing in nursing homes and hospitals to maintain and improve safety for patients and staff.

Sherry Culp of the nonprofit Nursing Home Ombudsman Agency of the Bluegrass said that while regulations issued in 2016 by the Centers for Medicare and Medicaid Services have offered some positive changes, such as requirements for improved training and "appropriate competencies and skills," and better provisions for planning of care, it didn't do enough with staffing.

"The final rule really fell short on nursing staffing standards," she said. "We wanted there to be registered nurses in the building 24 hours a day. . . . We know that an RN level of nursing is the level that has the competence to deal with some of the significant changes in conditions that occur in this vulnerable population."

Culp said the rules only require an RN to be in the building eight hours a day, and that person is often "locked up in an office doing paperwork," while 90 percent of the care is provided by nurse aides, who have less than 100 hours of vocational training. Her agency monitors living conditions at nursing homes and informs residents of their legal rights.

Woodcrest Nursing and Rehabilitation Center in Elsmere has
a one-star rating. In 2016 a resident fell down the stairs in his
motorized wheelchair, died and went undiscovered for
nine hours. (Herald -Leader photo by Marcus Dorsey)
She said the agency gets calls from overwhelmed aides who tell her they have been put into impossible situations to care for as many as 40 people with little orientation and no help. "I think a lot of nurse aides are just thrown to the wolves," Culp said.

As part of a three-part, in-depth report on the dismal state of Kentucky's nursing homes, John Cheves of the Lexington Herald-Leader reports about the staffing issues in Kentucky's nursing homes, noting that collectively Kentucky's nursing homes rank as some of the worst in the country.

As of Aug. 7, he reported that Kentucky had 52 "one-star" nursing homes (18 percent of the state total), which are considered to be "much below average" and 71 "two-star" homes (25 percent), which are "below average." These ratings come from CMS's five-star rating system, which looks at a facility's staffing, health inspections and quality of resident care.

Hospitals have staffing issues, too

Staffing issues are also an issue in hospitals, said Christine Pontus, associate director of health and safety for the Massachusetts Nurses Association.

Pontus pointed out that registered nurses are vital to the care of patients because they are the front line person to recognize and react to a patient's ever-changing health status. She called this process "surveillance" and said that basically, "That's what nurses do."

She shared research to support the importance of nursing surveillance, which found that "greater nurse surveillance capacity was significantly associated with better quality of care and fewer adverse events," and the ability of nurses to provide appropriate surveillance is, among other things, largely dependent on adequate staffing.

Culp said RNs are needed 24 hours a day in nursing homes because it is imperative that someone with appropriate training be able to to determine if further care is needed when residents fall and hit their head. She said some of these fall victims have injuries that go unnoticed, "sometimes ever, or until their death or weeks later."

One study of staffing in hospitals, found that RNs who work in an environment that supports their physical and emotional safety are more able to provide better surveillance, which ultimately leads to improved patient outcomes, more positive patient experiences and higher RN engagement rates.

"National, peer reviewed studies show higher patient assignments are associated with more patient deaths, complications, medication errors and readmissions," Culp said.

Pontus noted that while Medicare requires "adequate" numbers of nurses at all levels, it doesn't define the term or who determines the numbers. Similarly, she said the Joint Commission that accredits hospitals calls for the "number, competency and skill mix of staff in relation to the provision of needed care and treatment," but does not clearly define or offer a formula to determine this mix.

"These ambiguous statements allow health care facilities to continue to operate at or below minimum [staffing] levels," she said. "Something is not working. Regardless of all the regulations and the Joint Commission, it's not working and we need to do something."

Jonathan Rosen, safety and health consultant for AJ Rosen & Associates LLC, cited another study that looked at nurse staffing and hospital deaths: "We estimate that the risk of death increased by 2 percent for each below-target shift and 4 percent for each high-turnover shift to which a patient was exposed."

So far, California is the only state to pass a nurse-to-patient ratio law. Rosen said a study found that since the requirements took effect, nurses' occupational injuries have dropped one-third.

Legislators say nursing-home staffing issues need a hearing soon, but co-chair of health panel suggests there's no time before 2019

State legislators want a hearing on nursing home staffing in Kentucky, following a series of stories in the Lexington Herald-Leader that showed how some residents have died as a result of neglect. "A Republican leader of the key committee on health care said she is getting letters from dozens of concerned nursing home residents in her district, urging her to support minimum staffing standards for the facilities," the newspaper reports.

“It sounds to me like a public discussion is due on this sooner rather than later,” state Sen. Julie Raque Adams, R-Louisville, told reporter John Cheves, who wrote the series. Adams is co-chair of the legislature’s Interim Joint Committee on Health and Welfare and Family Services.

Committee co-chair Rep. Addia Wuchner
The House chair of the panel, retiring Rep. Addia Wuchner, R-Florence, expressed doubt that it would be able to take up a bill pre-filed for the 2019 session to set staffing standards for nursing homes at any of its remaining monthly meetings before the session begins in early January. She told Cheves that the agendas are "jammed full."

"The committee is scheduled to meet Oct. 17, Nov. 27 and Dec. 12," Cheves notes. "An identical bill was ignored during the 2018 legislative session last winter, despite the sponsor, state Rep. Rick Nelson, D-Middlesboro, repeatedly calling for a committee hearing at that time." Nelson is also leaving the legislature.
Read more here: https://www.kentucky.com/news/politics-government/article219496255.html#storylink=cpy

"Meanwhile, Adams said, she plans to meet in coming weeks with her unhappy constituents in their nursing homes to learn more about the risks of having too few nurses and nurse’s aides on duty to care for residents," Cheves reports, quoting her: “I don’t know what’s going on behind the scenes, but there does seem to be some sort of initiative emerging here from the residents. This is clearly an important issue to them.”

About 34,000 Kentuckians live in long-term-care facilities, 12,500 in nursing homes, the Herald-Leader reports.

Another health committee member, Sen. Reginald Thomas, D-Lexington, told Cheves that a hearing is needed. “We have some of the worst nursing-home ratings in the country here in Kentucky,” he said. “We need to have standards for how many employees are on duty taking care of residents. The only time we talk about nursing homes in Frankfort, it’s for tort reform, to stop the so-called frivolous lawsuits after someone gets hurt. Maybe we should stop people from getting hurt.”

The Herald-Leader series reported that 43 percent of Kentucky’s 284 nursing homes were rated as “below average” or “much below average” this year by the Centers for Medicare and Medicaid Services. "That’s among the worst collective ratings for nursing homes in the country," Cheves reports.

In a column, the Herald-Leader's Tom Eblen writes, "The Kentucky Association of Health Care Facilities reported in 2017 that members had raised more than $170,000 in donations for state Senate and House races. That seems to be why bills filed year after year to set minimum nursing home staffing requirements never see the light of day." He urges readers to check the Kentucky Registry of Election Finance website to see who is giving to their legislators.

In an editorial calling for action, the Herald-Leader says, "Shamefully, our legislature has done more to protect the nursing home industry than to protect the Kentuckians who live in nursing homes. . . . We don’t expect easy solutions. The nursing home industry is a powerful lobby. But for the legislature to keep ignoring the problems in the face of so much suffering is cowardly and wrong and must end."

Thursday, September 27, 2018

Herald-Leader goes after understaffing at Ky. nursing homes

"At Sunrise Manor Nursing Home in Hodgenville, a frail woman spent a night in 2015 sitting precariously on her bathroom toilet, shouting uselessly for help, shivering with cold, because nobody remembered to return and assist her to bed. The nurse’s aide for that unit later told state inspectors that she had been overwhelmed trying to monitor 26 residents during the graveyard shift."

That's the first paragraph of one of the stories from John Cheves of the Lexington Herald-Leader about understaffing at Kentucky nursing homes. It goes on:

"At Stonecreek Health and Rehabilitation in Paducah that same year, harried nursing staff dealt with a resident screaming about excruciating pain from a neglected urinary catheter — he had an infection that soon would require emergency hospitalization — by removing his speaking valve, a plastic prosthesis in his throat, to render him mute. At Woodcrest Nursing and Rehabilitation Center in Elsemere this year, a resident told state inspectors that he was ordered to empty his bowels in bed when nobody on staff was available to take him to the bathroom."

The report has several videos. Here's one on how to pick a nursing home for a loved one: https://www.kentucky.com/news/local/watchdog/article214646475.html

An angry mother recalls her son's death in a nursing home: https://www.kentucky.com/news/local/watchdog/article218394420.html

Sen. Ralph Alvarado, R-Winchester, "works at nearly a half-dozen substandard nursing homes while he fights in Frankfort to protect the nursing home industry from personal injury and wrongful death lawsuits," and opposes bills to require more staff, Cheves reports. Here's a video:


Saturday, August 25, 2018

Oct. 4 Health Watch USA conference in Lexington will focus on health-care transparency and patient safety

Somerset-based Health Watch USA will hold its 12th annual Healthcare Transparency and Patient Safety conference Oct. 4 in Lexington.

This year's conference will look at the importance of nursing in the prevention of adverse events, how infectious disease puts both patients and staff at risk, the importance of patient access to their medical records and the value of patient advocacy.

Christine Pontus, associate director of the Division of Health and Safety for the Massachusetts Nurses Association, and Jonathan Rosen, the principal consultant for AJ Rosen & Associates, which provides occupational-safety and industrial-hygiene services to labor unions, government agencies and organizations throughout the U.S., will review key occupational hazards confronting nurses, including the importance of safe staffing and infection control.

Jayne O'Donnell, USA Today's health-care policy reporter, will discuss what she's learned while covering patient safety and will offer strategies for healthcare workers to use when talking to reporters about medical safety lapses. She will also discuss the roadblocks reporters face when reporting on patient safety.

Dr. Joycelyn Elders, a former U.S. surgeon general, will lead a discussion on the importance of patient advocacy, followed by six patient advocate presentations.

Lisa Danielpour, a marketing, social-media and nonprofit-management consultant, will show how giving patients full access to their records can improve patient safety and health outcomes.

The conference will run from noon to 9 p.m. at the Eastside Branch Library in Lexington and will offer continuing education credits for certain medical professionals. The conference hotel is TownePlace Suites, 1790 Vendor Way, Lexington, KY, Hamburg Shopping Center. Click here for more information and a link to register.

Saturday, March 3, 2018

Senate passes medical tort reform bill, 20-16

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. -- A medical tort reform bill passed the state Senate by an unusually close 20-16 vote March 1, with six Republicans and 10 Democrats opposing it. The vote raises doubts about the bill's prospects in the House.

Senate Bill 20, sponsored by Sen. Ralph Alvarado, R-Winchester, a physician, would limit contingency fees for attorneys in medical malpractice cases to 33 percent and keep apologies or expressions of regret by health-care providers from being used in malpractice cases.

A provision to keep medical peer reviews out of malpractice cases was removed from the bill because the legislature has already sent Gov. Matt Bevin a House bill with that provision.

The 33 percent limit was in a floor amendment adopted by voice vote and offered by Sen. Whitney Westerfield, R-Hopkinsville, chair of the Senate Judiciary Committee. It replaced original provisions that would have limited fees to 35 percent of the first $100,000 in damages, 25 percent of the next $100,000 and 10 percent of damages over $200,000.

Sen. Ray Jones, D-Pikeville, passionately opposed the bill in a floor speech. He said that it is a fundamental right of individuals to be able to enter into a contract and negotiate a fee amount with an attorney of their choosing. He added that limiting contingency fees will "prevent people from being able to get quality lawyers that will be willing to pursue their cases."

Jones, a lawyer, disputed Alvarado's assertion that Delaware has the same rules, saying the state allows attorneys and clients to contract around them. "This piece of legislation favors health care providers to the detriment of injured patients," he said.

The bill would also add to the review process that the legislature approved last year. Alvarado said that if a panel finds for the defendant, the plaintiff would be required to submit a sworn statement from a doctor saying that it has merit.

The bill would also change the law that allows any third party to be able to get medical records for free, which Alvarado said allows lawyers to go on "fishing expeditions" to find clients. The new rule would only allow patients free access to their own records. A floor amendment adopted by voice vote added an exemption for attorneys working without charge to have free access to their client's records.

Rep. Robin Webb, D-Grayson, a lawyer, also spoke against the bill. "This is against the medical consumer, it is against the patient, and once again against the right to contract and the free market principles that we hear so much about" from Senate Republicans, she said.

Republican senators voting against the bill were Tom Buford of Nicholasville, Jared Carpenter of Berea, C.B. Embry of Morgantown, John Schickel of Union, Wil Schroder of Wilder, and Brandon Smith of Hazard. Sens. Julie Raque Adams, R-Louisville, a lawyer who chairs the Senate Health and Welfare Committee, and Sen. Reginald Thomas, D-Lexington, who is running for Congress in the Sixth District, did not vote.

Monday, July 3, 2017

Attorneys file 111 medical-negligence cases in week before new law requires such suits to be reviewed by health professionals

In a proverbial rush to the courthouse, Kentucky lawyers filed 111 lawsuits alleging medical negligence in the week before a new state law took effect, requiring such suits to be reviewed by a panel of health professionals before they can proceed.

Andrew Wolfson of The Courier-Journal in Louisville reports that 68 of the suits allege "that doctors, hospitals, nursing home and other medical professionals caused the wrongful death of patients." Fifty of the 111 cases are in Jefferson County. "Forty-three of the suits were filed by the Lexington office of Wilkes McHugh, a national personal injury firm. Ricard Circeo, who runs the Lexington office, did not respond to requests for comment."

"Under the new law . . . the individual alleging harm must file a complaint with the state Cabinet for Health and Family Services, which triggers the process of setting up an outside panel to review the claim," The C-J's Deborah Yetter explains. "The panel consists of three licensed health professionals with a lawyer serving as chairman. Members must render an opinion on whether a breach of care occurred and whether such a breach was a 'substantial factor' in causing harm to the patient."

The panel has no authority but its opinion can be offered as evidence in the case. The process "can take more than a year," Yetter writes, but if the panel "takes more than nine months to issue a finding, the individual may go ahead and file a lawsuit. The parties also may skip the medical review panel process and go directly to court if both sides agree to do so."

The law was pushed by Republican state Sen. Ralph Alvarado of Winchester, a physician who has patients in nursing homes. He said it will discourage frivolous lawsuits, but plaintiffs' lawyers told Yetter that it will delay or deny access to the courts.

The law is "similar to ones in more than a dozen states," Yetter reports, and "had been sought for years in Kentucky by physician groups, nursing homes and others in the health business." It failed until the state House turned Republican in the November 2015 election.

Wednesday, April 12, 2017

Nonprofit grades hospitals on patient safety; Ky. improves slightly in national rank, but Louisville hospitals still get near-failing scores

University of Louisville Hospital reminds visitors
and workers to wash their hands to stop infections.
By Traci Thomas
Kentucky Health News

A nonprofit group that rates hospitals has released its latest patient-safety grades, giving most Kentucky hospitals a B or C. The scores are similar to grades released in October, but the overall score for Kentucky hospitals rose from 35th to 32nd among the states.

The Leapfrog Group, a nonprofit based in Washington, D.C., evaluated 2,639 hospitals nationwide, including 51 in Kentucky. Most of Kentucky's 129 hospitals were not rated because critical-access hospitals in rural areas don’t have to report their quality measures.

The grades are calculated using 30 publicly available safety-performance measures from the Centers for Medicare & Medicaid Services, the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention and the American Hospital Association’s annual survey.

The calculations gave an A to 12 of Kentucky's hospitals, or 23.5 percent, lower than the national average of 31 percent. The majority of Kentucky hospitals got average scores, with 16, or 31.4 percent, earning a B, and 20, or 39.2 percent, earning a C. The remaining three hospitals got a D, one fewer than in the fall.

The three that got a D are in Louisville and owned or operated by KentuckyOne Health: Jewish Hospital, Sts. Mary and Elizabeth Hospital and University of Louisville Hospital. A state inspection of University Hospital last year found that shortcomings in nursing had endangered three patients, and nurses and doctors told inspectors that staff shortages put patients at risk. The hospital has since corrected those problems.

Despite the low grades, KentuckyOne Health told The Courier-Journal that it's "committed to delivering high quality, safe care for the people of Kentucky," Darla Carter reports for the Louisville newspaper. "After financial squabbling between the university and KentuckyOne, an executive committee of the U of L Board of Trustees approved an agreement in December to clear the way for KentuckyOne to no longer run the day-to-day operations of the hospital and the James Graham Brown Cancer Center as of July 1."

St. Joseph Hospital and St. Joseph East in Lexington, also owned by KentuckyOne, received Cs again after getting the same grade in October.

Pikeville Medical Center has received A grades from the start.
Among Leapfrog's top safety picks is Pikeville Medical Center, the only Kentucky hospital to get straight As since the rankings began in 2013. The two University of Kentucky hospitals once again earned Bs.

The grades include separate ratings for errors, injuries, accidents and infections. Click here for Kentucky's hospital safety scores.The Leapfrog Group says its analysis was developed under the guidance of the nation's leading patient-safety experts. The report is peer-reviewed and published in the Journal of Patient Safety.

“When we launched the Leapfrog Hospital Safety Grade in 2012, our goal was to alert consumers to the hazards involved in a hospital stay and help them choose the safest option. We also hoped to galvanize hospitals to make safety the first priority day in and day out,” Leah Binder, president and CEO of Leapfrog, said in a report. "So far, we’ve been pleased with the increase in public awareness and hospitals’ commitment to solving this terrible problem. But we need to accelerate the pace of change, because too many people are still getting harmed or killed.”

Wednesday, December 28, 2016

Medicare cuts 11 Ky. hospitals for patient-safety issues; repeaters in Louisville, Danville, Hopkinsville, Lexington, Paducah, Florence

The federal government is penalizing 11 Kentucky hospitals for falling short on patient safety in the fiscal year that ended Sept. 30, two more than last year.

Medicare has imposed a 1 percent cut in payments to 769 U.S. hospitals that have high rates of potentially avoidable infections and complications such as blood clots, bedsores and falls. "The reductions apply not only to patient stays but also will reduce the amount of money hospitals get to teach medical residents and care for low-income people," Kaiser Health News reports.

This is the third year of the Hospital-Acquired Conditions Reduction Program, created by the 2010 health reform law, but the first year that "the spread of antibiotic-resistant germs" has figured in the assessment, Kaiser notes. The federal Agency for Healthcare Research and Quality "estimates there were 3.8 million hospital injuries last year, which translates to 115 injuries during every 1,000 patient hospital stays."

The many rural hospitals that are designated "critical access" are not subject to the penalties. Neither are "specialized hospitals, such as those that treat psychiatric patients, veterans and children," Rau notes.

"Of the remaining hospitals, the Affordable Care Act requires that Medicare penalize the 25 percent that perform the worst on these measures, even if they have reduced infection rates from previous years," Rau reports. The list of penalized hospitals is at http://khn.org/Njg1NzMw; it's also available as a PDF or in a sortable Excel file.

University Hospital and Jewish Hospital & St. Mary's Healthcare, both in Louisville and part of KentuckyOne Health, are on the penalty list for the third straight year.

Ephraim McDowell Regional Medical Center in Danville and Jennie Stuart Medical Center in Hopkinsville were penalized last year and are also on the list this year.

Harrison Memorial Hospital in Cynthiana, St. Elizabeth Fort Thomas and Baptist Health Paducah are being penalized for the first time. Nationally, "40 percent of the hospitals penalized this year escaped punishment in the first two years," Kaiser reports.

The University of Kentucky hospital, Lourdes Hospital in Paducah and St. Elizabeth Florence, which were penalized two years ago but not last year, are on this year's penalty list.

Hospitals that were penalized last year but are NOT being penalized this year are Georgetown Community Hospital, Muhlenberg Community Hospital in Greenville; Rockcastle Regional Hospital and Respiratory Care in Mount Vernon; Saint Joseph East in Lexington; and Taylor Regional Hospital in Campbellsville.