North Shore–LIJ Health System said today that starting Sept. 1 it will require newly hired nurses to either hold a Bachelor of Nursing Science degree or earn one within five years.
Michael Dowling, president/CEO of the Great Neck, NY–based 15–hospital health system, said the new requirement—the first of its kind for any hospital in New York State—is based on research that links higher levels of nursing education to improved quality outcomes, lower mortality, and fewer adverse events.
“As patient care becomes more complex and high–tech, there is growing evidence that developing a more highly educated nursing workforce improves patient safety and leads to higher–quality, more cost–effective patient care,” Dowling said, in a media release.
Nurses who do not have a BSN must enroll in a bachelor’s degree program within two years of their hire date and earn their degree within five years. North Shore–LIJ offers tuition assistance to employees for BSN degrees, and flexible onsite nursing degree programs with several Long Island universities and colleges.
Nurses already on staff who have not earned their BSNs are exempt from the new requirement, but they are encouraged to continue their education and take advantage of the health system’s tuition reimbursement program, says Maureen White, RN, senior vice president/CNO of the North Shore–LIJ.
“Nurses require a broad–based education that prepares them to meet increasingly complex patient health needs in constantly evolving practice environments,” White says. “Nurses must be prepared to work with individuals, families and communities of diverse backgrounds in a range of settings as part of interdisciplinary teams. The bottom line is that our nurses have a deep and direct impact on every single patient who enters our doors, more so than any other medical professional.”
White says about 60% of North Shore–LIJ’s more than 10,000 nurses already have a bachelors, masters or doctoral degree, and 465 nurses are now working on obtaining their bachelor’s degree.
“So it’s clear that many already recognize the importance of advancing their clinical knowledge skills and enhancing patient care in their own environment,” White adds.
In 2009, a bill was introduced in the New York State Legislature to require registered professional nurses to attain a BSN degree within 10 years of their initial licensure. If passed, New York would be the first state in the country to have a BSN as standardized entry into the nursing profession. Attempts by nurses and other advocates to pass similar legislation in the state date back to 1976.
Community Health Systems, Inc. has acquired Marion Regional Healthcare System in Marion, SC, the Franklin, TN–based private hospital chain announced this week. Financial terms of the acquisition were not disclosed.
The system includes Marion Regional Hospital, a 124–bed, full–service, acute–care hospital, Mullins Nursing Center, a 92–bed skilled nursing facility, and other ancillary services. Marion Regional Hospital becomes the sixth CHS–affiliated, acute–care hospital in South Carolina. It is located 20 miles east of Carolinas Health System, an affiliated, 420–bed, tertiary hospital in Florence, SC.
“We are pleased to expand our presence in South Carolina and look forward to opportunities for Marion Regional Hospital and our other affiliated hospitals in South Carolina to work collaboratively as they advance healthcare for their respective communities,” says Wayne T. Smith, chairman/president/CEO of CHS.
“We also look forward to working with the hospital’s medical staff and employees as we build upon their commitment to provide quality health services for the residents of Marion County,” he adds.
CHS is the largest publicly–traded hospital company in the United States and operates acute–care hospitals in non–urban and mid–size markets throughout the country. Through its subsidiaries, the CHS owns, leases, or operates 123 hospitals in 29 states with approximately 18,000 licensed beds.
WellCare Health Plans, Inc. said a federal court will allow the Tampa-based health insurer to pursue claims against former Chairman/President/CEO Todd Farha and other top executives.
In addition, WellCare said the U.S. District Court in Middle Florida this week dismissed all claims against current and former directors.
"This is a logical next step in the company's transformation that began in October 2007," said Alec Cunningham, WellCare's CEO. "This is another in a series of company efforts over the past two-and-one-half years to remediate past practices and forge a new future for members, associates, and stockholders."
In 2007, WellCare stockholders filed federal and state lawsuits against Farha, former CFO Paul Behrens, former General Counsel Thad Bereday, and other current and former WellCare directors. WellCare appointed an independent special litigation committee that concluded that the company should pursue claims against Farha, Behrens, and Bereday for breach of duty and breach of contract.
The SLC said it found no evidence supporting claims against the WellCare directors who were named in the actions. The SLC asked the federal court to make WellCare the plaintiff in the actions so it could pursue claims against the three former executives. In addition, WellCare entered a settlement with the original plaintiffs and their counsel.
"These are key legal developments for the company," said Timothy S. Susanin, WellCare's senior vice president, general counsel and secretary. "WellCare can now pursue its claims and hold these former executives accountable for their conduct."
WellCare has been the subject of widespread speculation and litigation for the past four years, after federal investigators raided the insurer's Tampa headquarters, carted off boxes of documents, and grilled executives.
In June, a federal judge unsealed a whistleblower complaint that accused WellCare of egregious conduct, including dumping hundreds of sick newborns and terminally ill patients from the membership rolls to bolster profits.
Florida Attorney General Bill McCollum told Health News Florida this month that former executives at WellCare are the subject of state and federal criminal investigations.
WellCare provides managed care services for Medicaid and Medicare for approximately 2.2 million people nationwide.
For the month of July, healthcare organizations will receive grants from Health and Human Services totaling $390 million to strengthen their medical surge capability.
HHS' Office of the Assistant Secretary for Preparedness and Response will issue the 2010 funds through the Hospital Preparedness Program. The grants are intended to bolster the ability of hospitals and healthcare facilities to respond to the public health emergencies such as natural disasters, disease outbreaks, or acts of terrorism.
All states, territories, New York City, Chicago, Los Angeles County and Washington, DC, will receive grants to develop the following:
—Interoperable communication systems
—Systems to track available hospital beds
—Advance registration of volunteer health professionals
—Processes for hospital evacuations or sheltering
—Processes for fatality management
—Healthcare partnerships at the community level
—Hospital participation in statewide and regional exercise programs
Various grants received:
—California, $32 million
—Los Angeles County, $12.3 million
—New York State, $13.6 million
—New York City, $10.2 million
—Texas, $28.2 million
—Florida, $22 million
Steven E. Weinberger, MD, has been promoted to executive vice president and CEO of the American College of Physicians, effective July 19. The selection was made after a national search and based on recommendations from a search committee appointed by the ACP Board of Regents.
Weinberger will administer ACP's activities in medical education and publishing, membership services, business development, and public policy. He succeeds John Tooker, MD, who announced his intention to step down last October. Tooker will serve as ACP?s associate executive vice president for one year to help the leadership transition.
A career administrator and board-certified internist and pulmonologist, Weinberger served as ACP's deputy executive vice president since 2009 and as senior vice president for medical education and publishing since 2004.
Before joining ACP, Weinberger was faculty associate dean for medical education and a professor of medicine at Harvard Medical School.
He also served as executive vice chair of the department of medicine at Beth Israel Deaconess Medical Center in Boston and executive director of the Carl J. Shapiro Institution for Education and Research, an organization affiliated with both Harvard Medical School and Beth Israel Deaconess Medical Center.
ACP is the largest medical specialty organization and the second-largest physician group in the United States. Its members include 129,000 internists, related subspecialists, and medical students.
Connecticut Tuesday announced that it has reached a settlement with Health Net and its affiliates over the failure last year to secure the private medical records of 1.5 million policyholders and for the insurers' delay in reporting the breach.
Connecticut Attorney General Richard Blumenthal said the settlement imposes a $250,000 fine on the company for HIPAA and HITECH violations, and requires the insurers to adopt rigorous security and notification measures.
The settlement involves Health Net of the Northeast, Inc., Health Net of Connecticut Inc., and parent companies UnitedHealth Group Inc. and Oxford Health Plans.
Blumenthal said the insurers cooperated with the settlement, accepted responsibility for breach, and agreed to a remedial action plan.
The May 14, 2009 loss or theft of a portable computer disk drive at the company's Shelton, CT office impacted about 446,000 Connecticut policy and 1 million other policy holders across the nation. The breached data included personal health records, bank account numbers, and social security numbers. Health Net waited until Nov. 30 to provide notice of the breach.
The information included 27.7 million scanned pages of more than 120 different types of documents, including insurance claim forms, membership forms, appeals, grievances, correspondence, and medical records.
Health Net had maintained that the disk drive had been misplaced, but Blumenthal said a consultant hired by Health Net concluded that it had been stolen.
"This settlement is sadly historic — involving an unparalleled healthcare privacy breach and an unprecedented state enforcement of HIPAA," Blumenthal said in a statement. "These missing medical records included some of the most personal, intimate patient information — exposing individuals to grave embarrassment and emotional distress, as well as financial harm and identity theft," he said.
Health Net issued the following statement: "Protecting the privacy of our members is extremely important to us. As the Connecticut Attorney General stated, Health Net has worked closely and cooperatively with his office and state regulators to enhance our security systems and controls through additional associate training and education, as well as state-of-the-art security programs. All of these improvements will result in Health Net being in the forefront of securing member health information. As stated in the agreement with the Attorney General, to date Health Net has no evidence that there has been any misuse of the data."
Health Net has offered to pay for two years of credit monitoring services for any impacted members who elect the service.
University of Florida officials in Gainesville have notified 2,047 people that their Social Security or Medicaid identification numbers were included on address labels affixed to letters inviting them to participate in a research study.
The letters were sent through the US Postal Service on May 24, and the information also was shared with a telephone survey company. The problem was discovered June 6. Using Social Security numbers and other individual identifying numbers for non-essential purposes is against university policy, UF said in a media release.
The company, Burlington, VT-based Macro International Inc., said it will purge and destroy the information and sign legal documents indicating the task has been completed. The Gainesville-based printer that produced the mailing labels, Renaissance Printing, said it has already done so, UF said.
"We were dismayed to learn of this breach and deeply regret any concern this may cause these individuals," said Susan Blair, UF's chief privacy officer. "We have taken steps to address this problem and are continuing to evaluate our processes and procedures."
The letters were generated as part of a research study conducted through the UF College of Medicine's Department of Epidemiology and Health Policy Research. They were sent to parents or guardians of adolescent girls listed in a statewide database to seek their participation in a telephone survey about human papillomavirus, or HPV, vaccination. The study included a control group of unvaccinated girls ages 9 to 17 and those ages 11 to 17 who had received the vaccine.
The numbers — which were included on the address label so the telephone survey company could identify participants by their number only — were supposed to have been generated randomly. Instead, 647 were Social Security numbers and the remainder were Medicaid numbers, in both cases preceded by an alphabetical character with the hyphens omitted.
UF officials told the Florida Agency for Health Care Administration and the federal Office of Civil Rights. Information about the breach and has posted a notice on the university's home page and the privacy office's website.
Rising operating costs, managing finances amid Medicare reimbursement shifts, and installing electronic health records are the top three challenges for medical practice managers, according to Medical Practice Today: What Members Have to Say, an annual survey from the Medical Group Management Association.
"It is not surprising that 'maintaining finances with the uncertainty of Medicare reimbursement rates' jumped to the No. 2 spot this year due to the continued congressional irresponsibility in not permanently addressing the flawed sustainable growth rate formula," said William F. Jessee, MD, president/CEO of Englewood, CO-based MGMA.
Medicare reimbursement rate uncertainty ranked No. 5 in 2008 and 2009.
The online survey of 1,798 people -- conducted from Feb. 12 to March 5 -- also found that "managing teamwork and group dynamics among physicians," an organizational governance issue MGMA introduced to the list this year, debuted at No. 8. "Implementing a patient-centered medical home model of care" made the biggest leap from last year's list -- from No. 22 to No. 12.
"Practices are clearly balancing the very serious issue of keeping their practices afloat amid unprecedented financial uncertainty with the more delicate practice management issues such as managing group dynamics and overseeing their organizations' strategic direction," Jessee said.
MGMA found that when compared with independent medical practices, hospitals and health system respondents were more concerned with:
Modifying physician compensation methodology
Recruiting physicians
Dealing with rising operating costs
Implementing a patient-centered medical home model of care
However, hospitals and health system respondents were less likely than independent medical practices to be challenged by "maintaining physician compensation levels" and "negotiating contracts with payers."
For a second year, MGMA also asked participants how the recession is affecting their medical groups and how they are responding. The participants said their practices have:
While these same issues ranked as the top five issues in 2009, the percentage of respondents who saw an increase in uninsured patients or postponed capital expenditures dropped this year. Among the ranking of the recession's effects, "staff salary freeze" accounted for the biggest jump in rank, moving up from No. 12 to No. 6.
Direct FDA jurisdiction over how CT scanners are used -- including radiation dose requirements -- would be a logistical nightmare because of the numbers and types of scanners in operation, and the variety of imaging services they provide, the American College of Radiology and the Society of Computed Body Tomography and Magnetic Resonance said Tuesday in a joint statement.
Instead, ACR/SCBTMR said that concerns surrounding imaging equipment could be addressed if the federal government required healthcare providers that use imaging equipment to adopt ACR safety standards.
ACR/SCBTMR were responding to a perspective piece published in the June 23 issue of New England Journal of Medicine which suggested that direct FDA oversight of CT scanners and other devices that deliver radiation is needed to control patient exposure brought on by the overuse of imaging equipment by inadequately trained medical staff.
The author, Rebecca Smith-Bindman, MD, a professor of radiology at UC San Francisco's Helen Diller Family Comprehensive Cancer Center, wrote that she and her colleagues had determined that the risk of cancer from a single CT scan could be as high as 1 in 80.
"Yet no professional or governmental organization is responsible for collecting, monitoring, or reporting patients' CT-dose information," Smith-Bindman wrote in NEJM. "The FDA approves CT scanners, but because it has no authority to oversee the way CT tests are used in clinical practice, it collects only limited data on routine doses. Radiologists and other medical specialists determine how CT tests are performed. Studies have consistently shown that physicians know little about radiation doses or cancer risks from medical imaging."
Smith-Bindman wrote that while radiation doses are supposed to be "as low as reasonably achievable," there are no guidelines to indicate what constitute reasonable doses for most types of CT. In addition, she wrote, enforcement and training requirements vary from state to state, and CT technologists often don't receive consistent and comprehensive training.
In their response Tuesday, ACR/SCBTMR said they share Smith-Bindman's concerns about the overuse and improper use of CT scanners, but said her call to put medical imaging directly under FDA oversight would create "narrowly defined regulations (that) may not allow for the flexibility that physicians need to provide the best possible care to their patients."
ACR/SCBTMR said a more effective and immediate path toward addressing radiation doses would be for the federal government to require all imaging providers to meet existing, previously voluntary programs that the ACR has already put in place. Those programs include:
Computerized exam ordering systems based on ACR criteria that help doctors prescribe the best exam for a patient's given condition, inform them when an exam that does not use radiation may be more appropriate or when no scan may be warranted at all.
ACR facility accreditation, which requires facilities to maintain image quality, checks radiation dose used, and minimizes the likelihood of adverse events such as those highlighted in recent news reports, by requiring physicians to meet certain education/training standards, scanners to be surveyed regularly by a medical physicist to ensure proper function, and technologists operating scanners to be certified.
The ACR CT dose index registry, which allows providers to submit radiation dose data so that facilities may compare their CT dose indices against realistic national benchmarks and may re-examine their imaging protocols if necessary.
"Lawmakers and government agencies need to work with the provider community to help ensure that that the next steps to address the very important issues of medical radiation reduction and necessary utilization are the correct steps," ACR/SCBTM said in a media release. "Federally mandating participation in these existing programs can help ensure that medical imaging is safe, effective, and available without removing treatment decisions from doctor's hands, and without further stressing the American healthcare system."
St. Joseph's Women's Hospital in Tampa has broken ground on a $75 million expansion project. The 125,000 square foot building will house the St. Joseph's Children's Hospital's Neonatal ICU with 64 NICU private suites, the Shimberg Breast Center, and other specialty services for women and newborns.
The Shimberg Breast Center, with 24 private suites, will include diagnostic tools such as CT scanner, ultrasound, Dexa scan, digital mammography and state-of-the-art MRI. It is expected to be completed by Fall 2012.
In addition to all private suites, other amenities include: full in-suite accommodations for families of NICU and women's hospital patients; wireless communications and Internet access; all-digital diagnostic imaging services; and Biometric Palm Scanning technology for registering and admitting patients.
The Shimberg Breast Center was named after Tampa philanthropists Hinks and Elaine Shimberg, who were the primary donors for the expansion. Elaine Shimberg is a breast cancer survivor, and the grandmother of a baby born prematurely.
St. Joseph's Women's Hospital, part of 10-hospital BayCare Health System, is the only freestanding hospital in the Tampa Bay area for women and infants.
