St. David's South Austin (TX) Hospital will begin a $72 million renovation and expansion project in April that will add three floors, more than 100,000 square feet, and 25% more beds. Effective immediately, the hospital has been renamed St. David's South Austin Medical Center.
"This renovation highlights three of the hospital's top priorities—providing the highest quality healthcare, ensuring hospital stays are comfortable and convenient for patients and their families, and offering resources for the community," said interim CEO Brett Matens, in a media release. "Our new name will better identify the hospital's current and future services to the community."
The project, scheduled for completion in April 2012, will include:
Expansion: A three-story patient tower, with one floor of universal beds for critical care; an expanded women's services area, including a new nursery and Level II nursery; renovated surgical suites, including new operating rooms for general surgery, neurosurgery, and orthopedic surgery; and a new post-anesthesia care unit.
Hospitality renovations: A new family waiting area outside of the nurseries, more parking, and additional larger-sized rooms for extended stays or patients with large families.
Community resource renovations: An auditorium and community center; a renovated chapel; and a remodeled dining area and food court.
Matens says the medical center will have to hire more nurses within the medical surgical areas and critical care departments, and support staff in all ancillary areas.
In 2005, St. David's South Austin Hospital completed a $50 million expansion project that included 34 new medical surgical beds, a cardiovascular center, an ICU observation unit, and a 360-space parking garage. St. David's South Austin Medical Center, owned by St. David's HealthCare, is an acute-care facility with 252 beds.
Architectural plans and interior design for the tower will be led by Nashville-based Gould Turner Group, Inc. The garage expansion will be led by Nashville-based Earl Swensson Associates, Inc. The general contractor has not yet been named.
Johnson & Johnson and two of its subsidiaries have been named in a kickback scheme that allegedly paid millions of dollars to Omnicare Inc., for dispensing J&J drugs to nursing home patients, the Department of Justice announced today.
In a civil False Claims Act complaint against J&J subsidiaries Ortho-McNeil-Janssen Pharmaceuticals Inc., and Johnson & Johnson Health Care Systems Inc., the federal government alleges that the kickbacks were designed to induce Omnicare's nursing home pharmacy company to purchase and recommend J&J drugs, including the anti-psychotic drug Risperdal.
"We will pursue those who break the law to take advantage of the elderly and the poor," said Tony West, assistant attorney general for DOJ's Civil Division. "Kickbacks such as those alleged here distort the judgments of healthcare professionals and put profits ahead of sound medical treatment."
According to the complaint, J&J knew that Omnicare's pharmacists reviewed nursing home patients' charts at least monthly and made recommendations to physicians on what drugs should be prescribed for those patients. The government further alleges that J&J knew that physicians accepted the Omnicare pharmacists' recommendations more than 80% of the time, and that J&J viewed such pharmacists as an "extension of [J&J's] sales force."
Johnson & Johnson issued a brief statement Friday afternoon defending its conduct. "We are reviewing the complaint filed today and will address the government's lawsuit in court," said Carol Goodrich, director of Corporate Media Relations at J&J. "We believe airing the facts will confirm that our conduct, including rebating programs like those the government now challenges, was lawful and appropriate. We look forward to the opportunity to present our evidence in court."
In November, the federal government, several states, and Omnicare entered into a $98 million settlement agreement that resolved Omnicare's civil liability under the False Claims Act for taking kickbacks from J&J.
In a statement Friday, Omnicare said, "As announced on November 3, 2009, Omnicare reached a voluntary civil settlement with the U.S. Attorney's Office, District of Massachusetts, the Departments of Justice and Health and Human Services, as well as various of the states in which the Company does business. The settlement related to the previously disclosed investigation with respect to qui tam complaints filed against the Company.
"The Settlement Agreement did not include any finding of wrongdoing or any admission of liability by Omnicare. The Company denies the contentions of the federal government and the qui tam relators as set forth in the complaints and further denies any liability related to those contentions. The Company chose to settle the matter to avoid expensive and time-consuming litigation and to focus on its mission of providing high-quality pharmaceutical care for the frail elderly," according to Omnicare.
The federal complaint alleges that J&J paid the kickbacks to Omnicare in several ways:
First, J&J allegedly increased the amount of the rebates as long as Omnicare implemented specific programs to increase the prescriptions of J&J drugs, said the Department of Justice.
Second, J&J allegedly paid Omnicare millions of dollars for "data," much of which Omnicare never provided. The true purpose of these payments was to induce Omnicare to recommend J&J drugs, according to the federal government.
Third, J&J allegedly made various other kickback payments to Omnicare in the form of "grants" and "educational funding," even though their true purpose was to induce Omnicare to recommend J&J drugs, said the Department of Justice.
DOJ filed its complaint in two consolidated whistleblower lawsuits already on file in federal court in Massachusetts.
The demand for healthcare workers appears to be accelerating in most areas of the nation, a new study shows.
Labor trends in 30 markets tracked by the consulting firm Health Workforce Solutions LLC found demand growing fastest in Sacramento, Riverside/San Bernardino, Pittsburgh, Cleveland, and Dallas for the fourth quarter of 2009. The New York/Northern New Jersey area ranked at the bottom of the 30 markets tracked.
"After several slow quarters, we are now seeing notable movement across a number of markets as healthcare employers begin to ramp up again," said David Cherner, managing partner of San Francisco-based HWS. "With the healthcare reform picture finally becoming clearer, many forward-thinking organizations appear to be refocusing back on their hiring needs at an opportune time before the competition for key clinical and ancillary personnel undoubtedly returns."
HWS' Labor Market Pulse Index also found that:
Much of the growth is being fueled by newly announced expansion plans and larger facility openings at organizations, such as Mercy San Juan Medical Center in Sacramento, the University of Pittsburgh Medical Center, the Cleveland Clinic and University Hospitals in Cleveland, and Texas Health Resources in Dallas.
Of the 30 major markets tracked, the slowest area for the quarter, the New York metro/Northern New Jersey area, remained relatively flat, dropping 4% from the prior quarter.
The Labor Market Pulse Index composite index, a representative basket of the 30 largest markets, posted a 19.5% increase in the fourth quarter of 2009 from the third quarter of 2009 and was up 17.3% compared to the fourth quarter of 2008.
For the fourth quarter of 2009, 21 markets of the 30 tracked by the LMPI showed signs of accelerated demand, up from 16 in the third quarter.
With a 21% Medicare reimbursement cut for physicians looming on March 1, the American Medical Association this weekend began airing tv ads that call on the Senate to permanently fix what has become an annual sideshow. The ads are airing in 10 states through the end of January.
"Time is running out for the Senate to act on this important issue for seniors, military families and physicians," said AMA President J. James Rohack, MD, in a media release. "Our new TV ad expresses the urgency of the issue, as physicians will be forced to make tough practice decisions if Congress does not fix the issue once and for all before March 1."
In 1997, Congress mandated Medicare spending cuts that were scheduled to begin in 2001. Those cuts have never taken effect, because each year the AMA, and other healthcare lobbying groups, push Congress to delay the cuts for another year. With each annual Band-Aid fix, however, the next year's cuts get deeper.
In October, AMA lobbied unsuccessfully for a bill that would have reset the sustainable growth rate formula for physicians back to zero to eliminate around $245 billion debt that has accumulated during the past six years as a result of Congress' annual fixes. The bill mustered only 47 of the 60 votes needed to bring it to the Senate floor.
The latest AMA ad focuses on seniors, veterans, and active military families, which are groups the AMA says will be hurt by physician payment cuts. A voice-over in the ad says: "Physicians who care for Medicare and TRICARE patients face a 21% cut, and seniors and military families will pay the price with fewer doctors and less access to the care they've earned."
"This ad is the opening salvo in our two-month campaign to urge the Senate to take immediate action to repeal the current Medicare physician payment formula and replace it with one that reflects the cost of providing care," Rohack said. "Congress can no longer put a Band-Aid on the problem by passing yet another short-term fix that creates instability in the system for seniors and their physicians. A permanent fix is crucial to building a solid foundation for health reform."
Five healthcare facilities in two counties near New York City have agreed to immediately stop dumping pharmaceutical waste into the city's watershed, the New York Attorney General's Office announced this week.
The five Putnam and Delaware county facilities named in the settlements are: O'Connor Hospital in Delhi; Margaretville Memorial Hospital; Mountainside Residential Care Center in Margaretville; Countryside Care Center in Delhi; and Putnam Nursing and Rehabilitation Center in Holmes.
Prosecutors say all five facilities cooperated with the investigation, and that the resulting agreements are the first to require the sources of pharmaceutical waste releases to end the risky disposal practice.
The five facilities are located within the New York City Watershed, an almost 2,000 square-mile area that drains into reservoirs and lakes providing drinking water to 8 million New York City residents and 1 million people in Westchester, Putnam, Ulster, and Orange counties.
Flushing waste pharmaceuticals allows for the release of painkillers, antibiotics, anti-depressants, hormones, and other waste drugs into the watershed—the drinking water supply for almost half the state's residents. State officials say that so far, only trace amounts of pharmaceuticals have been found in the New York City drinking water supply.
"Changing disposal practices begins with educating our healthcare workers, providing safe disposal options and enforcement of the law," said Adrienne Esposito, executive Director of Citizens Campaign for the Environment, which lauded the agreement. "When we fix our morning coffee, it should include sugar and milk, not Ritalin and antibiotics."
The settlements require that each of the healthcare facilities send their pharmaceutical waste to appropriate waste facilities. Each facility is required to take other specific steps to ensure safe disposal of pharmaceutical and other wastes in the watershed, including:
Ensuring that waste management practices, including those related to pharmaceutical waste, comply fully with all New York and federal laws and regulations related to waste management and clean water.
Paying civil penalties for past violations of law and costs incurred by the state in the investigation.
Implementing pharmaceutical "take back programs" to ensure the collection and proper disposal of pharmaceutical wastes generated by area households.
The AG's investigation found that the facilities' handling of pharmaceutical wastes and other wastes violated various provisions of the federal Resource Conservation and Recovery Act, and the federal Clean Water Act, according to the AG.
Two employees at Charleston (WV) Area Medical Center have been fired for reportedly refusing to receive hospital-mandated vaccinations against the seasonal flu virus, the hospital confirmed.
"Companies within the CAMC Health System employ more than 6,000 people. Nearly every one of them have been vaccinated as part of a new policy aimed at increasing the number of employees receiving the influenza vaccine," said CAMC spokesman Dale Witte, in a media release. "Only two employees decided to not be vaccinated and will no longer be permitted to work at CAMC."
The hospital did not identify the two employees, who were fired. Witte said CAMC was acting on the CDC recommendation that healthcare workers be vaccinated against influenza.
"CAMC is proud to be a leader in this important patient safety issue and therefore decided to make influenza vaccination mandatory to help prevent the spread of viral diseases as it does with other vaccinations," he said.
"Every employee is valuable. CAMC had hoped that it wouldn’t lose anyone by instituting this new policy," Witte said. "CAMC requires several vaccinations for employees to work at CAMC, and this is just another of those requirement to work at CAMC. CAMC is committed to providing the best care for its patients, and protecting them from the flu is an important part of that care."
In the last several months, hospitals across the nation have made the flu shots mandatory, and have threatened to fire employees who do not comply. In December, five employees at Children’s Hospital of Philadelphia were fired for refusing mandatory flu shots.
If passed as is, the Senate's current healthcare reform bill will put physician-owned hospitals on the endangered species list. Under the bill, physician-owned hospitals must meet a list of five "allowable growth criteria" if they want to continue receiving Medicare and Medicaid funding.
That doesn't sound horribly unreasonable until you learn that not one existing physician-owned hospital will be able to meet those criteria, says Molly Sandvig, Esq., executive director of Physician Hospitals of America (PHA), a Sioux Falls, SD-based advocacy group for the physician-owned hospital industry.
Some lawmakers are eager to put the kibosh on physician-owned hospitals because of a debate that has been raging in the field since physician-owned hospitals started cropping up in the 1990s. Opponents, including the American Hospital Association, believe that physician-owned hospitals enable physicians to perform unnecessary procedures so they can pocket more profit, says Terry Woodbeck, CEO of physician-owned Tulsa Spine & Specialty Hospitals.
Naysayers also fear that physicians with an ownership interest in a hospital will refuse to refer patients to other hospitals, even if doing so is in the best interest of patients.
Woodbeck disagrees with these arguments.
"Physicians live on physician referrals. If you get the reputation that you are a cutter, your referrals are going to dry up quickly and you are going to be nailed with a number of malpractice suits for doing unnecessary surgeries," he says.
Woodbeck adds that physician-owned hospitals provide some of the highest quality patient care in the country, and are a venue in which physicians and hospital administrators can align their financial interests to reduce the cost of care.
Regardless of the political motivations behind imposing growth restrictions on physician-owned hospitals, they will have a serious impact. Physician-owned hospitals that do not meet the five criteria would not be permitted to add beds and services to meet their communities' needs.
"If you can't grow and meet market demand, you become stagnant. You either sell your hospital, thus dissolving the physician-ownership model, or you go bankrupt," Sandvig explains.
In addition, if the bill passes as is, the percentage of physicians who have an ownership stake in any particular hospital will be chiseled in stone. For example, if 49% of a hospital is owned by physicians, the hospital would not be allowed to increase that number as of the date of the bill's passage.
Physician-owned hospitals that are currently under development will be grandfathered in if they are Medicare certified by August 1, 2010, but about 75 hospitals currently under development won't make the cut, says Sandvig. "These hospitals have steel in the ground, they are financed, and they have construction workers on site. There are over 25,000 construction and healthcare jobs that could be lost."
If physician-owned hospitals want to no longer receive funding from Medicare and Medicaid, they could grow unrestricted. However, that's not a feasible option for many physician-owned hospitals for whom Medicare and Medicaid constitute up to 40% of the bottom line.
"We don't want to be forced to pick our patients," says Sandvig. "The government is penalizing Medicare and Medicaid recipients at a time when hospitals are trying to figure out how to create greater access to quality care."
Another consequence of imposing growth limitations on physician-owned hospitals is that if they drop their Medicare and Medicaid coverage in favor of freedom to expand, they may be perceived by the public—particularly recipients of Medicare and Medicaid—as exclusive hospitals that are unwilling to greet patients who don't have bulging wallets. "It makes the physicians guilty of something that is imposed by the government," Sandvig says.
PHA is lobbying aggressively to convince lawmakers to amend the current bill and considering legal challenge, says Sandvig. "I'm not certain we will go forward with that at this point, but it is not out of the question."
The theft of 57 hard drives from a BlueCross BlueShield of Tennessee training facility last October has put at risk the private information of approximately 500,000 customers in at least 32 states, the insurer said this week in an investigation update.
The hard drives containing 1.3 million audio files and 300,000 video files related to coordination of care and eligibility telephone calls from providers and members were reportedly stolen from a leased office in a Chattanooga strip mall that once housed a BCBS of TN call center. The video files were images from computer screens of customer service representatives and the audio files were recorded phone conversations from Jan. 1, 2007 to Oct. 2, 2009.
The files contained customers' personal data and protected health information that was encoded but not encrypted, including:
Names and BlueCross ID numbers.
In some recordings–but not all—diagnostic information, date of birth, and/or a Social Security number. BCBS of TN estimates that the Social Security numbers of approximately 220,000 customers may be at risk.
"Law enforcement agencies working on the investigation of the theft are regularly monitoring activity on Web sites known to participate in illegal identity theft activities, as well as online marketplace and community networks. To date, there is no evidence any member's data has been accessed and used as a result of the theft," BCBS of TN said in a media announcement.
BCBS of TN had backup files of all stolen data and contracted Kroll, the risk consulting company, when the theft was discovered in October to review files and identify members whose personal information may be at risk. Due to the amount and types of the data involved, it is taking significant time to review each recording. BlueCross is working as quickly as possible to notify all affected members. As of Jan. 7, more than 110,000 hours were logged during this effort to identify members at-risk, the insurer said.
BCBS of TN has customers in 50 states. As of Jan. 8, the insurer had identified 32 states with 500 or more members whose data may be at risk. HHS, the State of Tennessee, and the attorney general's office and media in each state with 500 or more affected members have been notified about the theft, which is required by the Health Information Technology for Economic and Clinical Health Act. BCBS of TN has also placed a notice with all three credit bureaus regarding this theft.
Three levels of risk have been identified for those customers whose information may be at risk. Letters are being mailed to these current and former BlueCross customers explaining the level at which their personal information is at risk. They are being offered a variety of free services to mitigate the potential misuse of personal information.
Even as the health insurance lobby was publicly claiming to support healthcare reform last summer, the nation's largest insurers were reportedly funneling as much as $20 million through the U.S. Chamber of Commerce to fund attack TV ads to hobble the effort, National Journal reports this week.
That money came from Aetna, Cigna, Humana, Kaiser Foundation Health Plans, UnitedHealth Group, and Wellpoint, which are all members of the trade group America's Health Insurance Plans, according to two unnamed healthcare lobbyists sourced by the National Journal.
"The funds were solicited by AHIP and funneled to the U.S. Chamber of Commerce to help underwrite tens of millions of dollars of television ads by two business coalitions set up and subsidized by the chamber. Each insurer kicked in at least $1 million and some gave multimillion-dollar donations," the National Journal reported.
In a statement Wednesday, Robert Zirkelbach, press secretary for AHIP, said, "Reform needs to make healthcare more affordable, particularly for small businesses that struggle to provide coverage to their employees. We share the very serious concerns employers have raised about provisions that will increase health care costs, including new premium taxes that will hit small businesses hard. So when the employer community—our customers—asked us to contribute to their campaign, we readily agreed."
Chamber of Commerce officials did not immediately return calls from HealthLeaders Media seeking comment Wednesday. But in an e-mail message reported by the New York Times, Bruce Josten, executive vice president of government affairs for the chamber, wrote: "The chamber is fully engaged in the health care reform debate because it's critical to the future of our economy, and our members are the ones who pay for health care. We welcome any donors/funders to our efforts."
The report prompted an angry response from House Speaker Nancy Pelosi, D-CA. "These big insurance companies appear to have gotten caught secretly bankrolling the effort to kill health insurance reform for millions of Americans, despite their disingenuous claims of support for the legislation," Pelosi said in a media release. "This duplicity is not surprising coming from an industry that has used every method to try to kill health insurance reform that would save lives, save money, save jobs, and save Medicare."
Wendell Potter, a former communications director at CIGNA Corp., and now a leading critic of the healthcare industry, said he was not surprised, but still "outraged" by the National Journal report.
"It proves what I have been talking about since I switched from being a spokesman for the health insurance industry to being a vocal critic of it. The industry is laundering millions of dollars through third parties to influence the healthcare reform legislation and kill provisions that might hinder insurers' profits," said Potter, a senior health fellow at the Center for Media and Democracy.
St. Vincent Health System and HealthSouth Corp. have announced that they are expanding their joint venture, St. Vincent Rehabilitation Hospital, in Sherwood, AR.
The joint venture purchased a 23-bed St. Vincent Rehabilitation Hospital/Doctors, formerly operated by St. Vincent Infirmary Medical Center, which will now be operated under the joint venture and will be managed by HealthSouth, based in Birmingham, AL. The unit will be relocated to St. Vincent Infirmary Medical Center in Little Rock, AR, within the next two years.
"By combining the capabilities of St. Vincent Rehabilitation Hospital with those of the St. Vincent Doctors unit, we will be able to offer sophisticated inpatient rehabilitative care to both sides of the river," said Lee Frazier, CEO of St. Vincent's Rehabilitation Hospital/Doctors, in a media release.
St. Vincent Health System, based in Little Rock, is comprised of three hospitals, a network of primary care clinics, a home health agency, and numerous other ventures and entities. HealthSouth is the nation's largest provider of inpatient rehabilitative healthcare services, with operations in 26 states and Puerto Rico.
