September 15, 2004 Legislation

JCAHO

Hospitals 

Pain Meds

Physicians

Malpractice

JCAHO

Your close personal friends at the Joint have issued a new Sentinel Event Alert.  The alert concerns the prevention of Kernicterus, a good cause.  The recommendations are easy to do.  The documentation that they will require will cost the hospital money to comply.  That's OK since everyone know how much money hospitals are making off the uninsured. 

The Joint has also announced the magnitude of the raise for inspections.  It will be up 11.7% or $2700.  There will also be a separate fee of $3500 for hospitals over 200 beds for the cost of a certified healthcare engineer for the safety code deemed by the Joint.  Therefore the true raise will be 27% for the larger hospitals.      Top

Hospitals 

In the People's Republic the state had received multiple complaints about the care and delays in receiving that care at South Shore Hospital.  There was an investigation and in fact only two cases showed only minor violations.  The first was a documentation problem related to monitoring of pain and the second was the dispensing of a medication without a prescription.  The delays, according to the state, were not the hospital's fault but were state wide problems.  The state has had 1/3 of its EDs close in the last 25 years.   

In Spartanburg, NC, an area I recently visited, the Spartanburg Regional Med Center may face obstruction of justice charges.  The hospital probably got bad advice from its attorney and did not report a homicide that occurred at the hospital's behavioral medicine area until six days after the incident.  The hospital attorney has misread HIPAA and is using this as an excuse for not reporting the incident.      

The California Nurses Association is urging the Governor to sign a bill that would force all hospitals to have a lift team 24/7.  All hospitals except Kaiser have opposed the bill for obvious reasons of cost/benefit.  There really is no reason for the legislation as hospitals who are tired of paying large Workers Compensation claims can do what my hospitals did 15 years ago, purchase surgilifts.  These can be used by current personnel with little or no injury to their backs.  The legislation, as most bad laws, is a zero tolerance program. 

Marin General Hospital in California has been threatened with loss of Medicare certification.  This, of course, will not happen.  It is the only hospital for the majority of people in the county.  The hospital was deficient in medical records, dietetic services, pharmacy, infection control anesthesia and others.  This does not speak well of the Sutter run hospital. 

Speaking of Sutter, their Vallejo hospital was also in the tank for violations.  They have just learned how to swim by providing their new policies and procedures to the powers that be. 

The Tucson, Arizona, hospitals have begun a month long test of no diversions.  It will make no difference how crowded the ED is, the ambulance will not be diverted to another hospital.  This will hopefully lead to enlarging the EDs of the area. 

The Durham Regional Hospital had the patient jump from a window when he wasn't being observed.  Medicare and the State inspected them.  They put in new policies and all is forgiven by the agencies.   Top

Pain Meds

California has passed without a dissenting vote a new law that the Governor is expected to sign soon.  The law mandates that medical and law enforcement work together to set up protocols to prevent unwarranted arrests for prescribing pain meds.  Most of the high profile arrests now ruin the physician's life even though they are acquitted.  This would be great news for the 99.9% of the physicians who practice good medicine and want to treat pain correctly.  They do not want to live in fear of arrest by the authorities nor suit by the families. If this works it could serve as a basis for similar laws around the country.       Top

Physicians

Governor Schwarzenegger has vetoed a bill that would have allowed certain oral surgeons to do elective cosmetic procedures.  The Governor stated that the Department of Consumer Affairs should look into if the the oral surgeon's current training and education is enough to form an appropriate base for certification.        Top

Malpractice

In Connecticut, the home of many insurance companies, the Insurance Department had allowed the med mal insurance companies an increase in premiums of 90%.  The Department will now have an outside actuary relook at the approval.  The high increase was taken to the Department by the Trail Lawyers.  The Medical Association sat on its thumbs.  The decision will be forthcoming in about 8 weeks. 

In Illinois, the Governor may finally be getting a clue.  The Democrat has thwarted malpractice reform in the state.  The Governor realized that the issue may be a political one against his party in the upcoming election.  He wants the insurers, physicians and trial attorneys to resume negotiations.  This will come to naught.  Caps will not be negotiated say the trial lawyers.  This defeats the whole purpose of negotiations.       Top

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DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.