August 15, 2001

No Flood Related Hospital Sentinel Event

Boston Children's has Death 

Pennsylvania Blood Test Error

Kaiser Flip-Flops

Texas Tough on Insurers

Hospital Caves to A/G

Clinical Trials 

Seismic Deadline Looms

Patient's Bill of Rights

JCAHO

Physician Availability Act

Aetna Agreement

No Flood Related Hospital Sentinel Event

The Joint Commission has stated that Memorial Hermann Hospital's six deaths during the June, 2001 Houston flood were not sentinel events.  This was based on the newspaper articles and the investigation by the Medical Examiner.  All the deaths were unavoidable and not flood related.  The Commission has someone in Houston now looking at the other two hospitals that reported deaths during the flood, St. Luke's and Methodist.                            Top

Boston Children's Has Death

The death of a 13 month old child has drawn criticism from the Department of Health.  The child had a prior ventricular shunt and this needed replacement.  All operating rooms were full so the team decided they could wait until the next morning.  She became comatose and in spite of emergency surgery died. The senior attending physician fell asleep with his pager on vibrate and did not awake.  The remainder of the team were less experienced physicians.  The blood carbon dioxide was not written in the chart and was well off the normal range.  The hospital is looking at the systems that failed and how the incident might have been prevented. I am sure the JCAHO will also look into this sentinel event at the Best Children's Hospital in the country as will the legal system.                            Top

Pennsylvania Blood Test Error

St. Agnes Hospital erred in their calculation of patient's INR.  this caused problems for over 900 patients.  The State is not happy since they believe that if all the regs had been followed no problem would have occurred.  There was a wrong number placed in the INR formula.                             Top

Kaiser Flip-Flops

Kaiser originally backed a proposal to go from 10:1 nurse staffing wanted by other California hospitals to a 4:1 ratio over five years.  Now Kaiser states they want a delay  since they have about 1000 staff openings.  The new regs with a yet an undetermined staff ratio is to go into effect in January 2002. Kaiser now states the filling of the short positions plus the newly mandated positions will cost the HMO over $200 million. Now the HMO is spending $100 million for traveling and registry nurses.  Open mouth, Insert Foot!                            Top

Texas Tough on Insurers

Texas insurers have agreed to pay fines to the State totally $9.2 million and millions more to providers.  This stems from late payments and is the Governor's way of defending his veto of a law that would have allowed the providers to sue insurers under the 1999 law.  The Governor's spin doctors, who are paid promptly, state that this is not a reaction to the veto.  The real physicians wonder where the Department of Insurance was for the past several years.            Top

Hospital Caves to A/G

The Community Hospital Board of Directors showed lack of spine when they caved to the threats of the Attorney General. The Board cut health services to illegal aliens living in the community.  They put their own well-being ahead of the community they are to serve.  The Board's attorney told the Board that they may be prosecuted if they do not stop providing non-emergent care to the illegals.  The only legal care that may be provided is emergency room, immunizations and treatment for communicable diseases and child abuse.   

However, Harris County attorneys have stated the state attorney general is "flat wrong."  The attorneys state the law only prohibits hospitals from being forced to give care to illegal aliens, not are prohibited from doing so voluntarily. The attorneys also state the federal law relied on by the attorney general states no penalties.  The controversy continues.   Top

Clinical Trials

California has just passed the the Governor has signed a law requiring insurance companies to cover all cancer patient clinical trial costs.  This includes tests, physician visits, hospitalizations and drugs for the clinical trials.  The MCOs were on board with this and there was virtually no opposition.               Top

Seismic Deadline Looms

California hospitals must be seismic retrofitted by 2008 or completely rebuilt by 2030.  If not, they are history.  This is expected to cost about $24 billion, at a time of dropping reimbursements and the unknown future hospital configurations , a no win situation.  In the Bay Area alone the job is huge.  Of the largest hospitals Mills leads the pack with 15 of 16 buildings needing upgrading.  This is followed by CPMC where 14 0f 19 need the work.  The best of the large hospitals is Alta Bates, John Muir/ Mt. Diablo and Stanford that only require about 20% of their buildings upgraded.                Top

Patient's Bill of Rights

As all know, the House and Senate have each passed their version of a Bill of Rights. All agree on the important aspects.  The hang-ups are in the way to enforce.  Now the states are entering the fray.  Many states have their own laws to protect consumers.  The states fear that the new law if ever passed may preempt their laws, which may be more stringent.  The way to take care of this is to place in the bill, as with HIPAA, that the more stringent protections between the state and the bill hold.                              Top

JCAHO

The Joint Commission has issued yet another rule.  This one MS.2.6 requires med staff regs on the supervision of residents.  The supervisors must hold unsupervised privileges in the patient care aspects they are supervising.  There must also be a mechanism of communication between the education committee and the medical staff and governing board.  More common sense rules that are probably not needed.        Top

Physician Availability Act

In yet another unfunded regulation Rep. Visclosky (D-Ind) has sponsored a bill mandating a non-emergency room physician be available 24/7 in hospitals with over 100 beds.  The IG would monitor and there would be a warning for the first offense, and a civil fine of not more than $100,000 plus a plan of correction within 30 days for the second offense.  The bill is now in the Energy and Commerce Committee (HR 1399).  Hopefully, it will die there.                        Top

Aetna Agreement

Aetna has reached an agreement with the 25 New York hospitals that sued the organization for either not paying claims or paying in a tardy manner.  No settlement amounts were announced but I would assume Aetna paid what they should have plus interest and legal fees.  I wonder which is more money what they paid or the time value of money?                        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.