Beginning last Thursday, word began trickling out to journalists and the public that KentuckyOne Health, a major regional unit of Catholic Health Initiatives (CHI), was preparing to announce plans to sell almost all its hospitals and medical centers in Louisville and a handful elsewhere in the state. I had been told earlier in the week that the announcement would be made today, Monday, but there were so many leaks that KentuckyOne sent an email to its employees outlining its plans. I presume KentuckyOne wanted take control of the message before the reportage dam broke. The email can be read here.
For those of us in Louisville, the only major facility not being sold is Our Lady of Peace, a psychiatric hospital. Both of KentuckyOne’s acute care hospitals, (Jewish Hospital and Sts. Mary and Elizabeth Hospital), the Frazier Rehabilitation Institute, and all four outpatient Medical Centers (Jewish East, South, Southwest, and Northeast) are on the chopping block. Nearby Jewish Hospital Shelbyville, which recently underwent a critical review by the Inspector General for an EMTALA violation, is also for sale. KentuckyOne employs many physicians. The fate of individual owned- or contracted medical practices in Louisville and elsewhere is not clear to me from the email. Continue reading “KentuckyOne Health To Sell Its Major Assets In Louisville.”
A number of threads that I have been following this past year or so came to a head this last month. These include a guilty verdict in federal court for a cardiologist in Ashland, Kentucky who had been accused of falsifying billing records to secure payment for performing medically unnecessary invasive procedures. The Leapfrog organization published its updated list of hospital safety grades. Additionally, and certainly not least, there are worsening signs of a dysfunctional and perhaps disintegrating relationship between the University of Louisville and KentuckyOne Health, the unit of Catholic Health Initiatives (CHI) that in Louisville owns Jewish and Sts. Mary and Elizabeth Hospitals, and manages the University of Louisville Hospital and its James Graham Brown Cancer Center. Although these themes are not necessarily unrelated to each other, in this article I will comment on the UofL/KentuckyOne situation and deal with others subsequently. First some background for what promises to be a major change in the alignments of the downtown medical center. Continue reading “What Is Happening To Our Downtown Louisville Medical Center?”
I have been advised by two sources that KentuckyOne Health will soon announce the elimination of several system-wide or senior executive positions designed to improve efficiency, reduce costs, and emphasize local leadership. The as-yet unconfirmed names of the individuals currently in those positions include clinical and operational executives at the highest level. I am unaware if the names of included leadership comprise a complete list or represent the tip of the iceberg of things to come. Perhaps as an early indicator, the senior physician executive at Jewish and Sts. Mary & Elisabeth Hospitals left that position a few weeks ago. As a company outsider, it is impossible to know all the reasons for changes in personnel. These often include the personal career plans of the employee, but also concerns about the fit between employer and employee in meeting the goals of the particular corporation. KentuckyOne may well once again be feeling financial pressures that cannot be denied. It has laid-off employees in the past to decrease expenses – a strategy that in the longer run was not entirely successful at University Hospital.
On the other hand.
One of the most common complaints I hear from my University of Louisville colleagues reflects what is considered to be unwanted and disruptive outsourcing or other “outsider intrusion” on the part of Catholic Health Initiatives or KentuckyOne management that does not allow for appropriate local initiative or control, or which treats all hospitals the same no matter where they are located, or fails to acknowledge the particular needs of their patient population. From this perspective, a diminution of the role of system-wide executives might be considered a worthwhile result. On the other hand, I suppose it is possible that a state-level KentuckyOne system control might be replaced by even more direct CHI control from Colorado! The desire for local control is, however, at odds with current national and local policy, or financial pressures for hospital and health system consolidation and coordination. The health of KentuckyOne and its partnership with the University of Louisville is a matter of critical concern for Jefferson County and the Commonwealth. Things have not been going well so far. Continue reading “KentuckyOne Poised To Announce Layoffs of Senior Executives.”
Revenge of the Aztecs- Part II
Lessons and challenges from the outbreak of Zika virus.
Although it was discovered 69 years ago in the Zika Forest of Uganda, even as a physician I had not previously known of the Zika virus. I first read about it a month ago in the daily two-page news brief on a cruise ship as it left the harbor of San Juan, Puerto Rico – one of the very places we were now warned by pubic health authorities to avoid! Additional concern was generated by the fact that our cruise itinerary included two other islands in the Caribbean where the disease was breaking out.
The Zika virus belongs to the flavivirus family which includes Yellow Fever, West Nile Virus, and Dengue – serious players. It did not help matters that I had lost a friend to hemorrhagic Dengue fever on the Caribbean island of St. Croix a few years earlier. Like its sister viruses, Zika appeared to be transmitted primarily by mosquitoes carrying blood from one bitten person to another – the usual mechanism of arthropod vector transmission.
Where did it come from?
Although the primary infection itself may be asymptomatic, Zika’s usual symptoms are relatively mild and include fever, headache, joint pains, and conjunctivitis (red-eye). The first well documented epidemic of Zika in humans occurred on the Pacific island of Yap in 2007, and then in French Polynesia in 2013. Impressive was the high proportion of individuals infected. On the French islands, a possible connection was made to an increased incidence of the reactive and probably auto-immune Guillain-Barré syndrome which can cause life-threatening paralysis by attacking the nervous system . In 2015, some traveler, perhaps attending a world cup soccer match, probably brought the virus to South America where it exploded to infect over a million individuals so far. Additional millions are expected to become ill as the epidemic runs its course. Public anxiety and my own was amplified by the fact that so little is known about the disease and its natural history. Continue reading “A Herd of Humans – A Murder of Mosquitoes.”