Category: Norton Kosair Children’s Hospital

Changes Coming to Downtown Louisville for KentuckyOne Health.

Not so bad so far!

I have been scanning the usual media outlets for some clue about what went on at the Tuesday institutional town meetings that Jewish Hospital announced publicly last week. I am finding nothing, nor have I any idea what was discussed.  I have a feeling that if something big had been revealed, that we would have heard of it by now. KentuckyOne and the University of Louisville continue to keep the lid on pretty tight.

What I did find was a YouTube video message from KentuckyOne’s CEO, Ruth Brinkley. It contained nothing particularly surprising or controversial. Its principal function appeared to be to calm employee anxieties that arise naturally during rapid institutional change. It begins by telling the “good news” that half of the $218 million budget deficit has been made up through the hard work and sacrifice of employees, although no details are offered. It restates the obvious, that major change takes time and is difficult. Employees were told that no further large-scale layoffs were anticipated.

Patient referrals and provider recruitment.
Other successes announced include increased referrals to system physicians and mid-level primary care providers through the “Anywhere Care” tele-health initiative or from referrals through HealthGrades. Fifty-eight new primary care providers of a variety of professions have been added to the network.

Employees are told they can help by speaking well of and conveying their pride in the organization to their family and friends. They are urged to select KentuckyOne primary care providers. Suggestions for cost-saving measures from employees are solicited with special recognition awarded for measures that are adopted. Much of the rest of the message is a restatement of the goals of the organization including improving the health of Kentuckians. It is noted that the challenges still facing KentuckyOne are not unique to it. [I agree.] Continue reading “Changes Coming to Downtown Louisville for KentuckyOne Health.”

Troubles Persist at King’s Daughters Hospital.

Settlement proceedings with federal agencies ongoing.

A measure of the difficulty facing our Louisville Hospitals.

Last March I gave an update on the struggle of King’s Daughters Hospital in Ashland, KY to recover from the abrupt decrease in patient volume and income following the disclosure of a Federal investigation of their cardiac program. Several years of financial boom and building turned into a bust of multi-million dollar losses and a downgrading of their bond rating. A paragraph in their FY2013 Audit led me (and pretty much everyone else) to believe that the hospital had reached a settlement with the Department of Justice and Inspector Generals’ offices. My efforts to obtain a copy of the settlement from Kentucky authorities was unfruitful despite apparent cooperation with my request. A report in today’s Modern Healthcare gives the reason why as well as an interim financial update.

The jury is still out!
In fact, settlement discussions were indeed in progress but are not final. The $48.9 million mentioned in the footnote of the audit referred to a reserve set aside to cover any fine and associated legal costs. The Hospital corrected the misleading language.

“Standard accounting principles require a reserve be set to reflect potential exposure for legal matters once the amount can be reasonably determined. Unfortunately this accrual was reflected in the audit footnote disclosure as though a final settlement agreement had been executed. While it is true King’s Daughters has been in ongoing negotiations with the Department of Justice, a final settlement has not occurred. King’s Daughters will update this notice if a final settlement with the Department of Justice is reached.”

Ongoing losses despite some improvements.
As of March 2014 the hospital reported a 13.5% decrease in admissions and a 15.2% decline in patient days for the year. Meaningful savings in operating expenses were won and the state’s expanded Medicaid program led to a decrease in “self-pay” uninsured patients. These gains were lost to unspecified severance benefits, and consultant and legal fees. The hospital, like others, continues to pay a heavy price for its alleged angioplasty-misadventures. Continue reading “Troubles Persist at King’s Daughters Hospital.”

Yet Another Lawsuit over Norton-Kosair Children’s Hospital.

Kosair Charities sues Norton Healthcare over alleged contractual breach.

Breaking News 7:20 p.m.

It has been a while since I’ve written anything about the painful marital difficulties between the University of Louisville and Norton Healthcare over the custody their child, Norton-Kosair Children’s Hospital. Frankly I did not have much new information and I did not want to fan the flames while the court-ordered mediation of last February played out. I was getting nervous when even a few weeks ago I learned that a mediator had not yet even been appointed.

The latest broadside in this drama comes as Kosair Charities joins the fray in a lawsuit against Norton Healthcare claiming among other things that Norton is using its Kosair name and monies in violation of earlier agreements. To add insult to supposed injury, Kosair Charities claims that despite its financial support, the performance of Kosair Children’s Hospital lags behind that of its peers in the region and elsewhere. (Of course, such a criticism would then also apply to the University of Louisville which provides much of the professional support of the hospital.) Naturally, the claims expressed by one party in a lawsuit represent only one side of the story.

Shifting Alliances? An Invisible Hand?
If it weren’t so painful, I might extend my simile of domestic discord to suggest that a home-wrecker might be involved. Can anyone confirm the whispers in my ear that UofL is seriously courting Kosair Charities this Derby season?  [It was true.]  Of course there is nothing wrong with courting potential donors to the University– UofL does that at its own sporting events all the time.[Your sports and education dollars at work for University lobbying.] I used to help arrange such things. However, at a time when there is an as yet unresolved attempt to seize control of Norton-Kosair Children’s Hospital by the University of Louisville, and with a contractual agreement to shift the University’s pediatric relationship to KentuckyOne Health in the background, the possibility of a change in allegiance of this significant third-party sponsor of the Hospital is destabilizing to say the least. My head spins at the complexity. Our community deserves to understand what is happening. After all, the monies Kosair Charities or Norton Children’s Hospital Foundation collects comes out of our pockets and is raised in support of a trusted community resource. How many families among us have not spent some of the most difficult hours of our lives in the wards and clinics of Norton-Kosair Hospital– and been grateful. Continue reading “Yet Another Lawsuit over Norton-Kosair Children’s Hospital.”

Pediatric Cardiac Surgery in Kentucky Revisited.

University Presidents speak about cooperation.red-blue-heart

A month ago, I wrote about issues concerning the pediatric cardiac surgery program at Kentucky Children’s Hospital in Lexington. That institution, part of the University of Kentucky’s University Hospital programs, was receiving much adverse publicity about allegedly poor mortality rates for cardiac surgery for pediatric congenital heart disorders. The institution temporarily suspended that surgery program and conducted an intensive in-house review emphasizing plans for the future.

My article was seen by Elizabeth Cohen, Senior Medical Correspondent for CNN who had been following the story. She asked me to respond to several questions. Because I believe the matter is relevant to health policy in Kentucky, I present here the responses I offered with some minor edits. Continue reading “Pediatric Cardiac Surgery in Kentucky Revisited.”