Showing posts with label Hospitals. Show all posts
Showing posts with label Hospitals. Show all posts

October 19, 2017

A Navy Hospital Ship Sits in Puerto Rico Mostly Empty While Hospitals Go Without

A floating state-of-the-art hospital is anchored off the coast of hurricane-ravaged Puerto Rico, but those in need are struggling to board the ship.

The Navy hospital ship Comfort has 250 beds for patients on the island shut out by clinics without supplies and other facilities lacking electricity.
But only 33 of those beds — about 13% — have been filled in the two weeks since the ship arrived, CNN reported.

“I know we have the capacity,” the Comfort’s mission commander and Capt. Kevin Robinson told the news station. “I know that we have the capability to help. What the situation on the ground is . . . that’s not in my lane to make a decision.” Puerto Rico Gov. Ricardo Rossello told CNN the problem is rooted in “the communication flow” between doctors and the territory’s Department of Health, which is tasked with referring patients to the ship. Hospitals said they were unaware what standards patients need to meet in order to board the medical facility.

“I asked for a complete revision of that so that we can start sending more patients over there,” Rossello said.

The hospital ship was deployed as part of the federal response to Hurricane Maria, which left the 3.4 million American citizens on the U.S. territory without power. Residents also face water and food shortages as well as ongoing health risks. Almost a month after the hurricane made landfall as a Category 4 storm, 86% of Puerto Rico is still without electricity and nearly 30% of residents do not have access to drinking water. Most cell towers and antennas are also still down.

The hospital did welcome one new patient Saturday — a baby girl who was born on the ship.
“I never thought that our special moment would happen here on this ship,” Sara’s father, Francisco Llull Vera, said in a statement Sunday. “Everyone has been so helpful and gentle while caring for our baby. I hope this opens the door for those who still need help to seek out the Comfort.” 

New York Daily News

More from CNN                           

 A floating hospital could help desperate patients in Puerto Rico, but nobody knows how to get there.

Clinics on the island have been overwhelmed with patients since Hurricane Maria made landfall there, but patients and staff say they’re not sure how to start sending sick people over. The ship, the USNS Comfort, is sitting right offshore with just 13 percent of its 250 beds in use nearly two weeks after it arrived.

The Comfort was deployed to Puerto Rico as a part of the US federal response to the storm, which devastated the island and left hospitals vulnerable to power outages, limited water supplies, and food shortages.

The Puerto Rico Department of Health gets to decide which patients can get care aboard the Comfort, but referrals have been minimal so far.

Ricardo Rosselló, the governor of the island, told CNN that the issue was not because of a lack of infrastructure, or physical means of getting patients to the ship.

“The disconnect or the apparent disconnect was in the communications flow,” Mr. Rosselló said. “I asked for a complete revision of that so that we can now start sending more patients over there.”

For doctors and care providers working in clinics and hospitals running on generators, speeding up the process could mean life or death for patients. While the official death toll has crept up to 48 so far, reports from the island indicate that people have been dying in hospitals as doctors run out of medication or fuel from generators, leaving people who rely on oxygen, or dialysis, at risk.

As of Sunday, 85 percent of the island still lacked power.

Captain Kevin Robinson, the mission commander aboard the Comfort, told CNN that help is waiting for those in need. The ship has 250 beds, and just 33 of them are in use.

*Headlines about P.R.

*San Juan mayor sends public plea to Trump over Puerto Rico crisis
*Jennifer Aniston has donated $1 million to Puerto Rico
*Trump's popularity dives after lackluster Puerto Rico response
*Donald Trump launches fresh attack on Puerto Rico
“I know that we have the capacity. I know that we have the capacity to help. What the situation on the ground is… that’s not in my lane to make a decision,” Mr. Robinson said. “Every time we’ve been tasked by [Puerto Rico’s] medical operation center to respond or bring a patient on, we have responded.”

"The military and every department in the Federal government have only one head over others, one commander, one channel of orders coming from the very top. Particularly the military, trained to go by the rules of engagement or operation. They need precise orders and they need the authorization of money to take on tasks that they have not been financially preauthorized.  You can't order the navy to go and help someone without making it possible for those orders to be enforced. You can't also say do it today and tomorrow you say something contradicting.
You know who the commander is. He was elected by our Electoral college system, which still stays as the law of the land and it will remain so as long as we have one political party controlling everything that comes down from Washington DC and wants to keep the status quo on the system that gave them a victory the last time around."   Adam Gonzalez 

August 13, 2017

60 Children Die in India's Hospital Because It Ran Out Of Oxygen

Thirty children have died at a public hospital in India over the past two days, with government critics blaming a shortage of oxygen after a supplier of liquid oxygen cut off deliveries because of unpaid bills.

Government officials were scurrying to explain what had happened, admitting that the state-run hospital owed more than $50,000 to a supplier of liquid oxygen and that oxygen supplies had been “disrupted.”

“There was some payment issue to the oxygen supplier, and there was a shortage of liquid oxygen,” said Anil Kumar, the commissioner of the city of Gorakhpur. But, he added, “those deaths were not due to lack of oxygen.”

Other officials said the hospital had a backup oxygen supply, though they did not explain why so many children had died in such a short time. Since Monday, a total of 60 children have died at the hospital, many from acute encephalitis and others in the neonatal unit.

The hospital, Baba Raghav Das Medical College, is in Gorakhpur, several hundred miles east of New Delhi, India’s capital. It is the rainy season in India when officials say it is not unusual for as many as 10 children to die there every day from Japanese encephalitis, a mosquito-borne disease. 

While the cause of the deaths remained unexplained — by officials, at least — India’s health care system is often unsparing when it comes to payments. This week, Indian newspapers carried an account of a man who suffered a severe head injury in a motorcycle accident and was turned away from half a dozen hospitals, apparently after they determined he would not be able to pay his bills.

The man was a poor farmhand, and the ambulance driver trying to help him said hospital officials turned the victim away after asking about his financial background. For seven hours, the man was driven from hospital to hospital before arriving at a government one, where he was declared dead on arrival. 

You agree to receive occasional updates and special offers for The New York Times's products and services. 
Government officials said that by Friday morning, they had found new supplies of oxygen for the hospital.

Opposition politicians instantly seized on the deaths, calling the government insensitive. “The state government is responsible for the deaths,” said Raj Babbar, a leading opposition figure. “How can there be a shortage of oxygen?”

Other opposition leaders demanded that the government pay $30,000 to compensate each family. Next week is India’s 70th anniversary of independence from Britain, and some scholars made the connection.

“This is not a tragedy. It’s a massacre,” said Kailash Satyarthi, a children’s rights advocate and winner of the Nobel Peace Prize. “Is this what 70 years of freedom means for our children?”

Mothers get the news. The cause was not even known right away, so many deaths got someone suspicious who investigated

Adamfoxie*blog asks, where was the money to make sure something as basic as oxygen will be in good supplies at all hospitals in India? Even Ambulances' are assumed to carry oxygen there, may be not. When in the United States there are budgetary cuts it is the hospitals, schools, food program and all those things that middle and poor people need. The rich have their own sources to get what they want and need and don't wait for the government for not much except tax cuts. Where does the money cut from all those above mentioned go?  The money is always there is just how it is allocated. In the US like in India and others, to the military. 

Certain bombs cost as much as a million dollars each. We also spend a lot of money in increasing the amount we can destroy the world over. 50 times sometimes is not enough if the President is bragging to the Russians and 100 may sound better sounds better (my numbers), now is not millions but Trillions.

In India, like in the US, it works the same way. I invite you to read the news that came along from India from Reuters as we got the news about the dead children:

NEW DELHI (Reuters) - India's military has increased operational readiness along the eastern Indian border with China, sources said, as neither side shows any sign of backing off from a face-off in a remote Himalayan region near their disputed frontier.

Indian and Chinese troops have been embroiled in the seven-week confrontation on the Doklam plateau, claimed by both China and India's tiny ally, Bhutan.

The sources, who were briefed on the deployment, said they did not expect the tensions, involving about 300 soldiers on each side standing a few hundred feet apart, to escalate into a conflict between the nuclear-armed neighbors, who fought a brief but bloody border war in 1962.

But the military alert level had been raised as a matter of caution, two sources in New Delhi and in the eastern state of Sikkim told Reuters on the condition of anonymity because of the sensitivity of the matter.

The crisis began in June when a Chinese construction crew was found to be trying to extend a road in the Doklam region that both China and the mountainous nation of Bhutan claim as theirs.

India, which has special ties with Bhutan, sent its troops to stop the construction, igniting anger in Beijing which said New Delhi had no business to intervene, and demanded a unilateral troop withdrawal.

Prime Minister Narendra Modi's administration, though, has dug in its heels and said that the Chinese road activity in the region near the borders of India, Bhutan and China was a threat to the security of its own northeast region.


October 17, 2014

Ebola Crisis: Hospital Says Sorry


The top doctor at the Texas hospital where an Ebola patient infected two nurses before dying has apologised for its failure to diagnose him promptly.
Dr Daniel Varga of Texas Health Presbyterian Hospital told a congressional panel it remained unclear how the nurses caught the disease.
Congressmen are questioning public health officials about the threat of an Ebola outbreak in the US.
The epidemic has killed more than 4,000 people, almost all in West Africa.
The World Health Organization (WHO) has said it will "ramp up" efforts to prevent Ebola spreading beyond the three countries most affected by the deadly virus - Guinea, Liberia and Sierra Leone.
Fifteen African countries are being prioritised, top WHO official Isabelle Nuttall told a news conference in Geneva. They will receive more help in areas including prevention and protection. 
Also on Thursday, US President Barack Obama authorised the calling-up of National Guard troops and reserves, if necessary, to fight the spread of Ebola. 
Nearly 4,000 US troops are being sent to West Africa to assist in containing the virus, mainly by building treatment units.
Hazmat workers help each other put on protective clothing before entering The Village Bend East apartment complex where a second health care worker who has tested positive for the Ebola virus resides on October 16, 2014 in Dallas, Texas.Hazmat workers prepare to clean the apartment of the second nurse infected
At the sceneLaura Trevelyan, Dallas, Texas
At Dallas-Fort Worth Airport, a young couple embrace in arrivals and leave for the city centre discussing the case of Nina Pham, the Dallas nurse infected with Ebola who cared for Thomas Eric Duncan. How could it happen here, they ask in wonder. 
There's a pervasive sense of unease about the Ebola virus in the midst of this prosperous city. Three schools have closed temporarily because two of the pupils were on the same flight as nurse Amber Vinson on Monday night - she has become the second nurse to contract Ebola from Duncan and the CDC want to trace all 132 people on the plane.
And faith in Texas Health Presbyterian Hospital Dallas has been shaken - this prestigious institution, favoured by the wealthy of Dallas for their healthcare, has had to apologise for failing to diagnose Ebola symptoms in Mr Duncan.
A hospital nurse told NBC News this morning she could no longer defend the hospital at all.
In Washington DC on Thursday, a panel of the House of Representatives energy and commerce committee questioned senior public health officials about the threat of Ebola to the US.
Witnesses included Centers for Disease Control and Prevention (CDC) director Dr Thomas Frieden, Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Dr Varga, chief clinical officer at Texas Health Resources, the parent company of Texas Health Presbyterian Hospital in Dallas.
In prepared testimony, Dr Varga acknowledged medical staff at Texas Health Presbyterian Hospital erred in sending Duncan home after he arrived on 25 September with a fever, despite him telling them he had come from Liberia.
Duncan returned to hospital on 28 September, was officially diagnosed with Ebola two days later, and died on 8 October.
Dr Varga said: "We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry."
The hearing came a day after a second nurse who treated Liberian national Thomas Eric Duncan, Amber Vinson, was diagnosed with Ebola. 
It's unclear how her and the other nurse, Nina Pham, contracted the virus while using protective clothing. Ebola.
The House panel questioned health officials over protection for health workers
Centers for Disease Control and Prevention (CDC) Director Dr Tom Frieden, left, prepares to testify on Capitol Hill in Washington 16 October 2014
A national nurses' union has suggested infection control procedures were lacking and the nurses were not sufficiently trained.
Dr Varga admitted under questioning his hospital's staff had received information about Ebola response but had no training before Duncan's arrival.
The CDC has come under fire for allowing Ms Vinson to fly on a commercial aeroplane to Dallas from Cleveland, Ohio, the day before she fell ill with Ebola.
Dr Frieden on Thursday said, "My understanding is she reported no symptoms."
Amber Vinson -undated photoAmber Vinson travelled on an aeroplane before showing symptoms
Nina Pham is reportedly in a good condition and is being transferred to the National Institutes of Health in the US state of Maryland.
Senior Republican congressmen on the panel called for a travel ban from what one described as the Ebola "hot zones".
They rejected public health officials' insistence that such a move would only isolate the affected countries and hinder efforts to stanch the outbreak there.
New US Ebola control measures
  • A "site manager" will supervise how workers at the Texas Health Presbyterian Hospital put on and take off protective clothing
  • Two nurses from Emory University Hospital in Atlanta will offer "enhanced training" in Dallas
  • An immediate response team will travel to the site of any future Ebola diagnoses to hit the ground "within hours"
  • New guidelines for testing at hospitals throughout the US, with special emphasis on asking questions about travel history 
Duncan was not symptomatic when he arrived in Dallas from Liberia in September, but reportedly failed to tell authorities prior to his departure that he had had contact with an Ebola patient.
  Can it Spread to US?
The US is now screening passengers arriving from the three countries most affected - Liberia, Sierra Leone and Guinea - at multiple airports.
On Wednesday, Mr Obama said the risk of Americans getting the virus was still "extremely low", but ordered "much more aggressive response", including increased CDC involvement.
In other developments on Thursday:
  • A Spanish healthcare worker, who came into contact with a nurse already infected, is being tested for the virus
  • An Air France passenger with a high fever, reportedly from Nigeria, is to be examined in hospital for Ebola symptoms after arriving in Madrid from Paris
  • UN Secretary-General Ban Ki-moon said just $100,000 dollars had been given to a UN Ebola trust fund which needed $1bn
  • World Bank President Jim Yong Kim warned against imposing “travel restrictions on the whole world”

November 15, 2013

Same Sex Partner is being Kept From Partner’s Hospital Room by Mom

INDIANAPOLIS — A woman says she can't visit herunconscious same-sex partner in a local hospital because the partner's mother has banned her from the room.
Sarah Bray, 34, says her partner was taken Wednesday morning to Franciscan St. Francis Health-Indianapolis after a drug overdose. Bray says she was able to visit her partner until her partner's mother arrived and ordered her to leave.
"This is a clear violation of LGBT hospital visitation rights," David Stevens, a spokesman for GetEqual Indiana, said about the rights of lesbian, gay, bisexual and transgendered individuals. Bray reached out to Stevens' group about her concerns.
The case raises complicated questions about hospital visitation rights, especially for same-sex partners. Gay rights advocates argue that Bray's rights are being violated. But legal experts consulted by The Indianapolis Star say not enough details are known to determine whether the hospital is discriminating against her by allowing Bray to be banned from the room.
A memorandum signed by President Barack Obama in 2010 extends hospital visitation rights to same-sex partners at hospitals that accept Medicare and Medicaid — even in states such as Indiana that don't recognize same-sex partnerships. It also extends patient care decisions to same-sex partners if they have been designated as the next-of-kin representative.
The patient typically determines who that next-of-kin representative is. But in cases such as the St. Francis one, in which the patient can't voice that choice, doctors ultimately have the power to decide.
In either case, legal experts say, a next-of-kin representative must make a strong argument to ban someone from visiting a patient, such as concerns over disruption or harm to the patient.
"You'd have to have a good reason," said Jennifer A. Drobac, a professor of law at the Indiana University Robert H. McKinney School of Law in Indianapolis. "It would have to boil down to a medically necessary decision."
Banning someone simply because of animosity or disapproval of an individual — which Bray says is happening in her partner's case — isn't a strong enough argument, Drobac said.
"That clearly is discrimination," she said.
Joe Stuteville, a hospital spokesman, acknowledged that the hospital usually gives the upper hand to a patient's next-of-kin representative to determine who can or can't visit. "Without having the specifics on this case," he said, "I can only say we do not discriminate. We understand end-of-life issues."
Bray said her two sons, 10 and 12, discovered her partner facedown on a bathroom floor, foaming at the mouth, about 6 a.m. Wednesday. Bray said her partner had overdosed on several medications in what she believes to be a suicide attempt. The Star generally does not identify people who attempt suicide.
About 6:45 a.m., Bray's partner, who is an employee of St. Francis, was taken by ambulance to the hospital, where Bray was able to visit her for about an hour. That is when Bray called her partner's mother to alert her of the incident. Bray's sons then arrived and visited her partner for several minutes, crying and hugging her. However, Bray said, when her partner's mother arrived, she ordered the three of them out of the room.
Bray said she hasn't been allowed to see her partner since, claiming that the hospital sided with her partner's mother's wishes to keep her away. Bray said her partner's mother does not support their relationship, which is why the mother didn't want her in the room. When reached by phone Wednesday for comment, the patient's mother said, "We're not interested," and hung up.
"She's playing with the wrong person," Bray said, "because I know that I have rights, and I'm going to fight for those rights no matter what."
David Orentlicher, a professor at the IU law school, acknowledged that arguments between families and partners can make things tricky.
"Sometimes you have situations where the person that is closest by blood or marriage is not necessarily the best representative for the person," Orentlicher said. Those cases, he said, are more subjective when a doctor ultimately decides whether someone else fits the bill.
Stuteville, the hospital spokesman, said cases in which families and partners disagree do not happen often.
"It is rare," he said. "In the end, we think families and friends come together in terms of end-of-life care."
Bray and her partner have been together since May but have known each other for nearly 13 years. The two plan to marry in Iowa next month and picked out rings Tuesday, Bray said.

January 24, 2013

Catholic Hosp. in Lawsuit Uses “Fetuses' Not A Person Defense"


 A Catholic hospital embroiled in a lawsuit involving the death of twin fetuses is arguing that they should not be held responsible for the death of the unborn children because "a fetus is not a person”. 
The defense stems from a wrongful death lawsuit brought against Catholic Health Initiatives.
On January 1, 2006, thirty-one-year-old Lori Stodghill began experiencing shortness of breath and vomiting. Being 7-months pregnant with twins, she contacted her obstetrician, Dr. Pelham Staples, who told her to go to the emergency room (ER) at St. Thomas More hospital in Cañon City, CO. Her husband, Jeremy, took her to the emergency room and left her with the admitting staff while he parked the car. When he arrived back in the ER, he found Stodghill unconscious with a nurse rubbing her chest and telling her to "wake up".

The emergency room staff frantically tried to revive Stodghill while also paging Staples, who was the on call obstetrician for the evening, as well as Stodghill's doctor. Staples never came to the hospital, but he did speak to Jeremy on the phone. Jeremy told Westword:
"He said, 'Well, what do you want to do? Take the babies? Take the babies? "I kept responding, 'I'm not a doctor!'"
An ER nurse checked for fetal heartbeats, but could not find any. ER doctors assumed the twins were dead and decided against doing a perimortem Cesarean section, an emergency procedure that can save both the lives of mothers and babies in some instances. Stodghill eventually died of a massive heart attack after the main artery leading to her lungs clogged. Her two unborn sons also died.
Following the death of his wife and two unborn children, Jeremy filed a wrongful-death lawsuit. The lawsuit argued that if Staples had responded to the hospital or instructed the ER staff to perform a caesarian-section, Stodghill may have still died, but the twin may have been saved. The lead defendant in the case is Catholic Health Initiatives (CHI), operator of St. Thomas More hospital and approximately 170 other medical centers in 17 states around the U.S.
According to their website, the mission of CHI is to:
"nurture the healing ministry of the Church by bringing it new life, energy and viability in the 21st century. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we move toward the creation of healthier communities."
Adhering to the U.S. Conference of Catholic Bishops' Ethical and Religious Directives for Catholic Health Care, CHI believes they should:
“witness to the sanctity of life ‘from the moment of conception until death. The Church’s defense of life encompasses the unborn.”
In 2010, Catholic bishops with the Colorado Catholic Conference issued a letter regarding a petition aimed at collecting signatures for a constitutional amendment designed to define "personhood". In the letter, the bishops say:
"We affirm the principle that life begins at conception and therefore we affirm the personhood of the unborn."
However Jason Langley, attorney for CHI, has argued that the lawsuit should be dismissed, saying:
"[The court] should not overturn the long-standing rule in Colorado that the term ‘person,’ as is used in the Wrongful Death Act, encompasses only individuals born alive. Colorado state courts define ‘person’ under the Act to include only those born alive. Therefore Plaintiffs cannot maintain wrongful death claims based on two unborn fetuses."
During the initial trail, held in the Fremont County District Court, Judge David M. Thorson ruled in favor of CHI. When the case went to the Colorado Court of Appeals, Judge Arthur Roy also sided with the defense.
In September, Beth Krulewitch and Dan Gerash, attorneys for Stodghill, appealed the case to the Colorado Supreme Court. In their petition, both argue that Judges Thorson and Roy overlooked key facts in the case and that their rulings will open up new loopholes in malpractice laws, essentially relieving doctors of responsibility to patients whose viable fetuses are at risk.
The court will decide within the next couple of weeks whether or not to hear the case. Whatever the eventual verdict, the case has sparked sharp reactions by those on both the pro-choice and pro-life argument. Many on the pro-choice side feel the argument is hypocritical, saying the church has no problem abandoning it's principles when money is involved. Some on the pro-life side are equally critical, with several on the forums calling the church a "sell out" and hypocrites. One person states:
Last time I checked, the Church declares basic truths. These truths (and Truth) are not separate from the law. Indeed the (secular) law should conform to them, not be subordinated or even ignored.
Also, I'm fairly certain the Church makes no distinction between human being and human person. Indeed, human beings are a subset of personhood. There are more persons than there are human persons.
Another points out that by using this argument, the church is missing an opportunity to potentially change the law, saying:
"This is really bad. If the defendants win and the court cites the argument that they cannot overturn the law, this means the court could have overturned the law, which would have been HUGE for pro-life. It would have certainly gone to the Supreme Court in a very good case for making new law about the status of the unborn, especially in this late-term situation.
They could have settled. It isn't just that they passed on the opportunity to affect the laws across the country, but they are solidifying the position of "a fetus is not a person." In future, when pro-life lawyers try and get the fetus recognized, the opposition will cite this case against them."
Greta McClain

December 5, 2012

Hospital Trying To Deport Dream Student [on a Coma]

Author: Tim Paynter 

In a land where most people have far more than they need and where body fat rates continue to rise, some have been cast aside. Maria del Rocio Almanza Quiroz, just call her Rocio, (Roseeo)suffered flu-like symptoms on November 6th 2012. She collapsed six days later with a viral illness which invaded her brain. As doctors induced a coma to reduce brain swelling, Rocio could not know her life would depend upon the valiant efforts of her U.S. citizen husband to stop her deportation, not at the hands of ICE, but by the hospital staff charged with saving her life.
Rocio is a dream student, that is, the child of an undocumented immigrant.  Rocio's dream was about to come true. Rocio was to appear the day after she collapsed for her biometrics examination under a limited immigration program sponsored by the Obama Administration. The program allows youths who were brought to this country, often before they could form memories, to remain together with their families. Rocio made the trip to the U.S. at age three.
 (Above, friend Carmen Cornejo, who is a close friend of Rocio Almanza and compassionate writer)
Since undocumented immigrants don’t qualify for health care in many states, especially in Arizona, the hospital staff was eager for Rocio to leave. The Banner Desert Campus Hospital in Mesa, Arizona, demanded the family pay up. They tried to convince husband, Chirstian Solorio , to sign for a “medical deportation”. That means, instead of ICE deporting his wife, Rocio who now qualifies for deportation relief, the hospital would do it instead. They call the practice “dumping”.
What the hospital proposed was for Rocio to be disconnected from life support, placed on a stretcher, and given a free ride across the border. Once there, she would be pushed out of the ambulance and left to die. Meanwhile, Mexican hospitals would not likely take Rocio as she is not in their systems, having spent almost all of her life in the U.S.

Fortunately, Christian and Rocio's family are no dummies. They have refused to approve the “medical deportation”. In the meantime, Rocio has regained consciousness, though she developed fluid in her lungs and pneumonia when they tried to remove her from life support. The family is frantically trying to raise money to keep Rocio under hospital care. If the family is not successful then the hospital plans to dump Rocio anywhere they can, even if it means booting her out the front door.

To those who say it can't happen this way in America one only needs to examine the case of 17 year old Joe Arvizu. Joe was "medically deported" to Mexico after living a fair part of his youth in the U.S. His death was as much due to the failure of the system for a person desperate for treatment of the Leukemia that ravaged his blood as it was the Leukemia itself.
The U.S. is quickly turning into a place where there are two kinds of people. Those who have more than they can consume during their lives, to the extent of over consuming and becoming obese, and a larger class who work to keep the privileged in comfort.  With the distance between rich and poor expanding, undocumented immigrants are not the only ones who will suffer hospital dumping, but they certainly have been good test cases as to the acceptable level of care for those who have the least in American society.

November 6, 2012

Hospitals Suing Medicare Auditors for Cutting Treatment to Pocket Millions

     WASHINGTON (CN) - Federal auditors are illegally "clawing back" hundreds of millions of Medicare dollars over minor patient treatment decisions, and getting a cut based on how much they can take back, the American Hospital Association claims in court.
     Joining as plaintiffs with the American Hospital Association (AHA), which represents nearly 5,000 hospitals, are three individual hospitals and Trinity Health Corp., a Catholic chain that owns 35 hospitals and manages 12 more.
     They sued Health and Human Services Secretary Kathleen Sebelius in Federal Court, claiming the arbitrary clawbacks violate federal law.
     The hospitals say the Centers for Medicare & Medicaid Services hire Recovery Audit Contractors, (RACs), and give them free range to "overrule physicians' expert medical judgments long after the fact, determining that particular Medicare patients - patients whom they have never even seen - should not have been admitted to the hospital to receive inpatient care."
     These auditors deny "hundreds of millions of dollars" in Medicare treatments, the hospitals say, and are paid a percentage of what they can grab.
     "In the first quarter of 2012 alone, information provided to the AHA by hospitals shows that they were forced to repay $236 million for medically necessary items and services that RACS deemed should have been provided on an outpatient, rather than an inpatient, basis," the AHA says.
     The hospitals claim the auditors make their arbitrary decisions months and sometimes years after the decision to admit the patent has been made.
     "Prolonged uncertainty about whether Medicare will ultimately pay for the services previously provided wreaks havoc on hospital financial planning, including the ability to assess capital and staffing needs," the complaint states. "Both the uncertainty and the actual loss of Medicare funds ultimately may adversely affect patient care."
     The AHA claims that Recovery Audit Contractors collected $1.86 billion in alleged overpayments from October 2009 through March 2012.
     "Because RACs are paid on a contingent basis, they established their claim-review strategies to focus on high-dollar improper payments. One such high-dollar item is inpatient hospital care, which, depending on the care provided, can cost tens of thousands of dollars per patient," the AHA says.
     The hospitals say the auditors keep 9 to 12.5 percent of the Medicare funds they can take back.
     The hospitals say they can, and often do, successfully appeal an auditor's decision, but the appeals process costs hospitals hundreds of thousands of dollars per year.
     Plaintiffs include Missouri Baptist Sullivan Hospital, Munson Medical Center in Michigan, and Lancaster General Hospital in Pennsylvania.
     They claim the arbitrary denial of Medicare funds violates the Medicare Act and the Administrative Procedure Act.
     They seek an order vacating the CMS' payment denial policy and reimbursements for the money wrongfully taken from them.
     They are represented by Sheree Kanner, with Hogan Lovells.  Court House News

October 1, 2012

At Discharge if you Get xtra Care at any Hospital Is Not That They Like U

By Ricardo Alonso-Zaldivar,AP

 If you or an elderly relative have been hospitalized recently and noticed extra attention when the time came to be discharged, there's more to it than good customer service.

As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama's health care law to improve quality while also trying to save taxpayers money.
About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates.
Data to assess the penalties have been collected and crunched, and Medicare has shared the results with individual hospitals. Medicare plans to post details online later in October, and people can look up how their community hospitals performed by using the agency's "Hospital Compare" website.
It adds up to a new way of doing business for hospitals, and they have scrambled to prepare for well over a year. They are working on ways to improve communication with rehabilitation centers and doctors who follow patients after they're released, as well as connecting individually with patients.
"There is a lot of activity at the hospital level to straighten out our internal processes," said Nancy Foster, vice president for quality and safety at the American Hospital Association. "We are also spreading our wings a little and reaching outside the hospital, to the extent that we can, to make sure patients are getting the ongoing treatment they need."
Still, industry officials say they have misgivings about being held liable for circumstances beyond their control. They also complain that facilities serving low-income people, including many major teaching hospitals, are much more likely to be fined, raising questions of fairness.
"Readmissions are partially within the control of the hospital and partially within the control of others," Foster said.
Consumer advocates say Medicare's nudge to hospitals is long overdue and not nearly stiff enough.
"It's modest, but it's a start," said Dr. John Santa, director of the Consumer Reports Health Ratings Center. "Should we be surprised that industry is objecting? You would expect them to object to anything that changes the status quo."
For the first year, the penalty is capped at 1 percent of a hospital's Medicare payments. The overwhelming majority of penalized facilities will pay less. Also, for now, hospitals are only being measured on three medical conditions: heart attacks, heart failure and pneumonia.
Under the health care law, the penalties gradually will rise until 3 percent of Medicare payments to hospitals are at risk. Medicare is considering holding hospitals accountable on four more measures: joint replacements, stenting, heart bypass and treatment of stroke.
If General Motors and Toyota issue warranties for their vehicles, hospitals should have some similar obligation when a patient gets a new knee or a stent to relieve a blocked artery, Santa contends. "People go to the hospital to get their problem solved, not to have to come back," he said.
Excessive rates of readmission are only part of the problem of high costs and uneven quality in the U.S. health care system. While some estimates put readmission rates as high as 20 percent, a congressional agency says the level of preventable readmissions is much lower. About 12 percent ofMedicare beneficiaries who are hospitalized are later readmitted for a potentially preventable problem, said the Medicare Payment Advisory Commission, known as MedPAC.
Foster, the hospital association official, said medication mix-ups account for a big share of problems. Many Medicare beneficiaries are coping with multiple chronic conditions, and it's not unusual for their medication lists to be changed in the hospital. But their doctors outside sometimes don't get the word; other times, the patients themselves don't understand there's been a change.
Another issue is making sure patients go to their required follow-up appointments.
Medicare deputy administrator Jonathan Blum said he thinks hospitals have gotten the message.
"Clearly it's captured their attention," said Blum. "It's galvanized the hospital industry on ways to reduce unnecessary readmissions. It's forced more parts of the health care system to work together to ensure that patients have much smoother transitions."
MedPAC, the congressional advisory group, has produced research findings that back up the industry's assertion that hospitals serving the poor, including major teaching facilities, are more likely to face penalties. But for now, Blum said Medicare is not inclined to grade on the curve.
"We have really tried to address and study this issue," said Blum. "If you look at the data, there are hospitals that serve a low-income patient mix and do very well on these measures. It seems to us that hospitals that serve low-income people can control readmissions very well."
Under Obama's health care overhaul, Medicare is pursuing efforts to try to improve quality and lower costs. They include rewarding hospitals for quality results, and encouraging hospitals, nursing homes and medical practice groups to join in "accountable care organizations." Dozens of pilot programs are under way. The jury is still out on the results. 

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