The following hospitals and health systems have announced or shared plans for raising workers' pay since Nov. 23:
Note: This is not an exhaustive list.
1. Members of the Windham Federation of Professional Nurses approved a new contract with Windham Hospital in Willimantic, Conn., that resolves a nearly year-long labor dispute. The contract addresses recruitment and retention concerns and includes significant economic investments in staff, according to the union. Union members approved the agreement Dec. 2, about two months after a late September strike.
2. Members of the California Nurses Association at 21 Northern California Kaiser Permanente facilities approved a new contract. The contract boosts wages for Northern California nurses by 22.5 percent over four years. It also adds more than 2,000 new registered nurse and nurse practitioner positions across Northern California facilities.
3. Resident physicians and fellows at the University of California Irvine and the University of California San Francisco reached new contracts that include wage increases and other benefits. Both agreements include raises to help keep up with inflation, beginning with an average of more than 7 percent for physicians, depending on their experience level, according to the union. UCSF residents and fellows reached a tentative agreement with the hospital on Nov. 29, while the UC Irvine physicians approved their new contract on Nov. 18.
4. Members of the National Union of Healthcare Workers approved a new contract with Dallas-based Tenet Healthcare's Fountain Valley (Calif.) Regional Hospital and Medical Center, averting a potential strike. Union members approved the new contract Dec. 1 after authorizing a strike in October. Under the agreement, union members will receive fair and competitive rate increases, according to Tenet. The contract also confirms the hospital's commitment to comply with state-regulated nurse staffing ratios.
5. Nurses at Cooperman Barnabas Medical Center, an RWJBarnabas Health-owned hospital in Livingston, N.J., approved a new contract that includes wage increases. Under the new agreement, union members will make at least $43 per hour, according to the union. The agreement, which also addresses staffing, will expire on Dec. 1, 2023.
FOOT AND ANKLE ASSOCIATES OF LAKELAND
Matt Werd, DPM, FACFAS, was a featured sports medicine speaker at the national meeting of the American Academy of Podiatric Practice Management held Nov. 3 in Fort Lauderdale. The AAPPM meeting attracts foot and ankle specialists from throughout the United States and internationally. Werd’s lecture subject was “Prefab AFOs (Ankle-Foot-Orthoses) to Keep Athletes Active.” He also served as an expert panelist for a question-and-answer session on lower extremity sports injuries. Werd has co-authored two editions of the medical text “Athletic Footwear and Orthoses in Sports Medicine” Springer Publishing 2017.
Registered nurse practitioner D’Aishia Burgess works alongside board-certified pulmonology specialist Naem Shahrour, from Watson Clinic Main at 1600 Lakeland Hills Blvd., Lakeland. Burgess achieved her bachelor's in nursing from Polk State College in Winter Haven and her master's in nursing from Florida Southern College in Lakeland. She is a member of the American Association of Nurse Practitioners and the Florida Association of Nurse Practitioners, and is certified by the American Nurses Credentialing Center. 863-680-7190.
Physician assistant Amanda Porter serves patients of board-certified orthopedic surgeon Obafunto Abimbola from Watson Clinic Main at 1600 Lakeland Hills Blvd. in Lakeland. She earned a bachelor's in athletic training from the University of Wisconsin Oshkosh in Oshkosh, Wisconsin, a master's in physical education Western Michigan University in Kalamazoo, Michigan, and a master's in health sciences from George Washington University in Washington, D.C. She is a member of the American Academy of Physician Assistants, the Physician Assistants of Orthopaedic Surgery and the Florida Academy of Physician Assistants. She is certified by the National Commission on Certification of Physician Assistants. 863-680-7214.
Registered nurse practitioner Nicole B. Hamlin works alongside board-certified otolaryngologist and facial plastic surgeon Raam S. Lakhani, M.D., from the Watson Clinic Bella Vista Building, 1755 N. Florida Ave., Lakeland. Hamlin earned her bachelor's in nursing from the University of South Florida in Tampa and her master's in nursing from Florida Southern College in Lakeland. She is a member of the American Academy of Nurse Practitioners. 863-904-6296.
Registered nurse practitioner Brandi C. Ray sees patients of board-certified internal medicine specialist Agustin Tavares from Watson Clinic South, 1033 N. Parkway Frontage Road, Lakeland. Ray earned her bachelor's and master's in nursing from the University of South Florida in Tampa. She is a certified family nurse practitioner by the American Academy of Nurse Practitioners, and is a member of the American Academy of Nurse Practitioners and the American Association of Critical Care Nurses Alumnus. 863-680-7190.
Julian Rios, a registered nurse at Watson Clinic Urgent Care Main, was recently named the recipient of the November Program for Employee Excellence and Recognition award. Rios has been with Watson Clinic for 14 years. Over the course of his career, whether he was providing care to urology patients or as an employee health nurse in our human resources department during COVID, Rios has been admired for his easygoing and friendly nature and for being an exceptional team member. Rios received a plaque, dinner at a local restaurant, a reserved parking spot and a gift certificate from the Medical Spa at Watson Clinic.
David Graham, a board-certified radiation oncologist at the Watson Clinic Cancer and Research Center, is the first specialist in Florida to be named a Center of Excellence for his expertise in utilizing the SpaceOAR Hydrogel, an injectable spacer that minimizes the side effects of radiation therapy for prostate cancer patients. This recognition was presented by the device manufacturer Boston Scientific. Radiation therapy can produce undesirable side effects. The SpaceOAR Hydrogel is a soft injectable spacer that gently separates the prostate from the rectum, greatly minimizing the possibility of side effects. Graham received his medical degree from St. George’s University School of Medicine in Grenada, West Indies. He performed an internship in general surgery at Guthrie Clinic in Sayre, Pennsylvania. He performed residencies in radiation oncology at Northwestern University School of Medicine in Chicago and Eastern Virginia Medical School in Norfolk. He is board certified in radiation oncology by the American Board of Radiology. Graham is a member of the American Medical Association, the American Society of Therapeutic Radiation Oncology, the American Society of Clinical Oncology, the International Association for Hospice and Palliative Care, the Cyberknife Society and the Radiosurgery Society. 863-603-4717.
LAKELAND REGIONAL HEALTH
Mohammad Elballat specializes in pulmonology, critical care and sleep medicine. He is board certified in internal medicine, pulmonology and critical care. Elballat has experience in sleep apnea, insomnia, narcolepsy, parasomnias and managing complex surgical patients and critically ill neurosurgical patients. Elballat earned his medical degree in general medicine and surgery from Tanta University, Egypt. He completed his internal medicine residency at the University of Miami/JFK Consortium in West Palm Beach. Elballat completed his pulmonary critical care fellowship at the University of Tennessee Health Science Center in Memphis, Tennessee, and his sleep medicine fellowship at the University of South Florida in Tampa. Elballat cares for patients at our Grasslands Campus and the Medical Center.
Sydney Pate recently joined Lakeland Regional Health as a surgical first assistant. She is a certified physician’s assistant who has extensive clinical experience in plastic surgery, general surgery, emergency medicine, internal medicine, pediatrics, family medicine, and OB/GYN. Pate earned her bachelor's in chemistry and master's in physician assistant studies from Butler University in Indianapolis. Pate sees patients at the Lakeland Regional Health Medical Center.
Lakeland Regional Health is one of 2022’s Digital Health Most Wired hospital and health systems, as announced by the College of Healthcare Information Management Executives. This is the eighth time that Lakeland Regional Health has earned the Most Wired recognition. Lakeland Regional Health Medical Center achieved Level 8 Acute recognition and Lakeland Regional Health ambulatory locations received Level 8 Ambulatory recognition. The CHIME Digital Health Most Wired program conducted an annual survey of more than 38,000 organizations to assess how effectively they apply core and advanced technologies into their clinical and business programs to Boost health and care in their communities.
Azlyn Goff is a pediatric orthopedic surgeon at Nemours Children’s Hospital, Florida in Orlando and Lakeland. In addition to English, Goff is fluent in Spanish. She joined Nemours Children’s Health in September after completing a pediatric orthopedic surgery fellowship at Vanderbilt University Medical Center in Nashville, Tennessee, where she was an assistant clinical professor in the Department of Pediatric Orthopedic Surgery. Goff earned her bachelor's in chemistry and biochemistry at Florida State University in Tallahassee and her Doctor of Medicine degree at New York Medical College in Valhalla, New York. She performed her orthopedic surgery residency at Westchester Medical Center in Valhalla, New York.
This article originally appeared on The Ledger: Medical people: News about medical professionals around Polk County
Miami Herald 1 day ago
The president of a Miami Lakes medspa was about to supply his patient a Botox injection, Miami-Dade police say, when cops burst into the room arrested him.
The patient was an undercover Miami-Dade police officer. The man they say had the needle Tuesday afternoon is 52-year-old Hialeah resident Damian Beltran-Garces. Online state records say two things about Beltran-Garces: He’s the president of My Face and Body Aesthetics, 5803 NW 151st St., Suite No. 202, and he’s not a licensed medical professional.
Beltran-Garces was arrested on charges of practicing health care without a license and selling drugs without a prescription. As of Thursday morning, he remained in Miami-Dade Corrections custody on $10,000 bond.
My Face and Body was registered with the state by Elisa Betancourt on Dec. 28, 2020. Online state records say Betancourt, who remains the registered agent, was the president until Beltran-Garces took the position in August 2021. An arrest report says the Florida Department of Health tipped off Miami-Dade police that Beltran-Garces was doing medical work without a license at My Face and Body, which advertises various face and body treatments, including injections, on its website.
Tuesday, the arrest report said, two undercover officers made an appointment and showed up around 3:45 p.m. After a consultation for Botox treatment and establishing a price, the report says, Beltran-Garces left the room and came back in “with a vial labeled ‘Botox.’ “ Beltran-Garces “began to prepare for the procedure, at which time, the takedown signal was given.”
©2022 Miami Herald. Visit miamiherald.com. Distributed by Tribune Content Agency, LLC.
As hospitals across Ontario battle a surge in respiratory illnesses, ER closures, and long-wait times, one is considering hiring unvaccinated health-care workers, who say they’re eager to help ease staffing shortages.
In a memo to staff, obtained by CTV News, Mandy Dobson, Interim Director of Clinical Services at South Bruce Grey Health Centre (SBGHC), said the health network is conducting a review of its COVID-19 vaccination policy.
The health network, which runs four rural hospitals in Kincardine, Walkerton, Chesley, and Durham, said it “continues to experience significant health human resource challenges, which have resulted in Emergency Department closures at all four (hospitals).”
It also noted that it had COVID-19 positive health-care workers working due to “critical staffing needs.”
A survey was attached to the memo, gauging staff reaction to any potential changes to its policy to allow unvaccinated workers to be hired.
The memo follows a tense community meeting, in Chesley, Ont., on Oct. 18 when more than 400 residents packed into the town hall, claiming they fear for their health and safety, after their local ER was shut down for two months because of a severe shortage of nurses.
Among those who spoke to the panel of local politicians and health officials was Anne Laxton, a registered nurse, independently Checked by CTV News. She explained she had applied to work at the hospital system, but was rejected because did not get the COVID-19 vaccines for personal reasons.
But she told the audience she is ready and willing to work, with full PPE. "I would love to get a job. Hire me," Laxton told CTV News.
A video posted on Facebook shows Laxton speaking to the audience, with voices in the crowd calling out "Hire her, hire her." Confusing the matter is that the hospital has unvaccinated staff on duty because it did not fire those who declined vaccination.
While health-care networks in most provinces abandoned vaccine mandates for workers earlier this year, B.C. Nova Scotia and Ontario remain the three that continue to enforce COVID-19 vaccinations.
But with hospitals struggling to provide services, SBGHC appears the first in Ontario to publicly reconsider dropping the policy.
When asked for further information on the discussions underway, Meghan Legge, manager of communications for SBGHC, told CTV News in an email that the hospital "does not have a comment at this time."
CTV News spoke to four nurses, who are unvaccinated and say they were either fired or resigned because of the vaccine mandates. They spoke about their distress watching the current staffing shortages from the sidelines.
"I feel sad for the patients. I feel sad for the staff that (are) left," says Lori Turnbull. The 58-year-old worked as a nurse in orthopedic surgery and stroke rehabilitation and fired a year ago from a hospital in London, Ont. after a 30-year career.
She insisted that she is “not anti-vaccine” and has all the other recommended vaccinations, such as those for measles, mumps and polio.
Turnbull cites personal reasons for declining the COVID-19 shots, adding they were prepared to be tested regularly and would continue to wear full PPE at work.
They acknowledge that they made a choice not to be vaccinated but feel the terminations are “harsh.” Some told CTV News they were let go without severance for their "noncompliance." Some retired. Others now work as waitresses and even in dairy farming.
"I'm doing a lot of volunteer work," said Turnbull. "I'm not using my nursing skills for that.”
"I feel like I'm invisible and I don't even exist in terms of potential for, a hospital, here," said Isabelle, who asked CTV News not to use her last name. A long-time nurse, she now stocks shelves four days a week in a grocery store.
Erin Estabrooks says she was also let go from her job as a registered nurse at St Joseph's Hospital in London, Ont. in October last year. But, she says, she would return if the rules change.
However, in an email to CTV News, St. Joseph's communications officer Dahlia Reich said that the hospital's policy on COVID-19 immunization “remains unchanged," adding that "vaccination remains a critical component of a safe health care environment."
Three of the nurses said they would return to the front lines if allowed. "In a heartbeat, I'd love to (be back)," said Isabelle.
At least two of the nurses said they are considering taking jobs in provinces where COVID-19 vaccine mandates are no longer an issue, and where they say the hourly pay for nurses tops $90 an hour, almost double that in Ontario.
"I'm in the process to get my license to go and work and it pays a lot," said Isabelle, who admitted she would prefer to work in Ontario. Turnbull, however, says she won't leave the province but hopes people listen to her sidelined colleagues.
"We're not going to solve the nursing shortage that has been many years in the making, but we certainly could help. At least if you have adequate staffing, you know you're not gonna burn everybody out, Turnbull said.
In Canada, Saskatchewan, Alberta, Manitoba, New Brunswick, Newfoundland, and the Yukon rehired unvaccinated health-care workers earlier this year. Quebec introduced, but never enforced, a vaccine mandate. Ontario ended vaccine mandates, including those for hospitals, in March this year.
However, the Ontario Health Association (OHA) continues to recommend the continuation of mandatory vaccination policies among the province's 140 hospitals. It has jurisdiction to do so, say provincial officials.
"As set out under the Public Hospitals Act, hospital administrators are responsible for the day-to-day management of their hospitals, including policies related to human resources," Bill Campbell, media relations coordinator for the Ontario Ministry of Health, told CTV News in an emailed statement.
SBGHC may be an outlier, pointing out in its memo to staff that "hospitals are now at liberty to implement their own vaccination policies."
However, the Ontario Hospital association publicly holds to its vaccine mandate directive for its members. The OHA did not respond to questions about this directive from CTV News.
In a previous statement to CTV News Toronto in August this year, when asked about lifting the province’s vaccine mandates, Anthony Dale, the OHA president and CEO, said: “Health-care workers deserve to feel safe and to deliver patient care in an environment that requires the highest level of protection available against COVID-19.”
Ontario's nurses’ union is also not challenging the OHA vaccination directive.
"That's not what will save the system," insists Doris Grinspun, CEO of the Registered Nurses Association of Ontario. " What will save the system is very competitive compensation, workloads that allow nurses to provide the care that they want and know to provide, and fast-tracking more seats for RNs, for nurse practitioners," she said.
Mandatory vaccinations were initially introduced and enforced because they were believed to prevent infection and transmission, critical in a setting where sick vulnerable patients were getting medical care.
However, there have been many outbreaks among vaccinated health staff in hospitals across the country, with studies showing that while vaccination reduces viral load and reduces severe illness and death, it does not stop COVID infections or transmission. Research also shows the protection, based on antibodies, wanes after three months.
These findings are among the arguments made by some experts who question why the mandate is still being enforced.
"I don't see a logic to it," says Rafael Gomez, director of the Centre for industrial relations and Human Resources at the University of Toronto. "Why not allow these people back?”
"The difference between you know, having one or two more people means, you know, keeping an eight-hour shift right around so that people can be seen and their medical needs attended to," he added.
But others suspect there is pressure not to make changes.
"Other hospitals will be mindful of how it looks to now allow people back, or hire new unvaxxed (people), when they were very heavy-handed in forcing them out. None of them wants to blink first," says Lisa Bildy, a human rights lawyer, based in London, Ont.
"I don't think Ontario hospitals should do anything just because hospitals in other provinces are doing it,” Maxwell Smith, a bioethicist and assistant professor in health sciences at Western University in London told CTV News in an email. "If the health and safety of patients are our hospitals' top priority, then it's not unreasonable to expect those caring for our patients to adhere to policies that best protect their health and safety."
However, Dr. Stephen Shafran, a professor of medicine and infectious diseases at the University of Alberta, told CTV News that while it is "irresponsible" for nurses who deal directly with patients not to be vaccinated against COVID-19, PPE is a way of allowing them to continue to work on the front lines.
"This is exactly what many Canadian hospitals have done for years during flu season with nurses who have refused to take influenza vaccine," he said. "Having them work wearing PPE is probably a better choice than the alternative - insufficient numbers of health-care providers (HCPs) leading to reduced patient services and potential harms from too few HCPs per patients.”
He also pointed out that many unvaccinated health-care workers have already likely had COVID-19 and therefore would have some degree of immunity.
Malls aren’t just hubs where consumers can check off holiday shopping lists. They’re also destinations for patients seeking convenient healthcare.
Vanderbilt University Medical Center and Medical University of South Carolina Health have expanded operations outside traditional care settings and into nearby malls. Rather than constructing new facilities from the ground up, repurposing vacant space at shopping malls can be quicker and cheaper for providers and often makes care more accessible for patients.
Janice Smith, a registered nurse and vice president of adult ambulatory operations at VUMC, describes herself as a “risk-taker.” When health system leaders asked if she’d help convert the second floor of a local mall into clinics, she welcomed the challenge.
Nashville, Tennessee-based VUMC transformed 450,000 square feet of empty mall space in the city, formerly home to Reebok, JCPenney and a menswear store, into a women’s clinic, dermatology clinic and comprehensive spine clinic—to name a few of the specialty sites under the mall’s roof—starting in 2009.
VUMC signed a letter of intent in March to negotiate a lease agreement for 600,000 square feet in another mall just outside of Nashville and is working through terms of the lease.
“I think that speaks to the success we experienced with our first foray,” Smith said.
Embarking on the mall-to-medicine transition makes sense considering the ample parking, multiple points of entry, and easy access from interstates, leaders said.
“There were a lot of big wins for us, and it checked a lot of boxes from a care delivery standpoint,” said Tom Crawford, chief operating officer at Charleston-based MUSC Health.
As part of its goal to be the top healthcare provider in the state, MUSC Health needed to make its care more accessible, he said. Leaders originally planned to break ground on a piece of land before they opted to open new clinics inside a mall's former JCPenney in 2019, he said.
“It offered the bones that could be easily flipped into a healthcare facility,” Crawford said.
The facility, known as the West Ashley Medical Pavilion, houses MUSC Health’s ambulatory surgery center, diagnostic imaging center and infusion center. The health system also worked out a deal with the mall’s ownership group, giving it first right of refusal to adjacent stores if it looks to grow further.
Proximity to a shopping mall also serves visitors and family members. When a patient goes into outpatient surgery at MUSC Health, they’re required to bring someone who can’t leave the facility until the patient is released.
“Because that facility is hooked into the mall, it’s considered the same property. Instead of having a waiting room full of people, they can go to Target,” said Ginger Davis of real estate services company Trademark Properties, who oversees leasing and development planning for Charleston’s Citadel Mall.
With one move under her belt, Smith feels like the system has a head start if they reach an agreement with the local government to expand in a similar way again.
The medical facilities have also proved beneficial to their surrounding communities by generating foot traffic where it was once lacking.
“There’s been this resurgence in that area, and it’s wonderful that any organization can offer that back to the city,” Smith said.
Governor Godwin Obaseki, says only 10 percent of the over 7,000 private health facilities operating in Edo, are registered with the state ministry of health.
Obaseki made the disclosure during a latest inauguration of a five-man monitoring committee of the Medical Dental Council of Nigeria (MDCN), at the Government House, in Benin, the state capital, where he stressed the need to step up regulation to ensure quality, efficient and effective healthcare delivery to the Edo people.
The governor, who informed that his government was undertaking a holistic reform of the health system, said the committee will play a vital role in rethinking the role of the government in healthcare provision.
“This committee will be pivotal in the implementation of some aspects of our health transformational agenda. The medical practice we inherited from the colonial masters was the one which combined both the functions of regulations and operations at that time.
“Government in the past had the responsibility of regulation and providing medical services at the same time, but that has changed over the years. Now the government is no longer the prime provider of medical services. There are more services provided in the medical space by private individuals than government.
Read also: Why Nigeria must not ignore security risks to 2023 elections – Report
“As a state, we feel that the government should now emphasise and focus more on regulatory functions and less as an operator”, he said.
The governor added that “For us in Edo State, our responsibility as a government is to provide and ensure our citizens get the best healthcare services possible.
The government should now regulate those who provide that care and ensure our citizens get the best of care and care providers are compelled to perform and do what they need to do to provide quality and standard care that we desire in Edo State.”
“Current data show that we have over 7,000 private health facilities in Edo State which include hospitals, medical centers, nursing homes, laboratories, pharmacies, patent medicines stores, amongst others. Sadly, only about 730 are currently registered with the Edo State Ministry of Health which stands for about 10 percent.”
“As government, we cannot say we know the kind of care our citizens received in the state from health practitioners. We have already kick-started a series of activities that will enhance the regulatory capacity of the ministry of health.
“We would support residents in the state to provide us with feedback of their experience of healthcare services as malpractice and unethical conduct of health providers will be duly addressed while ethical centres will be rewarded.
“We would no longer accept the situation where people die in our hospitals and no proper investigation to know the cause of their deaths. We will not allow the operation of unregistered mortuaries in the state.”
Thirty-four of Iowa’s 136 home-health agencies were inspected by the state this year, with five of them cited for 10 or more violations.
At four of the 34 agencies, the violations were serious enough that the agency and its registered nurses were prohibited from providing any basic-skills training to home-health aides and barred from evaluating the aides’ competency for two years.
Eight of the agencies cited for violations this year are run by county public health agencies.
The home-health agency that compiled the worst record of performance in Iowa during 2022 was Nurse at Home in Burlington. The federal Centers for Medicare and Medicaid Services gave the agency a one and one-half star quality rating, and state officials cited the agency for 18 violations.
One of those violations was related to Nurse at Home’s failure to investigate an aide who reportedly borrowed $180 from a patient and didn’t pay it back.
One Nurse at Home patient told inspectors that aides didn’t come to their house “for a whole week because they didn’t have a nurse. So that was tough, but we made it work.” Another patient complained, “They have a lot of no-shows, they don’t call or they don’t have anyone to send.”
For a more detailed look at all of Iowa’s home-health agencies, including those that weren’t inspected in 2022, visit CMS’ Care Compare website or the Iowa Department of Inspections and Appeals website.
Here’s a summary of the inspectors’ findings at each of the 34 agencies visited by the state in 2022, listed in alphabetical order. Along with the inspectors’ findings, you’ll find CMS’ ratings, which are based on a scale of one to five stars, for each agency. (Some ratings are listed as ‘not available’ due to insufficient data on which to base a rating.)
Advanced Home Health Care, Burlington – Quality rating: Three stars. Patient survey rating: Four stars. The agency was cited for three violations in October 2022: failure to review patients’ current medications; failure to deliver care only as ordered by a physician in three of the 10 cases that were reviewed; and failure to include all of the necessary elements in patient-care plans in five of the 10 cases reviewed by inspectors.
Angels Care Home Health of Iowa, Council Bluffs – Quality rating: Three stars. Patient survey rating: Four stars. The agency had 476 patients in January 2022 when it was cited for five violations: failure to review all current medications in 14 of the 17 cases that were reviewed; failure to implement a complete plan of care in 11 of 17 of the cases that were reviewed; failure to provide physician-ordered services in seven of the 17 cases that were reviewed; failure to communicate and coordinate patient care services with physicians in eight of the 17 cases that were reviewed; and failure to ensure home-health aides provided care only as ordered by a physician in three of the four cases that were reviewed.
Angels Care Home Health of Iowa, Des Moines – Quality rating: Three and one-half stars. Patient survey rating: Two stars. Zero violations found during a July inspection.
Aveanna Healthcare, Sioux City – Quality rating: Three stars. Patient survey rating: Two stars. In July, the agency was cited for two violations: failure to follow a physician’s plan of care by not providing patients with the required number of hours of care; and failure to provide services as ordered by a physician by not completing wound assessments.
Aveanna Healthcare, Council Bluffs – Quality rating: Three and one-half stars. Patient survey rating: Three stars. The agency had 89 patients in July when it was cited for two violations: failure to ensure the accurate completion of all tasks in two of the five patient-care plans reviewed; and failure to provide physician-ordered treatment in two of the five cases reviewed.
Aveanna Healthcare, West Des Moines – Quality rating: Four stars. Patient survey rating: Two stars. The agency had 124 patients in July when it was cited for four violations: failure to follow the patients’ plan of care in seven out of eight cases reviewed, with several patients not receiving the physician-ordered skilled nursing care on days when it was ordered; failure to ensure the accurate completion of all elements in each patient’s plan of care; failure to update patients’ care plans with new physician orders; and failure to provide physician-ordered treatment. (An affiliated Aveanna Healthcare home-health agency, also in West Des Moines, was cited for one violation in July: failure to provide physician-ordered visits by a home-health aide.)
Aveanna Healthcare, Cedar Rapids – Quality rating: Three and one-half stars. Patient survey rating: Three stars. The agency had 166 patients in July when it was cited for two violations: failure to provide all of the required visits to patients in two out of three cases reviewed; and failure to provide medications or treatments as ordered by the physician in one out of three cases reviewed.
Aveanna Healthcare, Davenport – Quality rating: Three and one-half stars. Patient survey rating: Not available. Zero violations were cited during a July visit.
Buena Vista County Public Health, Storm Lake – Quality rating: Two stars. Patient survey rating: Not available. The agency had 50 patients in March when it was cited for six violations: failure to have a registered nurse assess patients within 48 hours of admission, with one patient not receiving an initial assessment for 10 days; failure to adequately review all patient medications in four out of seven cases reviewed; failure to devise a complete plan of care for patients; failure to ensure a registered nurse provided complete patient-specific written instructions to home-health aides; failure to assess wounds when necessary; and failure to send patient-care summaries to other medical providers when a patient is transferred elsewhere from the agency.
Caregivers Home Health, Chariton – Quality rating: Two and one-half stars. Patient survey rating: Four stars. The agency had 206 patients in February when it was cited for eight violations, including: incomplete patient-care plans in all of the four cases that were reviewed; failure to coordinate the delivery of care; failure to complete an interdisciplinary assessment of all patients; failure to provide the services outlined in each patient’s plan of care; failure to ensure that six out of the 11 home-health aides whose files were reviewed had successfully completed a competency evaluation; failure to ensure that a registered nurse provided home-health aides with individualized instructions on patient care; and the repeated failure to ensure that home-health aides reported any patient concerns, including low blood pressure, to a registered nurse.
Carroll Area Nursing Services, Carroll – Quality rating: Four stars. Patient survey rating: Four stars. The agency had 251 patients in February when it was cited for nine violations, a relatively high number. The violations included failure to review all patient medications in 11 of 13 cases that were reviewed; failure to devise complete plan of care for patients in 10 of 13 cases that were reviewed; failure to promptly alert a physician of changes in patient conditions in each of the two cases that were reviewed; failure to comply with infection-control guidelines; failure to conduct adequate interdisciplinary assessments of all patients; failure to provide the services outlined in each patient’s plan of care in four of the seven cases that were reviewed; failure to ensure that a registered nurse provided home-health aides with individualized instructions on patient care in four of eight cases that were reviewed; and failure to include all required elements in patients’ clinical record.
Cerro Gordo County Department of Public Health, Mason City – Quality rating: Three stars. Patient survey rating: Five stars. In February, the agency was cited for five violations, including inadequate patient-care plans in six of the seven cases that were reviewed; failure to promptly alert a physician to changes in patient conditions in both of two cases that were reviewed; inadequate infection control; failure to provide the services outlined in patients’ care plans in four of the seven cases that were reviewed; and failure to include the clinical record current and accurate documentation of medical interventions.
Chickasaw County Public Health & Home Care Services, New Hampton – Quality rating: Two stars. Patient survey rating: Not available. The agency had 59 patients in October when it was cited for seven regulatory violations, including failure to complete timely comprehensive assessments of residents after they’ve been hospitalized; failure to include wound care in patients’ overall care plans; failure to assess wounds as ordered by a physician; failure to comply with infection-control requirements; and failure to ensure that a registered nurse provided home-health aides with patient-specific instructions.
Community Health Services, Cresco – Quality rating: Two and one-half stars. Patient survey rating: Five stars. The agency had 32 patients in October when it was cited for five violations, including failure to ensure complete patient-care plans were devised in five of the eight cases that were reviewed; failure to provide medications and treatment as ordered by a physician; failure to promptly alert a physician to a patient’s changing condition; and failure to ensure that a registered nurse provided home-health aides with patient-specific instructions in two of the six cases that were reviewed.
Family Care Solutions, Davenport – Quality rating: Not available. Patient survey rating: Not available. The agency had a total of 41 patients in June when it was cited for four regulatory violations, including: failure to devise complete care plans for patients in four of the seven cases that were reviewed; failure to update care plans with all new physician orders; failure to ensure that a registered nurse provided home-health aides with patient-specific instructions in three of the five cases that were reviewed; and failure to ensure that home-health aides provided care in accordance with physicians’ orders.
Gateway Home Health (formerly Careage Home Care), Clarion – Quality rating: Three stars. Patient survey rating: Not available. In April, the agency was cited for 20 regulatory violations, an unusually high number. The agency was found to be not in compliance with Medicare regulations for home-health agencies, and so the agency and its registered nurses were barred from providing basic-skills competency training for two years and were prohibited from providing evaluations of home-health aides’ skills testing for two years. Among the problems cited by inspectors: failure to have procedures in place to notify state and local officials of homebound residents in the event of a natural disaster; failed to complete timely drug-regimen reviews in 14 of 15 cases that were reviewed; failure to update patient-care assessments within 48 hours of a patient being transferred from a care facility or hospital; failure to create accurate and complete care plans in three of 10 cases that were reviewed; failure to update plans of care with new physician orders in all of the six cases that were reviewed; and failure to complete and send patient-care summaries to physicians within two days of a patient being transferred to an inpatient facility. In September, inspectors cited the agency for failing to conduct a drug-regimen review in all of the five cases that were reviewed.
Genesis Visiting Nurses Association, Bettendorf — Quality rating: Three stars. Patient survey rating: Four stars. In January, the agency had 802 patients and was cited for four regulatory violations, including: failure to devise complete patient-care plans in 10 of the 17 cases that were reviewed; failure to ensure that clinicians followed agency policies when assessing patients’ wounds; and failure to ensure skilled professionals provided care as ordered by physicians.
Good Samaritan Home Care, Indianola – Quality rating: Three and one-half stars. Patient survey rating: Not available. In February, the agency had 57 patients and was cited for 11 regulatory violations, an unusually high number. Among the problems: failure to complete a timely drug-regimen review in four of the eight cases that were reviewed; failure to update patients’ comprehensive assessments within 48 hours of them returning home from an inpatient facility; failure to follow plans of care in four of the seven cases that were reviewed; failure to devise complete patient-care plans in four of the seven cases that were reviewed; failure to provide physician-ordered medications, treatments or other services in one of the eight cases that were reviewed; failure to ensure home-health aides had successfully completed all of the required basic-skills competency evaluations; and failure to ensure that a registered nurse provided home-health aides with patient-specific instructions in two of the three cases that were reviewed.
Home Care Services of Boone County, Boone – Quality rating: Three and one-half stars. Patient survey rating: Four stars. In November, this agency had a total of 71 patients and was cited for five violations: failure to update a patient’s comprehensive assessment to include information on the patient’s current health status; failure to complete a review of patients’ drug regimen in three of the seven cases that were reviewed; failure to complete all elements of a patient’s care plan in four of the seven cases that were reviewed; failure to provide care and treatment as ordered by physicians in two the seven cases that were reviewed; and failure to adhere to infection-control protocols.
Home Sweet Home Care, Atlantic – Quality rating: Not available. Patient survey rating: Not available. In June, this agency was cited for 19 regulatory violations, an unusually high number. Several of the violations were tied to the agency’s failure to devise an adequate emergency preparedness plan for use in the event of a natural disaster. Among the other problems: a failure to adequately assess each patient’s medications in three of the seven cases that were reviewed; failure to follow patients’ care plans in six of the seven cases reviewed; failure to ensure care plans were complete in four of the seven cases reviewed; failure to follow physicians’ orders or care-plan directives in three of the seven cases reviewed; failure to follow infection-control protocols; failure to ensure the home-health aides successfully completed competency testing in all of the five cases that were reviewed by inspectors; failure to ensure home-health aides provided care as ordered by physicians; and failure to complete and send patient-care summaries to physicians within two days of a patient being transferred to an inpatient facility.
Iowa Home Care, Ottumwa – Quality rating: One and one-half stars. Patient survey rating: Three stars. In January, the agency had a total of 190 patients and was cited for 10 regulatory violations, an unusually high number. Inspectors reported that the agency’s chief of organizational performance said the agency had stopped “admitting new patients due to the fines and being unsure if the office would be kept open. The agency was not going to hire any new employees due to the issue of fines.” (It’s not clear what fines were being referenced, as none were imposed by the state.)
Among the problems cited by the inspectors: failure to ensure initial visits with patients occurred within 48 hours of a referral; failure to complete accurate drug regimen reviews; failure to accurately complete a plan of care in five of the 17 cases that were reviewed; failure to provide medications and treatment as ordered by a physician in four of the 17 cases that were reviewed; failure to report to a physician any changes in clinical findings in three of 17 cases that were reviewed; and failure to coordinate patient care in four of 17 cases reviewed.
In August, inspectors returned and cited the agency for three additional violations: failure to follow a patient’s plan of care by not providing the physician-recommended number of home-care visits; failure to keep a patient’s plan of care up to date with new physician orders; and failure to provide care as ordered by a physician.
Iowa Home Care, West Des Moines – Quality rating: Two stars. Patient survey rating: Three stars. Zero violations cited during an August inspection.
Johnson County Visiting Nurses Association, Iowa City – Quality rating: Two and one-half stars. Patient survey rating: Not available. In January, the agency was cited for two regulatory violations: failure to follow a patient’s plan of care by neglecting to provide the required home-care visits and physical therapy; and failure to accurately report a patient’s medications in the plan of care.
Nurse at Home, Burlington – Quality rating: One and one-half stars. Patient survey rating: Not available. In March, the agency had 139 patients and was cited for 18 regulatory violations, an unusually high number. Inspectors concluded the agency was not in compliance with the conditions of participation in the Medicare program and so the agency and its registered nurses were barred from providing basic-skills competency training to others and were prohibited from providing evaluations of home-health aides’ competency for two years.
Several of the violations were related to a lack of emergency preparedness. Among the others: failure to review patients’ drug regimen as required in all of the nine cases that were reviewed; failure to follow patients’ physician-ordered plan of care in five of the 11 cases that were reviewed; failure to inform patients’ physicians of missed appointments with patients; failure to ensure the patients’ plan of care was accurate and complete in six of the nine cases reviewed; failure to ensure home care aides received the required competency testing; failure to ensure all home-health aides are assigned to a specific patient by a registered nurse; failure to ensure all aides provide services as ordered by physicians in six of eight cases that were reviewed; failure to provide aides with individualized and specific patient care instructions from a registered nurse in seven of eight cases that were reviewed; failure to accurately complete patient medical records in a timely fashion, with some entries being improperly backdated; and failure to complete the required background checks on employees in two out of four cases that were reviewed.
Inspectors cited several examples of Nurse at Home records explaining missed appointments by indicating the patients had refused care when staff arrived at their homes — a claim the patients denied. One patient told inspectors the agency didn’t always send someone to his or her home because they seemed to be short-staffed. “Once they didn’t come for a whole week because they didn’t have a nurse,” the patient said. “So that was tough, but we made it work.”
Another patient complained of seeing a nurse taking a picture of herself outside her door and then leaving without attempting to enter — apparently in an effort to show she had tried to deliver services that day. A third patient told inspectors, “The aides do a good job, but they leave, and the agency has a hard time replacing them. They have a lot of no-shows, they don’t call or they don’t have anyone to send. We never refuse care.”
The agency was also cited for a failure to investigate complaints and failure to take action to prevent the reoccurrence of violations. One of the complaints against Nurse at Home came from the sibling of a client who said a former home-health aide owed the client money. The sibling said that in September 2021, the worker was upset and sitting on the patient’s living room floor saying she had no money to buy gas or food and was unable to feed her children. The patient and her sibling then loaned the worker $100 in cash and gave her a Walmart gift card with an $80 balance. The aide said she would pay back the $180 but never did. The patient’s sibling reported the matter to a registered nurse at the agency and eventually went to the Nurse at Home office to explain the situation and get the aide’s contact information.
Nurse at Home’s clinical manager told inspectors the agency never investigated the matter, in part because the aide no longer worked there and the patient was no longer a client. The clinical manager also indicated she felt the loan was a “personal transaction” that didn’t involve the agency.
In June, inspectors returned and cited Nurse at Home for three additional violations: failure to accurately complete a review of patients’ drug regimen in three of eight cases that were reviewed; failure to follow the plan of care established by a physician; and failure to accurately complete all elements of patients’ care plans in six of 10 cases that were reviewed.
Regional Medical Center Home Care, Manchester – Quality rating: Two and one-half stars. Patient survey rating: Four stars. In March, the agency had 86 patients and was cited for one regulatory violation. State inspectors alleged the agency failed to maintain consistent policies and procedures related to employees who were not vaccinated against COVID- 19. The agency’s policies for dealing with unvaccinated workers directly conflicted with Regional Medical Center’s written policies.
Southwest Iowa Home Health Services, Hamburg – Quality rating: Not available. Patient survey rating: Not available. In May, the agency had 18 patients and was cited for seven violations, some of which were tied to emergency preparedness. Among the other violations: failure to spot discrepancies in patients’ drug regimen; failure to ensure home-health aides had all of the required competency evaluations; failure to ensure nurses provided aides with individualized, patient-specific instructions for each patient; and failure to supply other medical providers a summary of clients’ home care once those clients are transferred to an inpatient setting.
Sunny Brook Home Care, Fairfield – Quality rating: Not available. Patient survey rating: Two stars. In May, the agency had 173 patients and was cited for one violation: failure to ensure that all hard-copy patient records were maintained in a secure manner and were uploaded to the electronic medical record in a timely fashion.
Tama County Public Health & Home Care, Toledo – Quality rating: Three and one-half stars. Patient survey rating: Not available. In January, the agency had 51 patients and was cited for four violations: failure to ensure patients were informed of charges for services that may not be covered by Medicare or Medicaid; failure to complete a drug regimen review for three of the eight cases that were reviewed; failure to ensure aides provided care to patients only as ordered by the physician; and failure to ensure clinical records included current information related to therapy services.
Waterloo Visiting Nurses Association, Waterloo – Quality rating: One and one-half stars. Patient survey rating: Not available. In February, the agency had 131 patients and was cited for three violations. At that time, the agency was operating under a recently imposed order that prohibited the agency and its registered nurses from providing basic-skills training to aides or evaluating aides’ competency for a period of two years. That order stemmed from two separate December 2021 inspections that resulted in the agency being cited for a total of 28 violations. The February 2022 violations were for failure to assess each patient’s medications for duplications, side effects, ineffectiveness, potential interactions, etc.; failure to update a patient’s assessment within 48 hours of resuming care after a hospitalization; and failure to update patient care plans with new physician orders.
Wel-Home Health, Red Oak – Quality rating: Two and one-half stars. Patient survey rating: Five stars. In June the agency had 104 patients and was cited for nine regulatory violations, a relatively high number. Among the violations: lack of emergency preparedness; failure to assess each patient’s medications for duplications, side effects, ineffectiveness, potential interactions, etc.; failure to follow patients’ care plans as directed by a physician in three of seven cases that were reviewed; failure to ensure the accurate completion of patient-care plans in four of seven cases that were reviewed; failure to perform interdisciplinary assessments of patients; failure to ensure aides were competent in all required skills; failure to ensure aides provided care only as directed by a physician; failure to ensure the supervision of home-health aides by registered nurses; and failure to send hospitals a summary of patient care to accompany the clients who are transferred to hospitals.
Wel-Home Health, Sergeant Bluff – Quality rating: Not available. Patient survey rating: Not available. Zero violations were cited during an August inspection.
WesleyLife Home Health, Urbandale – Quality rating: Three stars. Patient survey rating: Three stars. In February, the agency had 536 patients and was cited five violations, including: lack of emergency preparedness; failure to follow a physician-ordered plan of care in two of the 17 cases that were reviewed; failure to accurately complete all elements of patient-care plans in six of the 17 cases that were reviewed; failure to ensure that skilled professionals provided care as ordered by a physician in four of the 17 cases that were reviewed; and failure to ensure aides provided care only as ordered by a physician in three of the six cases that were reviewed.
Winnebago County Public Health Nurses, Forest City – Quality rating: One and one-half stars. Patient survey rating: Not available. In February, the agency had 86 patients and was cited for three violations: failure to follow a physician-ordered plan of care in six of seven cases that were reviewed; failure to accurately complete all elements of patients’ care plans in two out of three cases that were reviewed; and failure to complete an interdisciplinary assessment of all patients.
Winneshiek County Public Health Nurses, Decorah – Quality rating: Not available. Patient survey rating: Not available. In April, the agency had 49 patients and was cited for eight violations and was found to be out of compliance with the conditions for participating in Medicare. As a result, the agency and its registered nurses were prohibited from providing basic-skills training to aides or evaluating aides’ competency for a period of two years.
Among the violations cited at that time: failure to ensure patients were admitted with a reasonable expectation that their medical needs could be met in their homes; failure to ensure all treatments required by the patients were included in their care plan; failure to provide treatments only as ordered by the physician; failure to provide education to contracted staffers on COVID-19 mitigation; failure to follow state pharmaceutical laws by storing patient medications in the agency office; and a failure by the agency’s governing body, which is the Winneshiek County Board of Health, to oversee the day-to-day operation of the agency. During a revisit in May, zero violations were cited.
Unemployed and having a hard time finding a job? Some jobless residents could get help finding jobs in the health care industry under a new bill advanced by lawmakers Thursday.
The bill (A6174) would require the state labor commissioner and health officials to establish a program aimed at identifying and recruiting unemployed people to work in health care facilities.
New Jersey’s unemployment rate stood at just 3.5% in November’s job report from the U.S. Bureau of Labor Statistics. But hospitals and health care facilities are suffering alarming shortages of nurses and employees.
In New Jersey hospitals, the turnover rate in intensive care and nursing departments jumped from 18% to 30% in 2021, and the rate of unfilled positions of registered nurses increased from 8.2% to 13.4%, according to a February report released by the New Jersey Hospitals Association. Hospitals are also expected to spend nearly $100 million more in overtime pay in 2021 than in 2020, according to the report.
New Jersey Council of County Colleges Vice President Catherine Frugé Starghill told lawmakers Thursday the measure would help supply people meaningful employment with substantial wages while “furthering the prosperity of our state.”
The council is working with the New Jersey Business and Industry Association to train jobless residents in different fields, including health care, at the state’s 18 county colleges, she said.
“This is aligning education to build an innovative workforce,” she said.
Community colleges are working with 20 high schools, eight four-year colleges and universities, and eight labor unions to create the “Centers of Workforce Innovation,” which will work to ensure “there are no dead ends to education and training for New Jersey residents,” said Frugé Stargill.
One of the centers working with community colleges will focus on patient care — including mental health, behavioral, and respiratory care — so people can get certified as nursing assistants or clinical medical assistants, she added.
The state Business and Industry Association supports the bill, saying it will “bolster the health care workforce.”
The measure appropriates $250,000 to fund new training programs and provide resources so unemployed people can pursue new careers.
The Assembly Labor Committee advanced the bill unanimously. The Senate companion bill has been introduced in the chamber’s labor committee but has not been heard.
GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Nov. 28—Multifarious are the reasons why trauma patients end up at Mount Nittany Medical Center.
Some are there to have a sexual assault examination conducted, while others are at the only hospital in Centre County because they were involved in a car crash or fell.
Their backgrounds, methods of treatment and timelines to be release are varied. But those who experienced some of life's most traumatic events share at least one thing in common: They may be discharged without proper clothing.
Those who undergo a sexual assault examination are often required to relinquish their clothing as evidence. Other patients may need to have their clothes cut off.
The remedy was disposable paper scrubs. Registered nurse Jenn Traxler and her mother, Regina Barton, wanted to change that.
The 35-year-old who joined the health system in 2008 launched in the spring a clothing initiative to provide free apparel to patients. Mount Nittany described its longtime employee as a "shining example" of someone who elicits positive change.
"It doesn't matter what happens; we're all human. Things happen to us every day. I want people to know there's somebody out there that thinks that — no matter what happens, no matter what the situation is — you're important," Traxler said. "I want you to be comfortable. I want you to know that somebody thinks about the fact that you might come in soiled and that's OK. That you might come in having had a trauma happen to you that was totally out of your control. We're going to send you out hopefully feeling as comfortable as we can get you until you can get home."
Traxler, who described herself as a devout Christian, was raised by a "very loving, close-knit family" in Cambria County. Barton was a stay-at-home mom and later worked for the United States Postal Service; her father works as a forester.
The family made use of yard sales, thrift stores and hand-me-downs to make ends meet. The family, Traxler said, was "always pinching a penny" to make sure they were dressed appropriately.
She grew up hoping to becoming a musician, but was steered toward nursing by the time she attended Mount Aloysius College. Traxler said she "fell in love" with the field.
Part of the work is helping people who may feel humiliated or embarrassed. Proper clothing, Traxler said, can supply "some semblance of comfort when they leave the ER."
"You don't know the story. You don't know what's going to happen and what's going to bring these people in," Traxler said. "The least that we can do is put them in something comfortable to wear home."
New or very gently used sweatpants, sweatshirts, T-shirts, sports bras, underwear and socks are among the items that Traxler is looking to gather for people of all ages, body types and genders.
Jeans and shoes that need to be tied are not at the top of the list; putting a pair of slacks over a broken leg or a wound can be challenging. Loungewear and shoes that can be easily worn and taken off are preferred.
"No matter what walk they come from," Traxler said. "They deserve to be treated with kindness and courtesy and compassion."
(c)2022 the Centre Daily Times (State College, Pa.) Distributed by Tribune Content Agency, LLC.
PETALING JAYA: Malaysians should be wary of certain parties claiming to be a registered medical practitioner or a medical specialist, says Tan Sri Dr Noor Hisham Abdullah.
The Malaysian Medical Council (MMC) president said in line with Section 14C of the Medical (Amendment) Act 2012, an individual can be registered and practice as a specialist in a specific medical field under the MMC medical registry, if they meet terms stated in Section 14B of the Act.
According to Dr Noor Hisham, the main requirements of being a registered specialist is that the said practitioner must be fully registered with the MMC, have recognised qualifications, attend specialist training in recognised institutions and prove that he is qualified and has good morals.
"All expert registrations must undergo evaluation by a special committee of the MMC who will examine all conditions above before a practitioner is certified as a medical specialist and can practice in this country
"No person or party can certify themselves as a medical expert in a field if their names are not in the MMC medical registry," said Dr Noor Hisham.
Dr Noor Hisham said the public can verify a practitioner's credentials on whether they are medical doctors or specialists, through the MMC official website.
"The purpose of MMC to provide this online facility is to assist the public in choosing medical practitioners and only certified medical specialists can supply medical services and treatment in this country, including matters of referral on medical and public health.
"With this, it is advised that the public isn't confused or cheated by anyone who claims to be registered medical practitioners or specialists," added Dr Noor Hisham.