Kentucky Law Review

MEDICAL: Medicare ratings of Nursing homes put Kentucky in the bottom half

Medicare has issued its report/survey of the nation's nursing homes.

One star ratings were the worst, and when it came to the percentage of one-stars per state, Kentucky was 33.  However, Tennessee was 47,  Indiana 45, West Virginia 40.  Small consolation.

Here is a link to the USA Today story:  click here

Some useful links from the story:

DATABASE: Find a specific nursing home's rating

CHART: The best and worst nursing homes

MORE: Feds rate U.S. nursing homes

You can enter city and state and get a much more concise listing of the nursing homes in a particular area.

Click here for a map showing Kentucky surrounded by a sea of blue (not good).

Here is an extract of the chart showing the percentages for one-star homes (with those states with the worse percentages at the top!).

 

Here is a link to the official Medicare web site where you not only get information on  selecting a nursing home, but can search the database to obtain individual results of the surveys. 

You can search by name, zip, county, state.

BTW:  Thanks goes to John Day at Day on Torts Blog whose post as it related to Tennessee nursing homes and this study gave me the heads up!  Here is his post: Tennessee Nursing Homes Rank At the Bottom

MEDICAL: Federal study finds that 90 percent of nursing homes violated federal health and safety standards during the last year

I have been told that John F. Kennedy in a message to Congress said that "On the basis of
his study of the world's great civilizations, the historian Toynbee concluded that a society's quality and durability can best be measured 'by the respect and care given its elderly citizens.'"

With that thought in mind, the following story has disturbing implications for all of us. 

Report: Vast Majority of Nursing Homes Violated Safety Standards

A government report has found that more than 90 percent of nursing homes violated federal health and safety standards during the last year. According to the Department of Health and Human Services report, about 17 percent of homes were cited for failures that resulted in harm or injury to patients. The report also noted that for-profit nursing homes were more likely to have deficient care problems than their non-profit counterpart

For New York Times story, click here.

Nursing Home Report (PDF via Dept. of Health and Human Services)

MEDICAL: "Patients Increasingly Distrustful of Doctors, Reports Suggest "

Recent research and anecdotal reports suggest that patients increasingly distrust their doctors. According to a study conducted by Johns Hopkins researchers, approximately a quarter of patients feel that doctors may expose them to unnecessary risk. The growing doubt around physician care, some contend, is part of a larger, systemic problem that removes doctors from the world patients live in.  Tara Parker-Pope, The New York Times  07/29/2008. Click here for article.   

This article highlights the interesting contrast in anecdotal analysis of many that jurors are amazingly willing to forgive and overlook medical mistakes that hurt others, but when it is in their back yard and affects their own physician-patient relationship and their own health . . . . . well, now that's different.

A growing chorus of discontent suggests that the once-revered doctor-patient relationship is on the rocks.

* * * But increasingly, research and anecdotal reports suggest that many patients don’t trust doctors.

About one in four patients feel that their physicians sometimes expose them to unnecessary risk, according to data from a Johns Hopkins study published this year in the journal Medicine. And two recent studies show that whether patients trust a doctor strongly influences whether they take their medication.

The distrust and animosity between doctors and patients has shown up in a variety of places. In bookstores, there is now a genre of “what your doctor won’t tell you” books promising previously withheld information on everything from weight loss to heart disease.

The Internet is bristling with frustrated comments from patients. On The New York Times’s Well blog recently, a reader named Tom echoed the concerns of many about doctors. “I, as patient, say stop acting like you know everything,” he wrote. “Admit it, and we patients may stop distrusting your quick off-the-line, glib diagnosis.”

click on heading for her entire story.

MEDICAL: Special Feature on the Crisis for Middle Class America (and more than just them!) on health insurance

Sunday's Courier-Journal has a special feature on health insurance and the uninsured - a crisis for many.

Health insurance: A growing middle-class crisis

Two million adults in Kentucky and Indiana routinely sacrifice proper health care to save money - even though they get insurance coverage. Between a quarter and a third of 20 to 30 year olds don't have health insurance at all. Today, The Courier-Journal begins a three-part series that examines the toll the health-care crisis is taking on middle class citizens at various stages of life.

MEDICAL: "Louisville surgeons perform hand transplant at Jewish Hospital "

Louisville's  doctors at the Kleinert Kutz & Associates Hand Care have performed another wondrous medical miracle.  These folks are world renown and are extending the reputation of Louisville medicine to the far reaches of the globe.  Story extracted from Courier Journal.  Joseph E. Kutz, MD, FACS and Harold E. Kleinert, MD, FACS are the founding members of this field and practice nearly forty years ago - "Kleinert Kutz is known worldwide for pioneering achievements in hand and microsurgery." 

Click here for their 2007 Magazine.

As far as lawyers should be concerned when they have a doctor from Kleinert Kutz testifying for or against them in a case, it should pretty much be a closed issue since by all standards they practically wrote the book on hand surgery.  At a recent deposition, it was noted by Dr. Kutz that over 1200 physicians have come through their doors for training in this specialty!

Louisville surgeons perform hand transplant at Jewish Hospital

Louisville surgeons yesterday performed the fourth hand transplant ever in the United States, giving an automotive shop manager from California a right hand for the first time in six years.

A 20-member team spent 14 hours at Jewish Hospital on the operation, which ended around 4 p.m., and Dave Robert Armstrong, 32, was in stable condition yesterday afternoon.

The group of surgeons is a leader in hand transplants, performing the nation's first in 1999, followed by two others in 2001 and 2006. Across the world, 39 hands have been transplanted on 31 patients.

"This has been the smoothest hand transplant we've performed," Dr. Warren C. Breidenbach, MD, FRCS(C) of Kleinert Kutz and Associates Hand Care Center said in a statement yesterday. "We cannot control the amount of damage when an accident happens, but in Mr. Armstrong's case we had very good muscles to work with. They were not as badly scarred as the previous three cases."

Armstrong, of Upland, Calif., lost his hand when a gun he was using misfired in April 2002. Since then, he had used a prosthesis for his daily activities, including a special one with a hook so he could lift weights.

A medical team from Jewish Hospital Hand Care Center, Kleinert Kutz and the University of Louisville developed the transplant procedure.

* * *

HL: Medical negligence case goes to jury in Lexington against gynecologist on claim of unnecessary removal of ovaries

From the Herald Leader is a story on medical negligence case with Plaintiff Lawyer Sheila Heistand and Insurance Lawyer Don Brown trying the case against Dr. Michael Guiler, who had previously been in the national spotlight because of other lawsuits filed in 2003 alleging he had branded “UK” — for University of Kentucky, his alma mater — on uteri before he removed them.

Updated: Jury finds Lexington gynecologist not guilty
By Anna Tong
A Lexington gynecologist was found not guilty of unnecessarily removing an Owingsville woman's ovaries Tuesday night.

Click on heading for the entire story by Anna Tong:.

Lexington gynecologist's case goes to the jury
By Anna Tong
atong@herald-leader.com
A medical malpractice case in which an Owingsville woman accused a Lexington gynecologist of unnecessary castration — removing her healthy ovaries — without warning her of the surgery's consequences went to the jury Tuesday.

The defense argued that the doctor used sound medical judgment.

“He's done the worst thing a physician can do — he violated her trust,” said Lexington attorney Sheila Hiestand.

The plaintiff, 38 year-old Connie Grimes, wept quietly after closing arguments, leaning on her husband.

Grimes is one of six women who filed a lawsuit against Dr. Michael Guiler in 2003, saying he performed medically unnecessary oophorectomies. The cases are being tried separately.

Removing a woman's ovaries results in early menopause and leaves patients at risk for breast cancer, embolisms and dementia because they can no longer produce their own estrogen.

Guiler has previously been in the national spotlight because of other lawsuits filed in 2003 alleging he had branded “UK” — for University of Kentucky, his alma mater — on uteri before he removed them.

Grimes is seeking almost $900,000 in reparations for the aftereffects of what she thinks was an unnecessary oophorectomy. She said that while she signed a consent form, she did not fully understand the consequences of having her ovaries removed at age 31.

For other stories involving Dr. Guiler posted at the Kentuck Law Blog, then click here.

MEDICAL: 'Sorry' started here: VA began error disclosure

When medical care means more than just saying you are sorry, but also saying you made a mistake - a medical mistake.

This story from the Herald Leader runs through a policy change some time ago where the VA Hospital tried something innovative - admitting their medical negligence.  You read the story; you judge the results.  From the Herald Leader -

'Sorry' started here: VA began error disclosure

MEDICAL: More on the controversial malingering test

From John Day on Torts Blog more on the Controversial Malingering Test being used by the insurance defense folks.

MEDICAL: Healthcare provider pleads guilty to Medicare fraud

Healthcare provider pleads guilty to Medicare fraud

A Louisville-based healthcare company will pay more than $3 million in fines as part of a penalty for submitting false statements to Medicare. HealthEssentials Solutions will also allow the government to pursue a $117 million claim against the company after admitting it deliberately filed false billing statements to Medicare.

READ MORE BY CLICKING HEADING FROM HERALD LEADER STORY.

DENTAL: State suspends 180 dentists for nonpayment of license renewals!

The following story on dentist suspensions does not bring smiles to anyone, and in the face of health issues in Kentucky must be a source of embarassment for those in charge.  Did the suspensions relate to the quality of their care?  Absolutely not!  It was just over their annual license fees!  Cha-ching.

Kentucky suspends more than 180 dentists, angers health advocates

By ROGER ALFORD
Associated Press Writer

FRANKFORT, Ky. (AP) -- Oral health advocates in Kentucky are fuming over what they call "a bureaucratic nightmare" that led to the temporary suspensions of more than 180 dentists.

The suspensions are especially troublesome in a state that struggles with poor dental health, said Dea Riley, head of the Appalachian Roundtable, an advocacy group for residents of the state's impoverished mountain region.

"There seems to be very little logic in this maneuver," said Riley, who was angered that dentists in some rural coal towns had to close their offices until paperwork was processed to restore their licenses. "They need to be allowing these doctors to practice dentistry, not make it more difficult for them."

Riley said the move by the Kentucky Board of Dentistry wouldn't have been so irksome if Kentucky didn't already rank among the worst states in the nation in toothlessness. A study by the Kentucky Institute of Medicine last year found that 37 percent of Kentucky adults were missing at least six teeth.

Despite those dismal statistics, the dental board ordered the suspensions of dentists who missed a Dec. 31 deadline to submit paperwork and pay a $230 fee. Lisa Turner, the dental board's interim executive director, said 187 practicing dentists were affected. All have since returned to work.

Turner said the problem arose when the dental board changed the way it notified dentists about the need to renew their licenses.

In past years, letters of reminder were mailed to the state's more than 2,300 practicing dentists to remind them that their licenses were set to expire on Dec. 31. Last year, the dental board simply printed a notice in its fall newsletter.

"Apparently a large percentage failed to read the newsletter," Turner said.

Because so many dentists didn't renew their licenses, the dental board decided to send a postcard reminder in December. It, too, went unheeded, she said.

Turner said the problem coincided with a push by the dental board for all dentists to renew their licenses online.

Dr. Scott Browning, a dentist in Vicco in rural eastern Kentucky, said he was surprised to learn in January that his license had been suspended because of the communications breakdown. He said he initially learned about his suspension when he called an oxygen supplier to place an order. He then called the dental board to verify what the supplier had told him.

"They should have a way of contacting the dentists," Browning said. "All it would have taken was a phone call."

Browning had to close his office for a week, postponing all appointments that he could, while frantically trying to get patients suffering from tooth pain into nearby dental clinics.

"That is what was really making me angry," he said. "I couldn't help my people."

Riley said it's little wonder that Kentucky is the butt of jokes about its poor dental health when the state suspends the men and women responsible for caring for teeth.

"This affects our national reputation," she said