Health & Hospitals

NEWS - Health & Hospitals

SBJ Staff Report

Jan 30, 2012 – Coastal Empire News (CEN), publisher of Savannah Daily News and The Savannah Business Journal, has asked Memorial Health University Hospital’s board of directors to review its practices which are potentially in violation of Georgia’s Open Meeting Laws.

Specifically, the board failed to discuss it current new strategy for underwriting the hospital’s $250 million in debt. But, there is also a general practice of not discussing key decisions of the hospital in public session.

CEN has spoken with the hospital’s Communication Department, with Maggie Gill, CEO and with Atty. Miles Fleming, council for the board. Fleming agreed last week to speak with the Attorney General’s office.

Additionally, CEN has asked Memorial to consider improving its public notice processes, including the utilization of its website, for all boards and sub-committees that the hospital administration is responsible for – both the publicizing of meeting notices and the publication of its open record minutes. A new website design is currently under development.

“Over the past two years, with very limited exceptions, the only media company covering the board meetings of Memorial Health has been ours,” according to Lou Phelps, publisher. “While it is not desired, we view it as our responsibility to bring these issues to the board’s attention, once again. We made this request more than a year ago.”

“Over the past two years, we have brought our concerns to the attention of past board chairman Bill Daniels and current chairman Curtis Lewis, as well as to the hospital system’s Communications department leadership and legal counsel. We recognize that they are deferring to the opinion of their counsel Miles Fleming of Hunter Maclean,” Phelps explained.

“And, we’ve been patient,” Phelps added. “I am not a fan of ‘gotcha journalism.’ Rather, we need to do our job as responsible journalists, with the expectation that public boards, authorities and commissions will do theirs by abiding to Georgia open government laws.”

“But the enormity of the decision asking the County to underwrite Memorial’s $250 million in debt has brought this issue to the front,” she added.

According to Phelps, she conferred with Senior Asst. Attorney General Stefan Ritter who trains, oversees and enforces the Georgia open government laws; Ritter encouraged Memorial Hospital to speak with the AG’s office. CEN has not filed a formal complaint.

“Our goal has been to attempt to share our understanding of the laws with Memorial’s leadership, and to confirm that the Memorial Hospital’s board’s practices are inaccurate. The AG’s office invited Fleming to call them to discuss the law,” said Phelps.

“The minutes are clear, in our opinion. This fall, the Chatham County Hospital Authority discussed the need to ask Chatham County officials to guarantee its loans, but the Memorial Hospital Board of Directors never discussed the issue in public. Clearly, the request came from the Memorial hospitals management team. Either board members were not informed, or they discussed it in executive session. You can’t have it both ways,” said Phelps, who has been in attendance at meetings this fall.

“Memorial Health has taken the position that they can go into executive session to discuss almost all hospital business for the purpose of ‘strategic planning,’” said Phelps. “At most board meetings, there is a report on the prior month’s financial performance, though almost no one ever asks a question about the numbers, and little else of substance is discussed. At some meetings, there is a vote in public on certain key contracts. But, there is no public discussion of those contracts. If there is discussion or dissension on the board about issues, it’s not done in public.”

The minutes also reflect that the board members are not signing an affidavit regarding their reasons for going into executive session.

Georgia law provides very specific reasons for closing a meeting. Those specific reasons must be narrowly interpreted and the public's right of access must be broadly interpreted, according to Attorney General Sam Olens. The statutory reasons include:

- Staff meetings held for investigative purposes under duties or responsibilities imposed by law;
- Meetings when any agency is discussing the future acquisition of real estate, except that such “meetings shall be subject to the requirements of this chapter for the giving of the notice of such a meeting to the public and preparing the minutes of such a meeting; provided, however, the disclosure of such portions of the minutes as would identify real estate to be acquired may be delayed until such time as the acquisition of the real estate has been completed, terminated, or abandoned or court proceedings with respect thereto initiated.” In other words, once the real estate transaction has concluded, minute of the deliberations must be released.
- Meetings of the governing authority of a public hospital or any committee thereof when discussing the granting, restriction, or revocation of staff privileges or the granting of abortions under state or federal law;
- “Meetings when discussing or deliberating upon the appointment, employment, compensation, hiring, disciplinary action or dismissal, or periodic evaluation or rating of a public officer or employee but not when receiving evidence or hearing argument on charges filed to determine disciplinary action or dismissal of a public officer or employee. The vote on any matter covered by this paragraph shall be taken in public and minutes of the meeting as provided in this chapter shall be made available. Meetings by an agency to discuss or take action on the filling of a vacancy in the membership of the agency itself shall at all times be open to the public.”
- Meetings of the board of trustees or the investment committee of any public retirement system created by Title 47 when such board or committee is discussing matters pertaining to investment securities trading or investment portfolio positions and composition.

Strategic planning is not a reason for an executive session, according to Ritter.

NEWS - Health & Hospitals

SBJ Staff Report

Jan 16, 2012 - Health Discovery Corporation (HDC) of Savannah and  NeoGenomics Laboratories Inc, wholly-owned subsidiary of NeoGenomics, Inc. entered into a Master License Agreement  last week where HDC granted to NeoGenomics Laboratories an exclusive worldwide license to sell HDC’s licensed patents and products.

HDC owns patents in laboratory testing, molecular diagnostics, clinical pathology, anatomic pathology and digital image analysis for diagnosing, ruling out, predicting a response to treatment, and/or monitoring treatment of hematopoietic and solid tumor cancers excluding cancers affecting the retina and breast cancer.

HDC’s pre-existing licenses, including with Quest Diagnostics Inc. and Smart Personalized Medicine, LLC relating to breast cancer, and commitments regarding the Letter of Intent to form a joint venture, Retinalyze, LLC relating to cancer of the retina, remain in effect. Moreover, HDC retains all rights to in-vitro diagnostic (IVD) test kit development.

NeoGenomics Laboratories will pay HDC $1,000,000 in cash and  1,360,000 shares of NeoGenomic’s common stock, par value $0.001 per share, which had a market value of $1,945,000.

In addition, the License Agreement provides for milestone payments to HDC, in cash or stock, in increments of $500,000 for every $2,000,000 in GAAP revenue recognized by NeoGenomics Laboratories up to a total of $5,000,000 in potential milestone payments. 

After $20,000,000 in cumulative GAAP revenue has been recognized by NeoGenomics Laboratories, HDC will receive a royalty of 6.5% on Net Revenue.

NeoGenomics Laboratories has agreed to use its best efforts to commercialize certain products within one year of the date of the License Agreement, subject to two one-year extensions per product.

If NeoGenomics Laboratories has not generated $5.0 million of net revenue from products, services and sublicensing arrangements pursuant to the License Agreement within five years of the effective date of the License Agreement, HDC may, at its option, revoke the exclusivity with respect to any one or more of the Initial Licensed Products, subject to certain conditions.

The effectiveness of the License Agreement is contingent upon the execution of an employment or other agreement between NeoGenomics Laboratories and Maher Albitar, M.D. and consulting agreements between NeoGenomics Laboratories and each of Dr. Stephen Barnhill, Dr. Herbert Fritsche, Dr. Isabelle Guyon, and Dr. Hong Zhang, principals of HDC.

NEWS - Health & Hospitals

SBJ Staff Report

Jan 16, 2012 - The Georgia House and Senate Democratic Caucuses held a press conference on Friday to discuss the Democratic state legislators’ support of the Affordable Care Act case.

“We support the Affordable Care Act because it provides new coverage for those locked out of the system or who have been underserved,” said Rep. Pat Gardner. “The new law gives all Americans the tools they need to make informed choices about their health and their families. This health care law should and will represent the needs of all citizens, not just some.”

Rep. Gloria Frazier concurred and highlighted the benefits of the Affordable Care Act to the American workforce, to small businesses and to senior citizens.

“Elder Americans are already benefiting from the provisions in the Affordable Care Act,” said Rep. Frazier. “For seniors, this law offers new preventive benefits, prescription drug discounts and more options for long-term care.”

Frazier said all Medicare recipients also qualify for a yearly wellness exam and many other free preventive care services for free.

Sen. Nan Orrock highlighted the positive effects on the health care law has already had on Georgia families. “The new federal health reform law is already making a difference here in Georgia,” said Sen. Orrock. “The law has brought relief to roughly 43,500 young individuals in Georgia who can now have quality affordable coverage through their parents. And nationally, one million young adults have gained health insurance thanks to the new law.”

Over 518 lawmakers representing all 50 states have announced that they have signed onto an amicus brief strongly defending the Affordable Care Act, which is currently standing before the Supreme Court.

NEWS - Health & Hospitals

By Lou Phelps

Jan 30, 2012 - The Memorial Hospital board of directors agreed Wednesday night to agree to change their By-Laws, and provide the Chatham County Commissioners with the power to appoint four of the hospital’s 17-member board of directors, if the Commissioners will agree to guarantee $250 million of the hospitals’ debt.

County officials have stipulated the requirement as part of its terms to guarantee the hospital system’s debt, now under consideration by the Chatham County Commissioners.

Chatham County owns all of Memorial Hospital’s buildings and its land (except for The Provident building), assets that are overseen by the Chatham County Hospital Authority, appointed by Chatham County Commissioners. But Memorial Hospital, for years, has been the guarantor of those loans, and makes all loan payments. No County tax funds are used.   

Lenders have required strict financial covenants, such as insuring that the hospital has 90 days operating cash on hand, because of the troubled financial results of the hospital over the past ten years, including a reported loss of more than $16 million in 2010.  The financial picture has also meant that Memorial has been unable to refinance the loans, or secure additional borrowing for needed capital improvements and expansion.   

Sometime this Fall, the Memorial Hospital Board of Directors voted to ask the Chatham County Hospital Authority to change the methodology – to ask the County to guarantee the loans versus the Hospital Authority.  There is no public record of the topic on the Memorial board agendas, however, and it does not appear in the Board’s published minutes. The Hospital Authority voted in public, according to their minutes, to make the request on October 5, 2012.  (See related story: Jan 30 - CEN Asks Memorial to Review Open Meeting Law Procedures.)

And, the Chatham County Commissioners discussed the topic in public at their December 12 meeting, though they have deferred any discussion to date on the advice of County Attorney Jonathan Hart. 

Hart has advised the Commissioners to more fully understand the implications to the County’s bond rating if they take on the Memorial debt in light of other significant financial obligations the County potentially has ahead.  These include possibly guaranteeing loans for a new hotel on Hutchinson Island, and absorbing the operating costs of the new County jail now under construction.   

Memorial’s covenants are choking, in their opinion, including a requirement to have 90 days of cash in reserve, a savings account in effect, according to Maggie Gill, current CEO of the hospital, and previously Memorial’s CFO for several years. . Memorial has never missed a bond payment

If the Chatham County Commissioners agree to guarantee Memorial’s loans, the hospital will not have to keep as much cash on reserve.  “There will still be a certain level of covenant requirements, but lower,” explained Curtis Lewis after the board’s meeting on Weds. Jan 25.

He estimates that they hospital would be able to free up “from $10 to $20 million in cash that could be used for needed capital improvements,” Lewis explained.  Memorial’s emergency room, for example, was built to handle 44,000 patients a year, but last year saw over 96,000.  And, the hospital’s security system for both the staff and patients is not up to standard.  The hospitals weak financial history has prevented them from securing additional borrowing for needed improvements.

What Memorial is seeking is analogous to the community banking crisis and tightening Federal banking regulations. Community banks are upset that banking regulators are requiring them to have better management practices and keep more money on reserve to weather failed loans, which restricts their loan activities.  But many consumers would agree with the changes in light of  the large number of Georgia bank failures.

NEWS - Health & Hospitals

SBJ Staff Report

Nov 29, 2011 - Georgia Ports Authority (GPA) and St. Joseph’s/Candler have launched a new major enhancement to GPA's employee wellness program, using the hospital system’s new Smart Health Express computerized medical kiosk technology.

The kiosk will give employees the opportunity to measure or research nearly every aspect of their health from a convenient on-site location.

“Keeping a close watch on your health is key to a long life and St. Joseph’s/Candler is proud to offer this unique technology to our partners at the Georgia Ports Authority,” said Paul P. Hinchey, president and CEO of St. Joseph’s/Candler. “This tool not only makes it more convenient to monitor your health, but can give your doctor great data to manage your health.”  St. Joseph's/Candler has managed GPA's employee wellness program since 1995.

This is the first Smart Health Express installed in the region. It consists of a curtained booth in which workers can track details such as weight, body mass index, blood pressure and other health indicators. The booth also offers direct telephone communication to health professionals who can answer questions.

GPA employees will be able to print out reports, as well as electronically share information with their personal physicians. In addition, the kiosk features educational videos on a range of health topics.

“This high-tech kiosk is the latest step in our ongoing efforts to promote health and wellness at GPA,” said Curtis J. Foltz, GPA executive director. “This new offering empowers our workers to take proactive steps in a convenient setting to guard their own health.”

“Our goal is to reduce costs for everyone, encourage healthy lifestyles, seek preventive care, and to promote health and wellness through prevention and intervention,” said Lise Marshall, GPA senior director of Human Resources.

St. Joseph’s/Candler has been the Georgia Ports Authority’s managed care provider since 1995. The arrangement provides port employees access to healthcare from the hospital level to physician appointments to ancillary health care services.

Recently, St. Joseph’s/Candler opened an onsite clinic with a nurse practitioner that facilitates the Ports’ Waterfront Wellness program. The program manages chronic health conditions and administers general health and wellness programs, onsite smoking cessation classes and onsite fitness classes.

Employees can use the Smart Health Express to be more proactive in their health care by:

• Measuring blood pressure and heart rate with medically certified, accurate equipment.

• Using the built-in seat weight scale

• Calculating Body Mass Index

• Taking temperature

• Taking Health Risk Appraisal and document Personal Health History

• Developing and maintaining a medication list

• Creating, storing and sending a Personal Health Record to health care providers.

• Viewing a health video library and read educational and health management tools that can be printed

• Calling the on-site SJ/C nurse practitioner or a registered pharmacist at the Candler Prescription Center.

• Calling the registered nurses at SJC Care Call Center for health information, and referrals to health providers and community resources

• Accessing health library of diseases and conditions, body guide, explanation of medical tests and a health-related calendar of events.

• In a few weeks, ports employees will have access to ProChange, a unique, evidence-based lifestyle management coaching program. The program includes targeted education, coaching and messaging based on an individual's lifestyle habits, priorities for health improvement, and his/her specific stage of readiness to change.

Privacy Concerns

Securing and keeping patient health information is the top priority for St. Joseph’s/Candler, according to Hinchy. The kiosk provides multiple features to protect patient privacy. Individual health records can only be accessed with an employee badge, a personal identification number or a thumbprint. Additionally, an electronic drape encloses the employee so no one else can see the computer screen.

NEWS - Health & Hospitals

SBJ Staff Report

Sept 26, 2011 - Douglas Tardio, president and chief operating officer of CareCore National, the nation’s largest specialty benefits management company which is headquartered in Bluffton,  has been appointed acting CEO, following a special meeting of the CareCore National Management Committee last week.

Former CEO Don Ryan passed away unexpectedly last week. Tardio will continue in his current role while expanding his responsibilities to drive the company’s mission of providing innovative healthcare solutions. “I look forward to working closely with Richard and the Management Committee to continue to creatively innovate within the specialty benefit management space. Don Ryan’s vision is now our vision.”

Tardio has been with CareCore since 2002, and has been in his current role for the past seven years. Prior to CareCore, he held management roles at Aetna and Oxford Health Plans.

“Doug worked alongside Don Ryan for nine years and will continue to actively pursue the company’s vision.” said Dr. Richard Weininger, MD, chairman of the CareCore National Management Committee this morning.  “His deep understanding of our customers’ evolving needs will ensure continuity of our current business operations and will promote expansive growth in our newer products, such as medical oncology, radiation oncology, pain management and lab management services.”

“I’m honored to carry on Don’s vision for the company. Over the last decade, Don established CareCore as the preeminent innovator in our industry, expanding our products from traditional radiology benefit management to include a wide variety of specialty benefit management services underpinned by cutting edge information technology,” said Tardio. “I look forward to working closely with Richard and the Management Committee to continue to creatively innovate within the specialty benefit management space. Don Ryan’s vision is now our vision.”

About CareCore National

CareCore National, LLC (www.carecorenational.com) is the nation’s largest specialty benefits management company, founded in 1994 to offer radiology benefit management services, The company has developed specialty benefit management programs design to manage benefits specific to cardiology, medical oncology, radiation oncology, sleep apnea, musculoskeletal management and, most recently, lab management services. CareCore currently contracts with more than 30 health plans with over 70 million insured. The company is headquartered in Bluffton, SC and has more than 1,200 employees.

NEWS - Health & Hospitals

by Lou Phelps
SBJ Staff

Oct. 3, 2011 – Across America, two pharmacy chains – both of which have a growing presence in the Savannah and Coastal Georgia region – are battling for market share in the business of pharmacy clinics.

They are CVS and Walgreen. Both companies have added or modernized their stores in the region over the past few years and Walgreens has been offering immunization clinics in Savannah and across the U.S.

But CVS has just upped the competition in Savannah, adding medical clinics in two of its stores in the area to complement its pharmacies which will offer a vast array of medical services in addition to immunizations. The in-store clinics will be located at the CVS on Ogeechee Rd. and in Richmond Hill. Also, they are studying two additional locations in the area, including one in the Wilmington Island area on the way to Tybee Island, for a possible opening in the Spring of 2012, according to Holly McDonald, regional manager for CVS's medical clinics system in Georgia.

Each of clinics will be staffed with a Family Nurse Practitioner (Masters Prepared) who will see all patients, and each clinic will have an additional physician partner for referrals.

The 'MinuteClinics' are a wholly-owned subsidiary of the CVS Corporation, not an outsource to an independent vendor. CVS launched a new TV ad campaign in Savannah last week to promote the clinics.

The clinics will be open seven days a week. Monday to Friday hours will be 8:30 a.m.-7:30 p.m., closed from 1:30-2:30 p.m., approximately, for lunch. Saturday hours will be 9 a.m.-5 p.m., closed from 1:30-2:30 p.m., approximately, for lunch; and Sunday hours will be 10 a.m.-5:30 p.m., closed for lunch from 1:30-2:00 p.m.

In addition to flu shots, the clinics will treat almost all common family illnesses such as strep throat, ear infections, minor skin infections and strains and sprains, as well as offering some wellness services. If someone has a strain or sprain that cannot be treated, they will be referred to a Savannah-partner physician for further care.

Nurse practitioners can prescribe medication, such as antibiotics, when indicated. However, they will not treat anxiety disorders or chronic pain issues, according to McDonald.

CVS will accept most major insurances, and pricing will generally run 40 percent to 80 percent less than most urgent care facilities in the area, such as at emergency rooms and primary care offices, she states. In the Savannah area, services will begin at $79 to $89, depending on the issue and whether tests must be run. Payments or co-pays will be required at time of service.

CVS believes in total transparency, according to the company, and all prices for services are posted for customers to review in advance.

The MinuteClinics will be able to run some tests immediately, such as strep throat screenings.

CVS will always encourage its patients to go into the primary care system to be followed up, if indicated, McDonald added.

To help customer's offset service costs, if they have no insurance, CVS will be offering a $5 gift card to use in the store while supplies last, even for flu shots which cost $ 29.92.

No appointment is necessary and most visit times are about 20 minutes.

CVS now has 600 plus clinics in the U.S. in 26 states, and opened its first clinic in 2000. Clinics have been open in Atlanta since 2005 where the pharmacy company now has 30 clinics in the metro area.

On the heels of strong demand for immunizations in the past couple of years, Walgreen (NYSE:WAG) has expanded its immunization offering across all of its 7,700 stores including Duane Reade pharmacies and its 350 ‘Take Care’ clinics in the U.S. The company, however, has not opened any of its clinics in the Savannah area.

Each CVS clinic will have one nurse practitioner on duty but larger clinics will have two nurses as volume warrants.

The CVS stores with new MinuteClinics have new signage so that customers are aware that there is a MinuteClinic inside.

Published by Savannah Business Journal.®All Copyrights Reserved ©2011. www.savannahbusinessjournal.com®

NEWS - Health & Hospitals

SBJ Staff Report

Sept 19, 2011 - East Georgia Regional Medical Center today was named one of the nation’s top performers on key quality measures for 2010 by The Joint Commission, the leading accreditor of health care organizations in America. The thresholds for consistent high levels of care in the areas of Heart Attack (Acute Myocardial Infarction), Congestive Heart Failure, Pneumonia, and Child Asthma Care, were recognized.

The hospital was recognized by The Joint Commission based on data reported about evidence-based clinical procedures that are shown to improve care for certain conditions, including heart attack, heart failure, pneumonia, surgical care and children’s asthma.

East Georgia Regional Medical Center is one of only 405 U.S. hospitals and critical access hospitals earning the distinction of top performer on key quality measures for attaining and sustaining excellence in accountability measure performance. Inclusion on the list is based on an aggregation of accountability measure data reported to The Joint Commission during the previous calendar year.

To be recognized as a top performer on key quality measures an organization must meet two 95 percent performance thresholds. First it must achieve a composite performance of 95 percent or above after the results of all the accountability measures for which it reports data to The Joint Commission were factored into a single score, including measures that had less than 30 eligible cases or patients. Second it must meet or exceed a 95 percent performance target for every single accountability measure for which it reports data, excluding any measures with less than 30 eligible cases or patients.

“Today, the public expects transparency in the reporting of performance at the hospitals where they receive care, and The Joint Commission is shining a light on the top performing hospitals such as East Georgia Regional Medical Center that have achieved excellence on a number of vital measures of quality of care,” according to Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., President of The Joint Commission.

“We understand that what matters most to our patients at East Georgia Regional Medical Center is safe, effective care,” said Bob Bigley, CEO. “That’s why East Georgia Regional Medical Center has made a commitment to accreditation and to positive patient outcomes through evidence-based care processes. East Georgia Regional Medical Center is proud to be named to the list of The Joint Commission’s Top Performers on Key Quality Measures,” Bigley said.

In addition to being included in today’s press release of The Joint Commission’s “Improving America’s Hospitals” annual report, http://www.jointcommission.org/annualreport, East Georgia Regional Medical Center will be recognized on The Joint Commission’s Quality Check website (www.qualitycheck.org).