Pat Kelsey Louisville contract: What to know about new basketball coach's salary, buyout
NEWS

Surgeon: Budget cuts make UofL Hospital unsafe

Andrew Wolfson
Louisville Courier Journal
U of L HealthCare

A leading University of Louisville surgeon says that staffing cuts by KentuckyOne Health at U of L Hospital have rendered it “unsafe” for the care of seriously ill and injured patients.

In an email to the university’s top health officials, Dr. J. David Richardson, vice chair of surgery and the current president of the American College of Surgeons, said the public hospital has “never been worse in the 34 years that I have been heavily involved with it.”

“Please understand this is not the complaining of a senior surgeon but a major patient safety issue!” Richardson said in the June 7 email, a copy of which was provided by another physician to The Courier-Journal.

In an interview, Richardson said the problems are so great that the only solution is to “unwind” the 2013 agreement in which the state turned over day-to-day management of the hospital to Catholic Health Initiative’s KentuckyOne Health.

“They are destroying the hospital,” Richardson said.

The email also laments the departure of Ken Marshall as the hospital’s president and says he was asked to resign. Marshall declined to comment, but Richardson said he had “tried his darndest” to maintain standards at the 301-bed trauma center.

Dr. J. David Richardson

Responding in a prepared statement, KentuckyOne Health said: "UHL is an excellent hospital with a dedicated and talented team of professionals that is staffed to meet the patient’s needs. Our focus has always been on quality, safety and patient experience."

The company also said it is committed to continuing the partnership, which it says is "generating positive trends on key performance measures, particularly in comparison with other academic medical centers nationwide."

The statement said that the company can't comment on why any employee resigns, for privacy reasons, but that it recognizes Marshall’s "extensive contributions to ULH and the community."

In its own statement,however, the university suggested that it agrees with the thrust of Richardson's observations.

Gary Mans, a spokesman for U of L’s Health Sciences Center, said Richardson has raised concerns that “echo ongoing discussions that the University has initiated with KentuckyOne Health regarding the need for KentuckyOne to do what it takes to ensure that nursing and support staff levels are sufficient to provide patients with the bedside care they need and deserve.”

He also said U of L and the faculty’s priority is the “highest levels of patient care and safety.”

In the email - sent to Dr. Toni Ganzel, dean of the medical school, and Dr. Greg Postel, interim executive vice president for health sciences -  Richardson says that “virtually all of the experienced nurses” that worked at the hospital before the CHI takeover were “fired or forced out.” He said others have left because of what they view as “unsafe working conditions” or noncompetitive salaries.

U of L Hospital drops Planned Parenthood pact

As a result, he said:

• The hospital is poorly staffed at night, requiring patients to be held in the emergency room until 9 or 10 the next morning, when more nurses are available. “Then magically beds appear.  This results in extraordinarily emergency department crowding and dangerous situations there when patients are not in a proper care environment.”

• Patients in the Intensive Care Unit are often unable to be moved to a more appropriate setting because of “no available beds,” even though there are dozens of empty beds around “but they are simply not staffed.

•It is “virtually impossible” to do clinic research in the hospital. One approved study was canceled last week because of inadequate nurse staffing, resulting in a “major embarrassment” for the hospital.

In an interview, Richardson said his letter understates “how bad things are.”

In the letter, he says in capital letters that “quite simply, we need to determine if CHI is going to allow us to run as an academic center or not. If not, we should simply admit that we are going to be another community hospital similar to what they have in Iowa or Kansas and quit pretending that we can have major teaching activities here, be a trauma center, and provide care for very badly ill or injured patients.”

In a follow-up interview, Richardson said that major “Level 1” trauma centers like U of H Hospital are “very complex” and require huge amounts of resources and commitment.

“You can’t do that halfway,” he said. “It doesn’t work.”

He said KentuckyOne Health laid off dozens of nurses within one week of signing the joint management agreement to run the hospital in January 2013.

Marshall joined U of L in 1989, and previously had been vice president of the hospital and chief operating officer of University Medical Center Inc, which operated the facility before the joint operating agreement with KentuckyOne.

KentuckyOne was formed in 2012 by the merger of Jewish Hospital & St. Mary's HealthCare and St. Joseph Health System of Lexington. The partnership agreement turned over management of most of U of L Hospital to KentuckyOne, whose majority owner is Denver-based Catholic Health Initiatives but kept the facilities under public control.

When the deal was announced in November 2012, officials said it would pump $1.4 billion into U of L health operations over 20 years. But the company has had financial troubles ever since, and in February 2014 announced it was laying off 500 employees in Kentucky.

The partnership called for KentuckyOne to invest $135 million in U of L over three to five years to support public health, nursing and other areas.

In July 2014, U of L President James Ramsey told the newspaper that its alliance with struggling hospital giant KentuckyOne Health "has had its challenges."

KentuckyOne had provided $72 million to U of L to date, Mans said. It could not be immediately determined yesterday what the total is now.

Reporter Andrew Wolfson can be reached at (502) 582-7189 or awolfson@courier-journal.com