Home2019-01-17T20:58:16+00:00

COVID-19: Behind The Numbers

By SUSAN ADELMAN, MD
Anyone who follows the supposed official numbers of people dying of coronavirus will find inexplicable discrepancies in the numbers from country to country. For example, the data for June 6 on the Worldometers website record 111,636 deaths in the United States and 4,634 in China, the country in which the virus originated. China? A country of 1.4 billion people? Really? India, a country with 1.3 billion people, reports only 6,933 deaths, as contrasted with Belgium, a country of 11.5 million people, which had 9,580 deaths. Seriously?

What about Germany, population 83.7 million, with 8,766 deaths, as contrasted with Spain, population 46.7 million, with 27,135 deaths, or Italy, population 60 million, with 33,846 deaths? How can this be? How do they count these deaths? Do they have political agendas?

Of course the website’s data collection methods could be faulty, and some have accused it of numerous discrepancies, but other websites have similar numbers. The key question is whether these are a potpourri of deaths from coronavirus, deaths among people who also have coronavirus, deaths of people who are assumed to have coronavirus, or even whether the deaths were of people proven by accurate tests actually to have coronavirus. We will come back to the various [Read More]

New Frontiers Await During Coronavirus Crisis

Those days are gone forever. I should just let them go…
—Don Henley

By PAUL NATINSKY
Irrevocable changes are here and more are to come. COVID-19 will change small things as well as large.

We might finally be seeing the end of currency. Bills and coins are some of the dirtiest things we encounter in the course of our daily lives. Gone for good, likely, is the handshake, possibly the casual greeting kiss or hug. I vote for the bow to replace these conventions—elegant and regal, safe and sanitary.

Big things will change, too. Social distancing and reduced capacities for indoor businesses, restaurants, bars, concert halls and movie theaters are likely to stick in some form. The same is true for public transportation and ride services. Masks? The nonsensical controversy there looks like it too, will continue for years, not months.

Distance learning for schools and remote working for businesses—already established by some institutions, pre-COVID, likely will continue to develop.

As scientists struggle to learn more about the virus amid a hostile political environment, solid answers on how to slow its spread and treat its ravages remain elusive.
Much hope is being pinned on finding a vaccine. If one is developed, would enough people vaccinate to slow or stop the virus? Would anti-vaxxers [Read More]

A Trained Response: Health And Safety Protocols Demand Full, Informed Implementation

By EWA MATUSZEWSKI
This column was not supposed to be about COVID-19—yet it must be. Not only because the virus continues to thrive in various parts of the country as I write this on the cusp of the 4th of July holiday weekend, but because in many ways the hard part has just begun.

I do not mean to minimize the extreme sickness and loss of life during the pandemic’s peak. That was a tremendously frightening and heartrending time not only in our nation but globally, and healthcare professionals at all levels used heroic measures to tame a fearsome, unknown enemy that was – and is – the virus. Their work continues, while ours has begun in fits and starts.

By “ours,” I refer to those of us in the healthcare community who are not treating patients in the hospital or rehabilitation facilities. I also refer to leaders beyond healthcare – business owners, managers and supervisors who must convey through their actions the seriousness of the virus and its easy spread. The standard has been set, with an array of health and safety protocols such as screening questions for potential COVID-19 symptoms or exposure, temperature screening, masks, physical distancing, hand washing, and reduced capacity. Some mandated, some strongly [Read More]

Maintaining Coverage For Services During The Pandemic

By ROLF LOWE
The COVID 19 pandemic has had a significant impact on health care providers of all sizes and practice areas. While non-essential services came to a halt during the early part of the pandemic creating a sudden income loss, the loss of insurance coverage for existing and potential patients due to a job loss, reduction in income or reduction in hours worked could have a lingering effect on patient visits for routine care and serious health conditions. Fortunately, the Health Insurance Marketplace created by the Affordable Care Act and the Medicaid program allow individuals who have lost their health insurance to find low or no cost options for health care coverage.

Providers typically verify insurance coverage when a patient shows up in the office for a scheduled visit. In the wake of the COVID 19 pandemic that practice needs to evolve. Providers need to be proactive and reach out to patients and inform them of potential alternatives for health care coverage in the event they do lose coverage. While there were significant job losses resulting in a loss of health care coverage early on in the pandemic, many employers took advantage of the Payroll Protection Program in the CARES Act to keep staff on [Read More]

Special Immigration Considerations For Medical Professionals During The COVID-19 Pandemic

By ALEXANDRA CRANDALL
The COVID-19 National Emergency has now been effective in the United States for three months. During this time, guidance from federal agencies has been dynamic as the government adapts to the “new normal.”

But even as the global health crisis halts nonessential travel and disrupts visa issuance to many foreign nationals, federal agencies have published additional guidance and announced special consideration for medical professionals. To be sure, these carve-outs are critical, as 17 percent of medical professionals—and 28 percent of all physicians—in the United States were born outside of the United States.

Medical Professionals Present in the United States:

USCIS has implemented a temporary policy change for former J-1 medical graduate physicians who (1) were granted a waiver of the two-year foreign residence requirement; and (2) currently practice in the United States as H-1B nonimmigrant physicians based on interest from a government agency.

Typically, in order to maintain their waiver, these former J-1 medical graduate physicians must work full-time (40 hours a week) and administer healthcare to a population in a “shortage area” (as defined by the U.S. Department of Health and Human Services). In a policy memo dated May 11, 2020, USCIS provided the following “flexibilities” for these medical graduates who “are assisting in the [Read More]

LANSING LINES

Gov Mulls How To Enforce Mask-Wearing
Gov. Gretchen Whitmer said July 9 she is reviewing the state’s current mask-wearing requirements to consider “whether or not we need to take this a step further to strengthen compliance.”

The governor led off her COVID-19 update press event with a picture from the Diamond Lake sandbar party from the over the weekend and said she wanted to make it “very clear” the law still requires people to wear masks in enclosed places of accommodation.

“Make the mask. Make the mask with a political statement saying ‘I hate masks’ if you want. But just wear it,” the governor said toward the end of the press conference.

Whitmer said “we do actually have penalties under the law,” but it comes down to enforcement, which she said comes at the local level. She said “we have the ability for a misdemeanor and a fine” but she said she is considering what’s going to be the “most helpful to encourage compliance.”

She added that “the last thing I want to do is be doling out lots of penalties.”

Meanwhile, Chief Medical Executive Dr. Joneigh Khaldun said statewide COVID-19 data trends “is not looking so good” and while Michigan is not in the “extreme situation we were in this [Read More]

Civil Immunity For COVID Care Stalls Amid Tough Questions

(This story courtesy of MIRS, a Lansing-based news and information service.)

House Judiciary Committee members had some hard questions May 19 about legislation that would give immunity to hospitals, nursing homes, and health care providers from civil suits related to the COVID-19 pandemic.

In the end, the bill designed to tie up a loose end caused by the Legislature not extending the governor’s original emergency declaration didn’t move out of committee.

“If this bill passes, if it actually gets signed in its current form, which is incredibly unlikely, then plaintiffs would be unable to bring a suit or a theory saying that there was a failure to exercise appropriate care under the circumstances?” Rep. Brian Elder (D-Bay City) asked of Amy Barkholz of the Michigan Health and Hospital Association. She testified in support of SB 0899, sponsored by Sen. Michael MacDonald (R-Sterling Heights).

Elder contended that under current law, “a regime of Michigan tort reform, it is already incredibly difficult to bring medical malpractice cases.” In court, the judge would have to consider the circumstances, which would necessarily include the fact that the state is under a pandemic.

“You are saying that a person, if they can find a lawyer, if they can actually get all of the experts [Read More]

Hiring A Diverse Army To Track COVID-19 Amid Reopening

By CARMEN HEREDIA & ANNA ALMENDRALA
As a contact tracer, Teresa Ayala-Castillo is sometimes asked whether herbal teas and Vicks VapoRub can treat COVID-19. These therapies aren’t exactly official health guidance, but Ayala-Castillo isn’t fazed. She listens and then suggests other ideas — like getting rest and drinking plenty of fluids.

“I don’t want to call them old wives’ tales, but these remedies are things that I’m 100 percent familiar with because my mom used them on me,” said Ayala-Castillo, a bilingual first-generation Ecuadorian American who works for the city of Long Beach, California.

Health departments across the United States are working at a furious pace to staff their armies of contact tracers to control the spread of the coronavirus that causes COVID-19. Experts estimate local and state health departments will have to add 100,000 to 300,000 people to get the economy back on track.

As they build these forces, many states and localities are trying hard to hire from the racial and ethnic minority communities hit hardest by the virus. They’re anticipating a need for skilled, culturally competent tracers who can convert suspicious or hesitant contacts into enthusiastic, willing participants in the drive to stamp out the virus.

Virus-tracking activities vary by state. Most states have created plans to [Read More]

ON POINT WITH POs: Intersection Of Business, Physician Practices Cannot Be Ignored

By EWA MATUSZEWSKI
The emergence of a best practices playbook for physician practices following the pandemic is likely as close as any primary care physician practice has come to having a strategic plan. Of course, a playbook or return-to-work strategy is not a strategic plan. It is focused on health and safety for patients, practice teams, vendors and anyone who sets foot in a physician’s office. But if you haven’t considered adopting a broader strategic plan as an offshoot of a playbook, it’s advisable to do so now.

Learn from other industries. I was in the trenches with PCPs as they struggled with financial issues, staff layoffs, insufficient personal protection equipment and other COVID-19 induced threats to a practice’s viability. Prior to the recent availability of guidance from national and state medical agencies and professional medical associations, which came far too late in my opinion, I turned to social media as part of my information gathering process to create our own back-to-work manual. That’s where I “met” Gary Johnson, Chief Manufacturing and Labor Affairs Officer at Ford Motor Company.

I don’t know Mr. Johnson, but I requested permission via LinkedIn to utilize the Ford Motor Company COVID-19 Playbook. He gave me permission and I incorporated some of the [Read More]

COMPLIANCE CORNER: Governor’s Guidlelines & Reopening Medical Services

By KAITLIN NUCCI
On May 21, Gov. Gretchen Whitmer issued Executive Order No. 2020-96 in response to the steady drop in confirmed daily cases of COVID-19. This new order has lifted the postponement of non-essential medical and dental procedures as of May 28 at 11:59 PM. Upon the resurgence of these medical and/or dental services, outpatient healthcare facilities will be subject to the workplace safety rules as provided in Executive Order 2020-97. These restrictions aim to continue the downward trend in daily confirmed cases, while acknowledging that COVID-19 remains a danger in the state of Michigan.

Executive Order 2020-97 enacts safeguards that facilities must use in providing non-essential services. These facilities will be required to post signs at entrances that instruct patients to wear some sort of face covering while inside. Patients will be required to wear this face covering while inside the facility, except as necessary for identification purposes or to conduct an examination or procedure, and facilities must provide face coverings and hand sanitizer at the patient entrances. Of course, employees will be required to properly use their personal protective equipment pursuant to CDC and OSHA guidelines.

A facility’s waiting area capacity must be limited to the number of people who can be present while [Read More]

LEGAL LEANINGS: Next Steps, Difficult Questions

By MARK E. WILSON
Over the past few months the State of Michigan along with the world has been stricken by a pandemic not seen for the last 100 plus years. Throughout the last few months the learning curve has been steep while the best medical and scientific minds have struggled to learn everything possible about the disease.

In Michigan at the end of May there had been nearly 58,000 cases and more than 5500 deaths due to Covid-19. It is likely we will find out that even more people have had the virus but never knew it. The shelter in place, social distancing, masking and closing of the economy were widely accepted as the only anecdotes available in the early days. The impact on those anecdotes will likely result in the State unemployment numbers being in the millions. Throughout the pandemic, reliance on the science and the data became the lynch pins for actions taken to save lives. And while every expert does not believe it is over, imagine the stress on the State’s citizens, economy and its health care system if the vast majority of the symptoms were not “mild.”

As more and more becomes known on how to limit exposure, protect people and eventually [Read More]

LANSING LINES

(This feature presented in cooperation with MIRS, a Lansing-based news and information service)

Statewide COVID-19 Testing At Center Of Recovery Plan
Michigan should implement statewide COVID-19 testing system to ensure people coming back into the workforce are not spreading the coronavirus, Business Leaders for Michigan advocated June 1 as part of their economic recovery plan.

The group is suggesting repurposing existing state and federal money and streamlining the government approval process to assist employers in getting their displaced workers back on the job safely.

In laying out the business roundtable’s three-part plan, BLM President & CEO Doug Rothwell also is advocating for the Department of Transportation and county road commissions to put a priority on starting “shovel ready” projects.

They want a streamlined permitting process, money put back into the Pure Michigan tourism program, and helping Michigan Business Connect with suppliers as their global supply chains adjust.

The Business Leaders also want a review of the state’s tax structure and the state Department of Licensing and Regulatory Affairs to accelerate certificate programs for in-demand positions.

At the front of all these proposals, Rothwell said, is putting a priority on protecting public health as part of its COVID-19 plan.

“The shutdown of operations across industries is unprecedented,” Rothwell said. “There was no playbook [Read More]

Detroit’s COVID-19 Numbers ‘Coming Down Extremely Fast’

(This story presented as part of a cooperative effort between Healthcare Michigan and MIRS, a Lansing-based news and information service.)

Detroit reported that the city’s COVID-19 related deaths continues to decline, with nine additional deaths reported May 1, bringing the city’s total to 1,045.
Mayor Mike Duggan said in his daily press briefing that the number of deaths at nursing homes, however, continues to grow. By May 1, 233 nursing home residents and three staff had died after testing positive for COVID-19, he said.

“The numbers are coming down extremely fast,” he said. “What we’re doing is continuing to work … Before this is over, we’re going to find a quarter to a third of all the deaths in the city occurred at the nursing homes and senior living facilities.”

Duggan said the numbers are low, in part, because “we did not get a bunch of old death certificates” from the state. He prefers to measure the city’s progress by using the weekly numbers, saying the city had 197 COVID-19-related deaths weeks four weeks ago compared to 81 this week.

To date, the city has 9,192 positive COVID-19 cases, city health officer Denise Fair said.

The Mayor also announced that more than 400 city employees were scheduled to return to [Read More]

Always The Bridesmaid, Public Health Rarely Spotlighted Until It’s Too Late

By JULIE ROVNER
The United States is in the midst of both a public health crisis and a health care crisis. Yet most people are not aware these are two distinct things. Further, the response for each is going to be crucial.

If you are not a health professional of some stripe, you might not realize that the nation’s public health system operates in large part separately from the system that provides most people’s medical care.

Dr. Joshua Sharfstein, a former deputy commissioner for the Food and Drug Administration and now vice dean at the school of public health at Johns Hopkins in Baltimore, distinguishes the health care system from the public health system as “the difference between taking care of patients with COVID and preventing people from getting COVID in the first place.”

In general, the health care system cares for patients individually, while public health is about caring for an entire population. Public health includes many things a population takes for granted, like clean air, clean water, effective sanitation, food that is safe to eat, as well as injury prevention, vaccines and other methods of ensuring the control of contagious and environmental diseases.

In fact, it is public health, not advances in medical care, that has accounted for [Read More]

Healthcare In A Post-COVID-19 ERA: What Will Stay, What Will Go

By EWA MATUSZEWSKI
Will healthcare be forever changed in a post-COVID-19 world? Hopefully yes and hopefully no. We must of course hang on to what is good about our healthcare system. Primary care physicians and nurse practitioners affirming the care model of the patient-centered medical home. Fearless leaders such as Dr. Kimberly Farrow, CEO of Central City Integrated Health, and Dr. Anthony Clarke of Health Centers of Detroit, who toiled away in the heart of the city, the epicenter of Michigan’s pandemic, to treat, comfort, educate and encourage our state’s neediest patients. In the meantime, minutes and hours away, family medicine physicians, internal medicine docs, pediatricians and other Michigan providers also cared for their patients, some introducing makeshift telehealth, others treating, if not COVID-19 symptoms, then the anxiety and depression they spawned. And that will be a healthcare change.

There will be a new COVID-19 post-traumatic stress disorder experienced by healthcare workers, first responders and grocery store clerks. Primary care providers and behavioral health specialists must be prepared. These same professionals must plan to support and care for each other, as well as colleagues who engaged in the war against COVID-19 with varying degrees of battlefield exposure. From the front lines to federally qualified health centers to [Read More]

Analysis: Is Sweden Different?

(EDITOR’S NOTE: The opinions expressed below are those of the author and not necessarily those of Healthcare Michigan or its publisher.)

By SUSAN ADELMAN, MD
One nation in the developed world stands out for its exceptional approach to the coronavirus pandemic – Sweden. While most Americans were locked down, we looked with jealousy at pictures of Swedes walking on the streets, seemingly unconcerned, living normal lives. How could they do that, and has it worked?

First, it is a myth that the Swedes have had no restrictions, but their rules certainly have been more relaxed than those in most of Europe or in the United States. While their schools remained open for younger children, colleges and universities went online. Businesses and hair salons are open, but people are advised to work from home where possible. Home care and nonessential travel were banned, and so were gatherings of more than 50 people. Restaurants remained open but not bars. Restaurants had to maintain 1.5 meters of separation between tables. Almost all games are closed or must be played without an audience. Concerts and large social activities are closed. Social distancing is voluntary, but the Swedes dutifully stay away from each other. Sweden’s borders are closed to non-EU residents. Internal travel [Read More]

LEGAL LEANINGS: Telehealth – Healthcare At A Social Distance

By KIMBERLY RUPPEL
In this new normal we are experiencing as a result of the COVID-19 pandemic, social distancing and telehealth go hand in hand. Telehealth includes a range of technology, for example, the use of real-time video interaction, “store and forward” technology, remote patient monitoring or online chat groups.

Telehealth is particularly well suited for initial screening of patients and providing quicker and safer access to providers now, and also once we are safely beyond the current health crisis. As a result, this is a critical time for healthcare providers to encourage their patients to make use of this valuable tool and to implement or improve processes and systems already in place. More often, older patients are reluctant to give up the familiar in-person encounter.

Yet, that is exactly the population that may benefit the most from the efficiency and convenience of avoiding travel time or sitting in a waiting room possibly subjecting themselves to exposure to unknown health risks from other patients.

Both federal and state guidelines on this topic are rapidly evolving, many of which are intended to be temporary and only apply while the current state of public health emergency remains in effect. The CARES Act provides a number of important temporary waivers of [Read More]

COMPLIANCE CORNER: Relief And Compliance Challenges

By STEPHEN SHAVER
The outbreak of COVID-19 sent shockwaves through the healthcare industry. Drastic declines in the hospital and healthcare provider revenue have hamstrung their ability to response to the outbreak and, in some cases, caused providers to shut down entirely. In response, Congress passed the Coronavirus Aid, Relief and Economic Security (CARES) Act, which included the creation of the Provider Relief Fund. The fund’s goal is to provide direct financial relief to hospitals and healthcare providers. The Department of Health and Human Services (HHS) has been charged with distributing the fund’s $175 billion war chest.

The fund’s distributions have been divided into general allocations, to be distributed to a wide range of providers, and targeted allocations, to be distributed to areas of need to address the COVID-19 outbreak. To be eligible for a portion of the $50 billion general allocations, a provider must have billed Medicare in 2019 and provided care for actual or possible cases of COVID-19 after Jan. 31, 2020. Guidance indicates HHS considers all patients to be possible cases of COVID-19. Most of this allocation was deposited in early- and mid-April 2020 directly into bank accounts associated with each qualifying recipient’s Tax Identification Number (TIN). Additional general allocation funds were made available [Read More]

IN MY OPINION: The Blurring Of Science And Politics

(EDITOR’S NOTE: Opinions expressed here are those of the author and not necessarily those of Healthcare Michigan or its publisher)

By ALLAN DOBZYNIAK, MD
The reaction to the COVID-19 virus hysteria is financially devastating to Michigan’s hospitals and many others throughout the country and world. The burning question is whether all of this is necessary. Hospitals have been devastated by erroneous assumptions based on incomplete, premature and error-laden data. This has led to flawed models, given credence from a consensus of two physicians. Finally, politics has warped clear analysis and solutions. The idea that there might be a middle ground regarding hospitals’ economic vulnerabilities and that of the livelihoods of millions of others in the United States is totally absent from discussions. Factually, there were many fewer cases, many fewer deaths, plenty of ventilators and plenty of hospital beds.

Worse, as increasingly reliable data is available, reasonable change in policy has lagged. The flu season just ending has caused more infections, more deaths and more hospitalizations, but it did not cause the public health and financial destruction of COVID-19. Any job is a vital job to the person who has lost it. Does anybody really know the death number, death rate, number of infections or recoveries? Does anybody [Read More]

Officials Warned About Safety Gear Shortfall Early, Emails Show

By RACHANA PRADHAN & CHRISTINA JEWETT
A high-ranking federal official in late February warned that the United States needed to plan for not having enough personal protective equipment for medical workers as they began to battle the novel coronavirus, according to internal emails obtained by Kaiser Health News.

The messages provide a sharp contrast to President Donald Trump’s statements at the time that the threat the coronavirus posed to the American public remained “very low.” In fact, concerns were already mounting, the emails show, that medical workers and first responders would not have enough masks, gloves, face shields and other supplies, known as PPE, to protect themselves against infection when treating COVID-19 patients.

The emails, part of a lengthy chain titled “Red Dawn Breaking Bad,” includes senior officials across the Department of Veterans Affairs, the State Department, the Department of Homeland Security and the Department of Health and Human Services, as well as outside academics and some state health officials. KHN obtained the correspondence through a public records request in King County, Washington, where officials struggled as the virus set upon a nursing home in the Seattle area, eventually killing 37 people. It was the scene of the first major outbreak in the nation.

“We should plan assuming we [Read More]

Everything Old Is New Again: Telehealth Takes Center Stage In Pandemic

By EWA MATUSZEWSKI
Despite its high-tech sounding name and implications, telehealth is not new. Our own organization was using it years ago for a very challenged subset of society—teems who had urgent and ongoing mental health needs living in rural areas underserved by behavior health specialists.The grant-funded program was offered with the assistance of Michigan Medicine and I strongly believe it was a lifesaver for some teens. Despite relatively early adoption in this and other select cases, though, I certainly can’t brag that all of our practices were using—or even remotely interested (pun intended) in—telehealth. It was a continuum from zero awareness to occasional use. What a difference a pandemic makes!

Interestingly, one of the earliest adopters of telehealth in mid-March 2020 was a “senior” internal medicine physician in our organization who still uses paper charts. He saw 30 patients in one day using telehealth. Moreover, many of these patients were elderly. The practice team, frequently the receptionist (thank goodness for high performing teams), walked patients who were amenable to it through the relatively easy telehealth set-up process.

Wait! Doesn’t a practice need an EHR to use telehealth? Surprisingly no. Any device can be used for “video chat” in a pinch, although it’s not advisable long-term, for reasons [Read More]

Hospitals To Hit Capaicity, TCF Center Becomes Field Hospital

(This story presented in cooperation with MIRS, a Lansing-based news and information service)

Multiple southeast Michigan hospitals are at capacity with COVID-19 patients and several more expect to hit capacity the first week of April as the number of patients continues to climb, according to the president and CEO of the Michigan Health and Hospital Association.

Michigan’s COVID-19 cases jumped to 6,498 by 3 p.m. March 30 with 81 percent still in the three-county region of Macomb, Oakland, and Wayne counties. Detroit continues to be the epicenter with 1,801 cases and 52 deaths.

With 134 hospitals statewide and roughly half in Southeast Michigan, Gov. Gretchen Whitmer is accepting the U.S. Army Corps of Engineers’ recommendation to move 900 bed spaces into TCF Center, formerly Cobo Hall, to address imminent capacity issues.

Even with the extra capacity, MHA President Brian Peters continues to have concerns. The first is what happens if the coronavirus spreads outstate and there is not a large facility like the TCF Center available to convert into a field hospital.

“Southeast Michigan, Detroit is experiencing the brunt of that now,” Peters said. “Our greatest concern is that we’re going to see that occurring in communities throughout the state of Michigan in the days and weeks ahead.”

One projection [Read More]

Court Case Reminds Providers To Properly Report Income

By RALPH LEVY
A recent Tax Court Memorandum decision, S. Ghadiri-Asli v. Comm’r, T.C. Memo 2019-149, serves as a reminder for healthcare providers to report properly all gross receipts and to substantiate business expenses claimed as deductions.

One of the two taxpayers, a physician, practiced medicine as a sole practitioner who specialized in infectious diseases. During the years in question, the physician’s billing and collection functions were performed by a third party outside billing service. All payments were remitted directly to the physician. Using the information provided by the physician to the billing service that included explanation of benefit (EOB) forms, patient face sheets and other correspondence received by the physician, the billing service would bill both third-party payors and patients for medical services provided by the physician. Each month the billing service would send the physician a summary of billings and collections received using the EOB’s and the other information provided by the physician. Each summary included an invoice for the services provided by the billing service based on a percentage of the total monthly payments received by the physician during the prior month. Although occasionally the physician questioned discrepancies between the monthly summaries and the physician’s bank statements, the physician always paid the amount [Read More]

Nursing Home Outbreak Spotlights Coronavirus Risk In Elder Care Facilities

By JONEL ALLECIA
An outbreak of coronavirus disease in a nursing home near Seattle is prompting urgent calls for precautionary tactics at America’s elder care facilities, where residents are at heightened risk of serious complications from the illness because of the dual threat of age and close living conditions.

The emergence of the novel contagious illness at the Life Care Center of Kirkland, Washington, has left one resident dead and four others hospitalized, with three in critical condition, local health officials said late last month. A health care worker in her 40s also remained in satisfactory condition. The resident who died was a man in his 70s with underlying health conditions, officials said.

Officials previously said that of the nursing home’s 108 residents and 180 staff members, more than 50 have shown signs of possible COVID-19 infections, the name given the illness caused by a novel coronavirus that emerged from Wuhan, China, late last year. Visits from families, volunteers and vendors have been halted and new admissions placed on hold, according to a statement from Ellie Basham, the center’s executive director.

“Current residents and associates are being monitored closely, and any with symptoms or who were potentially exposed are quarantined,” she wrote.

The cluster of illness is the first of [Read More]

In Fighting Coronavirus State Can Only Screen, Educate And Communicate

Michigan Chief Medical Officer Joneigh S. Khaldun told a Senate committee Feb. 27 that while there is no drug to attack the coronavirus, she and the Michigan Department of Health and Human Services are working to utilize the tools they do have—screening, communication and education.

Khaldun told the Senate Health Policy and Human Services Committee, “If this were to come to Michigan, we’d be focusing on non-pharmaceutical intervention.”

Khaldun noted that the state is closely monitoring the spread of the virus. The Detroit Metro Airport is one of 11 airports across the country where U.S. citizens who are considered at high risk based on their travels can re-enter the United States.

A process exists at Detroit Metro to identify those who need to be monitored. Currently, there are no confirmed cases in Michigan where travelers have been diverted from the airport to a hospital and quarantined. However, in one case a traveler was taken to the hospital, but later confirmed to not have the virus.

Sen. Paul Wojno (D-Warren) asked Khaldun if a university or college would need to be quarantined if the virus were detected on campus.

“We’ll have to take that on a case-by-case basis,” Khaldun responded.

Talk of quarantine led Sen. Kim La Sata (R-St. Joseph) to ask [Read More]