The Courier-Journal reported June 9 that Dr. J. David Richardson, a prominent surgeon and current president of the American College of Surgeons, said cuts in nursing and other staff had caused a “major patient safety issue” and were “destroying the hospital.”
Beth Fisher, a spokeswoman for the Cabinet for Health and Family Services, said Friday that its Office of Inspector General has an open investigation of the hospital.
The office investigates hospitals in the state for the federal Centers for Medicare & Medicaid Services, which can terminate a hospital’s reimbursements for serious violations.
KentuckyOne spokesman David McArthur said in a statement that it is awaiting the inspector general report and has already assembled a working group that will “evaluate and address any specific points and recommendations as soon as they are received.”
He said the company is committed to quality and safety and has been investing “significant resources to continually improve key areas of hospital performance.”
But in interviews, other physicians and hospital officials confirmed Richardson’s assertions. They included Dr. Susan Galandiuk, who said that layoffs and cuts have forced the hospital to hire temporary “traveling nurses” unfamiliar with procedures.
“You are in the operating room with nurses who have no idea what equipment you are using or what they are supposed to be doing,” said Galandiuk, a colorectal surgeon who is editor in chief of the world’s leading scientific journal in that specialty. “It is sad to see the deterioration.”
The investigation is the latest sign of problems at the hospital and KentuckyOne Health, whose parent company, Catholic Health Initiatives, lost $125.9 million in the last quarter of 2015 and has run up $9 billion in debt.
In January, the Joint Commission that accredits U.S. hospitals found 31 deficient areas at U of L Hospital, which KentuckyOne Health has managed since 2013.
Those included problems with infection prevention and transfusion errors as well as in broader categories, such as “the hospital plans the patient’s care” and “the hospital effectively manages its programs, services, sites, or departments.”
The hospital was accredited, but with the requirement of a follow-up survey.
McArthur said none of the problems were considered serious and all have been addressed and corrected.
In April, the hospital received a “D” grade from the Leapfrog Group, an independent organization founded by employers and medical experts. Two of KentuckyOne’s other hospitals in Louisville – Jewish and Sts. Mary & Elizabeth Hospital – also got D marks.
The organization, which assigns letter grades to more than 2,500 U.S. hospitals based on medical errors, accidents, injuries and infections, says selecting the right hospital can reduce a patient’s risk of avoidable death by 50 percent.
In his statement, McArthur said, “Guidance from outside organizations such as OIG and Joint Commission is helpful to us as we build on our success and ensure our physicians, nurses and all employees are supported in their work.”
Responding to Galandiuk’s comment about traveling nurses, McArthur said they are trained on equipment and procedures unique to U of L Hospital.
The newspaper reported this month that Richardson said in an email to university officials that Intensive Care Unit patients often cannot be moved to a more appropriate setting because there are “no available beds,” even though there are dozens of empty beds around “but they are simply not staffed.”
He also 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.
His comments were echoed in a study of job dissatisfaction among KentuckyOne Health nurses written by Karen Christopher, a U of L associate professor of Women’s & Gender Studies and Sociology.
In her report, Christopher said she talked to 20 nurses between August and February and found that 19 said chronic understaffing harmed their ability to provide quality care. Some said they were being required to care for five or six patients at a time who should have been given one-on-one care.
KentuckyOne Health has managed the hospital since 2013 under an agreement in which the company was supposed to invest $1.39 billion in the hospital over 20 years and $135 million within three to five years.
U of L spokesman Gary Mans said it has collected $72 million so far.
Richardson said KentuckyOne laid off dozens of nurses within one week of signing the joint management agreement and continued with cuts systemwide in 2014 as it tried to overcome a $218 million deficit.
Mans said this month that the university shares Richardson’s concerns and had initiated discussions with 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.”
In a statement issued Friday, U of L spokeswoman Jill Scoggins said the university and KentuckyOne Health are committed to ensuring safe and effect patient care and that “individuals and families across this community can be confident that University of Louisville Hospital is safe and staffed by a caring team of clinical and support staff solely focused on the health and wellness of those we serve.”
Richardson and other doctors have called for unwinding the management agreement, while KentuckyOne Health wants to preserve it, saying it has benefited the university and the hospital.