Kindred Care Quarterly

Kindred Healthcare’s Mission
is to promote healing, provide hope,
preserve dignity and produce value
for each patient, resident, family
member, customer, employee
and shareholder we serve.
Health Services Division
Kindred Care Quarterly
Medical Director and Attending Physician Update
VOLUME 6, ISSUE 2
Letter From the Chief Medical Officer, HSD
In this issue of
the Kindred Care
Quarterly, we
have the distinct
privilege to
recognize several
of our most
distinguished
Medical
Directors. You
will read about
their dedication and commitment to their
nursing and rehabilitation center staff and
the patients they care for. You will also note
several other key characteristics of these
outstanding professionals – they are leaders,
they are involved and committed, and they
are making a difference in the lives of many.
For the second consecutive year, we are
recognizing the contributions of Kindred
nursing and rehabilitation center Medical
Directors with Length of Service Awards at
10, 15, 20 and 25 plus years. Also, we bestow
our highest honor to those Medical Directors
who stand out among their peers as role
models for post acute care medical direction.
It is the Distinguished Service Award and
the plaque reads, “For meritorious service
in providing outstanding Medical Direction
and Leadership. In honor and celebration of
your dedicated service to patients/residents
and their families, for representing the center
positively in the community and facilitating a
caring culture among the staff.”
Candidates for the Distinguished Service
Award must have a written nomination
submitted by the Executive Director,
Director of Nursing Services or District
Director. The nominations are reviewed
by a selection committee and the award
recipients are honored both at the Kindred
Medical Director Banquet during the annual
American Medical Directors Association
Medical Director's Newsletter April 09 .indd 1
(AMDA) Symposium as well as with a local
event at their center.
Several common themes emerge each year
among the honorees. The first is the ability
to foster a stable and respectful working
relationship with center staff, described
most often as a doc who takes the time to
both listen to and teach the nursing staff
with the goal of constantly improving the
quality of care. The second is involvement in
the performance improvement process, and
third, a fondness for caring for the elderly.
Read about these outstanding physicians
beginning on page 2.
The 2009 AMDA Symposium was attended
by a record number of participants this past
March in Charlotte, NC. Over 2,000 were
registered for the event. Likewise, over 90
Kindred nursing and rehabilitation center
Medical Directors – a record turnout for
us – attended the Kindred banquet and
program as well. Kindred Medical Directors,
spouses and guests joined about a dozen
Kindred personnel to hear about healthcare
trends and receive an update on the status
of our quality achievements and goals, as
well as our strategic plans and direction. The
150 banquet attendees heard from Kindred
Board of Directors member Dr. Tom Cooper,
President of the Health Services Division
Lane Bowen and me on a number of relevant
topics and joined in formally honoring the
2009 Kindred Medical Director Distinguished
Service Award recipients.
Mark your calendars for next year’s AMDA
Symposium to be held in Long Beach,
California, on March 11-14, 2010.
One last item of extraordinary
noteworthiness that I personally view as
incredible (almost historic) is the designation
of Kindred Healthcare as the Most Admired
Company in the category of Health Care:
Medical Facilities by Fortune magazine. This
past month, Fortune offered their annual list
of Most Admired US companies by polling
over 4,000 executives. See page 9 for more.
This means that a post-acute care provider
(Kindred) surpassed hospital, surgicenter,
dialysis, and other healthcare providers to
be named number one. After 20 years of
devoting my career to long-term and post
acute care, it strikes me that we (all of us) are
truly making a difference, not just in the lives
of the patients, residents and families we
serve, but also in the healthcare continuum.
As the future unfolds, the work we do and
the value we create should increasingly be
viewed as part of the healthcare solution,
not part of the problem.
Thanks again for supporting our staff and
for your dedication to hope, healing and
recovery.
April 2009
1. Letter From the Chief
Medical Officer,
Health Services Division
2. Kindred Medical Director
Distinguished Service Awards
8. Survey Outcomes Continue
Improvement
9. Fortune Magazine Names
Kindred Healthcare Most Admired
10. Industry Updates and News
11. Upcoming Events
4/20/09 3:19:11 PM
Kindred Medical Director Distinguished Service Award Recipients for 2009
At the March American Medical
Directors Association (AMDA)
Symposium, eight Kindred Medical
Directors were honored with the
Distinguished Service Award. Three
more recipients were unable to attend
the symposium and will receive their
recognition at a local event, placing
the total number of honorees for
2009 at 11. Last year, there were
seven Distinguished Service Award
recipients.
The award plaque reads,
“For meritorious service in providing outstanding Medical Direction and Leadership. In honor and celebration of your dedicated service to
patients/residents and their families, for representing the center positively in the community and facilitating a caring culture among the staff.”
Highlights excerpted from the nominations are presented below. A hearty congratulations to all of the
2009 recipients
Dr. Gingrich follows the majority of
both facility’s patient population, both
on the long-term care units and on the
rehabilitation floors.
Dr. Sharman Gingrich – Brigham Manor
Nursing and Rehabilitation Center and
Country Rehabilitation and Nursing
Center, Newburyport, MA
Dr. Sharman Gingrich has been an active
member of the Newburyport medical
community and an outstanding clinician
and patient advocate at Brigham Manor
and Country Rehab for over 25 years.
In order to ensure high-quality patient
care Dr. Gingrich has provided a Nurse
Practitioner, who is in our centers daily
to ensure enhanced patient oversight.
As our reputation has improved, referrals
have also increased. Both Brigham Manor
and Country Rehab’s Medicare census has
doubled in large part due to the word
of mouth in the community about the
quality of patient care that Dr. Gingrich
brings to the center.
Dr. Gingrich participates in the centers
Performance Improvement Committee
and not only helps identify facility issues,
but also works with the team to ensure
the issues are resolved. Most recently
we were having issues with timely
physician visits and Dr. Gingrich in her
tactful way helped the facility work with
the physicians to maintain compliance.
Dr Gingrich has also been instrumental
in the two facilities combined ethics
committee, and in helping the day-to-day
teaching of the staff, many of whom are
new nursing grads.
Through her continued support and
dedication to quality patient care, both
facilities were able to achieve the Step
I AHCA Quality Award. In addition,
Dr. Gingrich has positioned us well in
preparation for Step II by continually
challenging us not only clinically, but in
all areas of patient and facility care.
The residents, both short and long term,
know Dr. Gingrich by name as she has
both a wonderful bedside manner and
excellent skills as a clinician. We proudly
nominate our Medical Director for the
Kindred Distinguished Service Award.
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Medical Director's Newsletter April 09 .indd 2
4/20/09 3:19:12 PM
Dr. Philip Groce – Augusta
Rehabilitation Center, Augusta, ME
Dr. Groce has served as Medical Director
here since 1995. He has added a great
level of stability to the facility. He is
one of the most visible and attentive
physicians I have had the pleasure of
working with. Families and residents
appreciate his attention to detail and
his ability to communicate with them.
In addition to providing excellent
day-to-day patient care, Dr. Groce
fulfills his Medical Director role as an
active member of our Performance
Improvement Committee. He attends
monthly and comes prepared with any
needed follow up or input on how to
improve upon what we do. He takes
the initiative to review other physicians’
frequency of visits and addresses with
them any delinquencies that may occur.
He does not hesitate to be a positive
voice for our center and address any
other issues he may find.
ago he gave up part of his office practice,
spending half time in his office and half
time at Ledgewood, to accommodate our
needs. Last July he gave up his private
practice altogether to practice full time at
Ledgewood. He now spends 32 hours a
week on site with availability 24 hours
a day, seven days a week. Ledgewood
currently has 60 short-term beds and 63
long-term care beds and since 1998, we
have grown from approximately 12-15
admissions a month to 80-90 admissions
per month.
Dr. Carl Johnson - Ledgewood
Rehabilitation and Skilled Nursing
Center, Beverly, MA
Dr. Johnson has served as Medical
Director since January of 1998. He began
his service at Ledgewood by spending
one day a week, seeing residents and
providing input to our performance
improvement processes. As our shortterm rehab business began to grow and
increased to 40 patients, he increased
his visits to three times a week with
increased hours at each visit. Two years
With an increase in his hours came a
decrease in laboratory and X-ray costs. As
Dr. Johnson increased his availability, he
brought the medical assessment expertise
that reduced unnecessary procedures
resulting in less demand for diagnostic
testing. We also saw a decrease in cost of
medications he was able to more closely
reconcile and evaluate effectiveness of, or
need for, medications.
Dr. Johnson has been an important part
of growing our short-term rehab business
and of our performance improvement
(PI) process. He attends our monthly
Dr. Groce also makes it a point to attend
our weekly Medicare rounds and sits in
while we review the progress and plan
for all of our short-stay patients. Dr. Groce
adds any details or his specific patient
plan of care to ensure all members of the
team are included.
Dr. Groce is very active in promoting
the importance of geriatric care
with other community and hospital
physicians.
He is truly dedicated to providing service
excellence to the geriatric residents here
at Augusta Rehabilitation Center and it
is a great honor to submit his name in
consideration for the Kindred Medical
Director Distinguished Service Award.
PI meetings and offers suggestions for
improvement in quality as well as cost
effectiveness. He is knowledgeable and
participates in our Joint Commission
accreditation process as well as annual
DPH surveys. He has business acumen
as well as clinical competency. We have
had excellent patient outcomes and
have excelled on our patient satisfaction
surveys and quality indicators. He has a
professional working relationship with the
local hospitals and specialists in the area
and often consults with local physicians in
order to improve clinical outcomes.
Dr. Johnson has an easygoing demeanor
and a wonderful bedside manner, always
giving time to residents, patients and
families. He works collegially with staff
and is always willing to answer their
questions and listen to their suggestions.
Throughout the medical community
and among his Ledgewood colleagues,
Dr. Johnson is well known for his holistic
and innovative approach to medical care,
as well as his passion for working with
elders. It is a great honor to nominate Dr.
Johnson for the Kindred Distinguished
Service Award.
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Medical Director's Newsletter April 09 .indd 3
4/20/09 3:19:14 PM
Dr. Kurtz has served the residents, families,
and staff of Northhaven tirelessly. She
has been very consistent in establishing
a rounding schedule and maintaining it
since she began attending residents. Dr.
Kurtz also participates in our Performance
Improvement Committee offering input
for our facility and challenging us for best
practices. She was very instrumental in
helping us to introduce such concepts
as “low beds” before they were a widely
accepted standard as they are today.
Dr. Jennifer Kurtz – Northhaven Health
Care Center, Knoxville, TN
Dr. Jennifer Kurtz has served Northhaven
Health Care since April 2001 and became
our Medical Director in October 2001. She
was working in our community with Baptist
Hospital as a primary care geriatrician when
she began her association with Northhaven
Health Care.
Dr. Frank Landry – Birchwood Terrace
Healthcare, Burlington, VT
4
Dr. Landry has served as Medical Director
for the last nine years. As a physician, Frank
(as he likes to be called) respects the role of
the interdisciplinary team and constantly
seeks our input and expertise. Frank cochairs our Performance Improvement (PI)
Committee and attends every monthly
PI meeting. Frank often attends care
conferences where he offers support and
insight to the residents, their families
and staff.
Medical Director's Newsletter April 09 .indd 4
Dr. Kurtz is dedicated to helping us
establish good medical protocols for
monitoring resident care. Most recently,
she has helped us to reduce physical
restraints. Today we have zero physical
restraints! With her encouragement and
oversight, we are also actively reducing use
of antipsychotic medications and ensuring
that we have in place non-pharmacological
approaches to caring for our residents.
Recently, his dedication was evidenced
during our annual survey as he made it
a priority to attend and his support of all
the staff was apparent in the kind words
he had for our employees just after the
exit conference. Frank congratulated us
on our great results and accomplishments
throughout the year – we received just one
federal tag. Dr. Landry is supportive of the
new innovative programs we have begun,
but also warned against us becoming
complacent. His support for our facility is
unwavering as he views our reputation in
the community aligned with his own.
Dr. Landry served as Governor of the
Vermont Chapter of the American College
of Physicians in 2003 and during his tenure
he received the Chapter Excellence Award
for each year of his tenure. In 2007 the
ACP recognized him with one of their
highest honors – the American College of
Physicians Laureate Award. Dr. Landry has
served as President of the Medical Staff at
Fletcher Allen HealthCare, Vermont’s largest
teaching hospital.
Dr. Kurtz also has quickly embraced
other practitioners at our facility to assist
in meeting the needs of our more frail
long-term care residents. She helped with
evaluating incontinence care protocols
that are associated with F tag 315 and
actually screened our residents for medical
symptoms that would contribute to
incontinence. She has also assisted us
and provided support for end-of-life and
palliative care by making appropriate
referrals to our participating hospice
provider. Dr. Kurtz will also take the time to
personally meet with families in their time
of need.
Dr. Kurtz is a certified medical director,
regularly attends AMDA symposiums and
serves as a member of Kindred Medical
Advisory Board. It is my pleasure to
nominate Dr. Kurtz for the Distinguished
Service Award.
It would take many pages to review Dr.
Landry’s accomplishments during his
tenure as our Medical Director, but it is the
small things he does which makes him truly
unique. Over the years Frank has personally
contributed hundreds of dollars to our
Christmas party as part of a raffle for those
employees who got their flu shot. During
inclement weather (which we get a lot of),
Frank calls the facility to offer his assistance
and make sure things are running smoothly,
and during the holidays he comes into the
facility on both Christmas and New Year’s to
check on new admissions to the facility.
At a time when medicine is seen as
technologically driven, Frank never loses
sight of his patients. It is not uncommon
to hear a family talk about a time when
Frank made a house call, or returned a
phone call at all hours of the night when a
concern arose. It is without reservation that
I nominate Dr. Frank Landry for the Medical
Director Distinguished Service Award.
4/20/09 3:19:18 PM
During this time I have seen his loyalty
and dedication not only to his residents,
but also to the center as a whole. He is
willing to take the time to meet with all
the families of the residents in our center,
even when the patient is not one of his.
He brings great skill and knowledge
to the facility as he is a member of our
PI committee and attends meetings
monthly. He is an integral part of
analyzing problems, developing solutions,
and shaping facility policy to ensure
exceptional care of our residents.
Dr. Isaac Miller - Guardian Care of
Roanoke Rapids, Roanoke Rapids, NC
I have known Dr. Miller for approximately
eight years and have had the honor and
the privilege of working with him as our
Medical Director.
Dr. Aman Nanda – Oak Hill Nursing and
Rehabilitation Center, Pawtucket, RI
Dr. Nanda has been an integral member
of the Oak Hill team since 2004. He is a
member and active participant on the
Oak Hill Performance Improvement
Committee. Here are just some of the
accomplishments Dr. Nanda has achieved
at Oak Hill.
• He implemented monthly audits of Oak
Hill lab errors and reduced the error rate
from 14% to 3% in 2008.
He is always available when we have
annual state surveys and is here to answer
any questions the surveyors may have.
He is a great leader and role model to
everyone and all departments.
above and beyond to ensure families are
aware of the care and services we render.
Dr. Miller never hesitates to stop along the
way and answer questions of the staff, and
to teach us by explaining the rationale for
his actions.
Dr. Miller is not just the Medical Director
here at our facility, he is family. Everyone
who comes in contact with him trusts,
respects and admires him for his service
and dedication.
It is a great honor to nominate Dr. Miller
for the Kindred Distinguished Service
Award. He has positioned us well in
preparation for Step II by continually
challenging us not only clinically, but in all
areas of patient and facility care.
When it comes to marketing Guardian
Care of Roanoke Rapids, Dr. Miller goes
• He established an Oak PI subcommittee
(consisting of the Medical Director,
Pharmacist, and DNS) to review the
medication regime of all Oak Hill
residents and subsequently reduced the
9+ medications Quality Indicator from
98% to 85% in 2008.
• He implemented the Protocols for
Physicians Notification at all nursing
units, thereby improving the quality of
nurse/physician communications.
• He developed a system to track physician
visitations and required documentation
to ensure their timeliness and
compliance.
• He reviewed and revised the Oak Hill
resident discharge protocols in 2008 to
ensure that discharging residents
received the necessary community
resources and the resident’s community
physician received a summary of care
notification.
• He implemented reviews of all Oak Hill
patient hospitalizations and has reduced
the frequency by over 50% since 2007.
Dr. Nanda has been a member of the
Rhode Island Department of Health
Medical Director Steering Committee
since 2007. Dr. Nanda is Assistant Professor
of Medicine, Warren Alpert School of
Medicine, Brown University where he
also serves as Chairman of the Reynolds
Residency Advisory Committee. Dr. Nanda
has been recognized as a “Best Doctor In
America” in geriatric medicine for
2007-2008.
Dr. Nanda is the co-investigator on two
clinical studies currently underway at
Oak Hill, the first titled: “The Clinical and
Molecular Epidemiology of Clostridium
Difficile-Associated Disease in a LongTerm Care Facility” and the second a
medical records review titled “Urinary
Tract Infections in Long-Term Care
Facility Residents”.
In summary, Aman Nanda is a caring and
compassionate physician, a clinical leader
both at Oak Hill and Brown University, and
an individual who gives of himself to both
Oak Hill and the community to improve
the quality of care for the older person. He
is an excellent representative of both his
profession and Oak Hill.
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Medical Director's Newsletter April 09 .indd 5
4/20/09 3:19:20 PM
to provide care for our residents. He
often comes into the facility on his
lunch break to assess a newly admitted
resident. Dr. Sawyer is actively involved
in our PI process and serves as strong
representative for our facility in the
community. He always makes time
for our residents even though he still
maintains a very busy office practice.
Dr. Charles Sawyer – Guardian Care of
Ahoskie, Ahoskie, NC
Dr. Charles Sawyer should be nominated
as a distinguished medical director
because he gives 150% every day. Dr.
Sawyer and his partners make rounds in
our facility every Wednesday morning
Dr. Sawyer is a well-known, respected
physician in the community. Yet, no
matter what the task, or how difficult it
may seem, Dr. Sawyer is there to assist
us in any way he can. By no means is
Charles Sawyer a perfect man, but he is
definitely an angel, a guardian angel. All
our residents look forward to seeing him
when he comes to the facility, whether
they are his patients or not.
Dr. Sawyer recognizes the potential of
our facility, and requires every one of us
to strive to meet our maximum potential
as well. Of particular note is the fact that
Dr. Sawyer has such strong confidence
in us to provide excellent care that he
admitted his mother to our care in her
time of need.
He never allows anyone or anything to
compromise the care he provides to his
residents. I have often heard him state
that he actually felt guilty for accepting
the monetary compensation he receives.
Such a caring and compassionate
physician is hard to find. All of us at
Guardian Care of Ahoskie recognize that
we are extremely fortunate to have such
a jewel among medical practitioners to
call our own.
It is a privilege to nominate Dr. Charles
Sawyer for the Kindred Medical Director
Distinguished Service Award.
Not Pictured:
Dr. Jeffrey Robbins – Windsor
Rehabilitation and Healthcare Center,
Windsor, CT
Dr. Robbins has been the Medical
Director for Windsor Rehabilitation and
Nursing Center for 15 years. Everyone at
Windsor Rehab loves to see Dr. Robbins
when he visits. He is here whenever we
need him. The staff knows that they
can call upon him for anything. We can
depend on him to answer our calls, and
he is prompt in getting back to us.
Dr. Robbins is a great team player and
collaborator. He is always giving us ideas
and thinking outside of the box to help
us solve problems. He is actively involved
in assessing our capabilities and our
clinical grid competencies.
He takes time with the residents to
help them cope or just feel like they are
staying in control of their own care. He
is always willing to take time to educate
staff, residents, and family members
when the need arises.
Dr. Robbins is very consistent, and we can
rely on him to step in when other doctors
are not able to fulfill their responsibilities.
He is a leading force among our medical
staff. He is always present at our medical
staff meetings and will encourage the
other members to participate and fulfill
their responsibilities.
Dr. Robbins is an advocate for the facility
in the community and it is an honor to
nominate him for the Distinguished
Service Award.
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Medical Director's Newsletter April 09 .indd 6
4/20/09 3:19:21 PM
Dr. Robert Karp – Starr Farm Nursing
Center, Burlington, VT
Dr. Robert Karp has been our Medical
Director for the past nine years. He is
an exemplary leader and teacher in the
fields of long-term, sub-acute and endof-life care. Dr. Karp willingly extends
his time and expertise above and
beyond the requirements, fostering a
team approach in providing the highest
quality and holistic care to our residents.
In short, Dr. Karp’s commitment to
excellence is visionary. As a teacher
and mentor, Dr. Karp works with new
medical students. In addition to helping
these future doctors learn about longterm care, he also counsels them as to
the challenges and issues faced by the
clinical team and direct-care staff within
our center. Each year he coordinates
groups of medical students to go to our
area senior care facilities to interact with
residents and staff for an afternoon and
then holds discussion groups in class
about their experience. Dr. Karp teaches
others to be advocates of patients
and their families, whether promoting
wellness or dignity at the end of life.
Dr. Karp willingly accepts new patients
admitted to Starr Farm, and is very
diligent about their continuum of care
until they return to the community, and
their primary care physician. He is in the
facility checking on his patients four to
five times per week, and he calls when
not in the building. He even calls on the
weekends to ensure patients’ needs are
being met, rather than having the nurses
rely on the on-call physician for patient
needs.
Dr. Sherri Brown – Canyon West Health
and Rehabilitation Center, Caldwell, ID
You can read the respect that she has for
our residents in her dictation.
It is our privilege to nominate Dr. Brown
for the Distinguished Service Award due
to her compassion, attention to detail,
and the clinical skills that she bestows
upon our facility, staff and residents with
every contact.
Upon visiting with staff, I found this to
be the way Dr. Brown is with all. The
Admission Coordinator praises Dr. Brown
for her quick response and availability to
the new residents and their families. This
assists with the transition to our facility
and builds a relationship that spreads
out to our community. The nurses call
her 24 hours a day. CNAs talk to her with
concerns and she addresses all concerns
quickly with a compassion for the
resident that is a comfort to all. She sets
time aside for families and their loved
ones. She is always approachable.
Before Dr. Brown decided to devote her
entire practice to LTC, she was affiliated
On her rounds you can always see her at
eye level visiting with each resident and
actively listening to their concerns.
I have never seen a doctor with so much
respect for the patients she treats. Their
cognitive abilities and issues never
diminish her respect or compassion
she has for them. She is very thorough
with her care and her documentation.
Dr. Karp is highly respected for his team
approach. He attends performance
improvement meetings and conducts
rounds on the floor with nursing and
social services staff. He has fostered an
environment of mutual respect and trust.
Issues and inquiries related to patient
care are addressed immediately. Dr. Karp
ensures that clinical staff members are
trained and understand all policies and
procedures.
In summary, Dr. Karp is not only a
wonderful physician and patient
advocate, he is a wonderful person.
The residents and staff of Starr Farm
Nursing Center are very fortunate for the
leadership, care and concern Dr. Karp
exhibits on a daily basis – he is an asset
to the entire community and field of
long-term and sub-acute care.
with the Saint Alphonsus Medical
Group ambulatory care practice. We
contacted the staff at Saint Alphonsus
and they also noted that every patient
was important to Dr. Brown and every
concern was addressed in a loving,
caring, compassionate way. Her patients
not only trusted her with their care, but
also adored her.
Caring is what we do best and Dr. Brown
is a huge part of accomplishing that
goal. Many reasons have been offered
as to why Dr. Brown is the best Medical
Director any nursing staff could hope for,
but it is her quality care that she provides
for the residents that make her truly
unique.
Distinguished Service Award Postscript
On a personal note, after reading and re-reading these nomination excerpts, one can only hope that our families and friends and
indeed someday ourselves are fortunate enough to wind up in the care of physicians with the qualities noted here. - Keith
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Medical Director's Newsletter April 09 .indd 7
4/20/09 3:19:22 PM
Survey Outcomes Continue Improving
Compliance with state and federal
regulations continues to hold a prominent
position in our quality improvement efforts.
One of the metrics we have been tracking
for several years is the percentage of annual
state surveys that result in a deficiency
cited at a scope and severity of F, H, I, J, K
or L. These are the levels that, in the eyes
of the surveyors, may potentially represent
an infraction that is either noted to be
widespread in the facility or results in actual
harm or some combination of both.
averages as demonstrated in the adjacent
graph. Thanks to all the dedicated staff and
conscientious physicians who have made
these dramatic improvements possible.
Kindred nursing center annual surveys have
markedly improved over the years in this
metric and are now better than industry
Improvement in % of SNF Annual Surveys with Higher Scope and Severity Tags
30.0%
28.9%
25.0%
21.8%
20.7%
20.0%
Kindred (48.1% Relative Improvement)
15.0%
24.1%
23.1%
15.0%
All For Profit (-10.6% Relative Deterioration)
Nation (-11.6% Relative Deterioration)
10.0%
June 2000 to August 2001 October 2007 to December 2008
Each data point represents the most recent Standard Survey for all Centers in Kindred (n = 226), For Profit (n = 10,540), Nation (n = 15,727)
as of December 31, 2008; Not same store comparisons (Kindred Continuing OPS for most recent data);
Higher Scope and Severity = Tag Level F, H, I, J, K, L
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Medical Director's Newsletter April 09 .indd 8
4/20/09 3:19:25 PM
Fortune Magazine Names Kindred Healthcare Most Admired
In March 2009, Kindred Healthcare, Inc. was named by
Fortune magazine as the Most Admired company in the
category of “Health Care: Medical Facilities.”
(Health Care: Medical Facilities)
The Most Admired list is the definitive report card on
corporate reputations. Fortune magazine ranks companies
within 64 industries, based on nine different “attributes
of reputation.” Kindred is ranked first in five of the nine
attributes, including people management, use of corporate
assets, social responsibility and financial soundness. To
create the industry rankings, surveys were sent to over 4,000
executives, directors, and analysts to rate companies within
their own industry.
In addition, the Company’s support center was recently
named one of the Top 25 Best Places to Work in Kentucky.
This is the third year in a row the Company received the
designation.
“These honors were earned by our 53,700 caregivers and
support center colleagues,” said Paul J. Diaz, President and
Chief Executive Officer of the Company. “As everyone in the
country struggles to pull through these difficult economic
times, we will continue to advance our core strategy that
taking care of our people, and focusing on the quality of our
services, drives our business results.”
Mr. Diaz went on to comment on President Obama’s plans for
healthcare reform. “As a provider of healthcare for over 33,600
patients and residents each day, and as an employer of
thousands of people in 40 states, we support the President’s
priority to reform the healthcare system. Post-acute providers,
like Kindred Healthcare, are an important part of improving
the efficiency and effectiveness of the nation’s healthcare
delivery system and we look forward to actively participating
in the public policy process to advance healthcare reform.”
Kindred Healthcare, Inc. is a healthcare services company,
based in Louisville, Kentucky, with annual revenues of over
$4 billion and approximately 53,700 employees in 40 states.
At December 31, 2008, Kindred through its subsidiaries
provided healthcare services in 655 locations, including
82 long-term acute care hospitals, 228 skilled nursing
centers and a contract rehabilitation services business,
Peoplefirst rehabilitation services, which served 345 nonaffiliated facilities. Kindred’s mission is to promote healing,
provide hope, preserve dignity and produce value for each
patient, resident, family member, customer, employee and
shareholder we serve. For more information, go to
www.kindredhealthcare.com
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Industry News and Updates
Flu Viruses Growing Resistant to Key Weapon Tamiflu
Evidence that flu viruses are becoming
more resistant to the drug Tamiflu has
sown deep concern among doctors
who are worried that their best flu
treatment is losing its punch. The
spread of resistance also has potentially
weakened a pillar of the stockpiles
of drugs that will be used to combat
global flu outbreaks, doctors say.
The first in-depth analysis of Tamiflu
resistance during last year’s flu season
found that about 12% of people with
one of the three strains that caused the
most illness, influenza A/H1N1, were
infected with resistant viruses. One in
five of last year’s patients caught the
strain, doctors reported Monday.
This year, Tamiflu resistance in that class
of viruses has reached almost 100%,
turning the tables on a drug designed
to defeat resistance. “They’re the most
common viruses circulating this year,”
says flu expert William Schaffner of
Vanderbilt University.
The evidence of growing resistance
prompted the Centers for Disease
Control and Prevention in December to
alter its treatment recommendations.
The CDC now urges doctors to use
Tamiflu for patients with influenza B
viruses or, when they haven’t identified
the flu type, with rimantadine, one of
two drugs from an older class of
flu fighting agents. Relenza, a close
cousin of Tamiflu, is still broadly
effective, doctors say, but the drug isn’t
recommended for children younger
than 7, those with asthma and those
unable to use an oral inhaler.
The study provoked immediate concern
among those in charge of outbreak
preparedness, says Robin Robinson, who
directs the emergency-response stockpile
for the Department of Health and Human
Services. Robinson says experts now
are considering whether to change the
stockpile to be better prepared to deal
with Tamiflu resistance.
Influenza Virus B
Doctors say the rapid spread of Tamiflu
resistance underscores the value of
vaccination. “That’s your best protection,”
says Alicia Fry of the CDC, who is a leader
of the government’s Tamiflu resistance
working group.
Dr. William Schaffner
“There are calls coming in from all
over the country to infectious-disease
doctors and public health specialists
asking them how to proceed.”
Fry’s team tested 1,155 A/H1N1 viruses
from 45 states. They found that 142
viruses from 24 states were resistant to
Tamiflu, or 12.3%. So far this year, 264 of
268 viruses tested were Tamiflu-resistant,
or 98.5%, they report in The Journal of the
American Medical Association.
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Upcoming Events
American Geriatrics
Society
Annual Scientific
Meeting
2009
CHICAGO
AMDA Core Curriculum on
Medical Direction in Long
Term Care
July 19-25, 2009,
in Miami/Coral Gables, FL
November 8-14, 2009,
in Long Beach, CA
The AMDA Core Curriculum on Medical
Direction (Core Curriculum) guides
participants through 20 critical areas
of long term care management. Each
topic builds on information shared and
interactive exercises of the topics that
precede to create a comprehensive and
cohesive picture of medical direction in
long term care. The Core Curriculum is
presented in two parts, each reflecting
Medical Director's Newsletter April 09 .indd 11
April 29 – May 2, 2009
Hyatt Regency Hotel, 151 East Wacker
Drive Chicago, IL
Learning Objectives
• Analyze current research in geriatrics and
understand its clinical implications.
• Interpret information on the prevention,
diagnosis, treatment, and management
of clinical disorders in older adults.
• Identify prevalent psychosocial problems
in older people.
• Describe medical, psychological, social,
and rehabilitative interventions to
prevent frailty and improve
independence and quality of life of older
people.
• Describe the problems of comorbidity,
multiple morbidity, and burden of illness
and their relation to normal aging, frailty,
disability and adverse outcomes of care.
elements of adult-learning practices. Part I
of the Core Curriculum is a prerequisite for
attending Part II.
The Core Curriculum is presented over the
span of seven days — Sunday evening
through Saturday afternoon. Parts I and
II of the course may be taken at different
times if necessary to accommodate
individual physician’s schedules. However,
it is recommended that physicians take
both parts of the course during the
same week for the best possible learning
experience.
Learning Objectives
The goal of this comprehensive course
is to create a stronger sense of the
leadership role of the medical director
and to provide opportunities to hone
skills and interact with peers. Following
the conference, participants should be
able to:
• Develop practical skills needed to fulfill
the role and responsibilities of the
medical director.
• Teach geriatrics effectively to
interdisciplinary health care professional,
students, and trainees.
• Identify ethical issues in health care
delivery, medical treatment, and
decision-making.
• Influence current health policy relating
to financing, measurement, and delivery
of geriatric care.
• Present effective, efficient and
sustainable delivery of geriatric health
care in acute, sub-acute long-term care,
and other settings.
• Analyze results of geriatric and risk
assessment of older patient, specify
appropriate interventions, and identify
anticipated outcomes.
Continuing Medical Education
The AGS designates this educational
activity for a maximum of 35.5 AMDA PRA
Category 1 Credits.
• Identify the unique aspects of the longterm care environment that impact the
medical director’s job.
• Describe the organizational
responsibilities and dynamics of the
medical director and the
interdisciplinary team.
• Develop communication skills to
deal with responsibilities for the
interdisciplinary team, residents, and
their families.
• Explain the resident care responsibilities
of the medical director, including
emergency care, quality management,
family systems, and ethical
considerations.
• Enhance leadership skills and team
building towards a stronger role for the
medical director with the
interdisciplinary team.
• Develop human resource skills to
deal with difficult situations and improve
personal effectiveness in this area.
11
4/20/09 3:19:28 PM
Professional
Liability
Professional Liability
Insurance
for Insurance for
Medical
Director Administrative
Duties
Medical Director
Administrative
Duties
Kindred Healthcare provides professional
liability insurance for Medical Directors
in the discharge of their administrative
responsibilities as a nursing center
Medical Director. This coverage is for
administrative services only and not for
the care or treatment of their patients
in the context of the doctor/patient
relationship.
If your personal Malpractice insurance
carrier requires proof of coverage
for your administrative duties as a
Kindred Medical Director, please ask
your Executive Director to contact Nita
Blevens in Kindred’s Risk Management
Department at 502.596.7159. She will
provide a copy of the professional liability
insurance certificate for your center.
rof ecnarusnI ytilibaiL lanoisseforP
AMDA Membership
seituD evitartsinimdA rotceriD lacideM
All Kindred Medical Directors are enrolled
in the American Medical Directors
Association. Membership in AMDA means
you should be receiving the Journal
of the American Medical Directors
Association (JAMDA) containing peerreviewed articles dedicated to the care
of patients in nursing centers and other
LTC settings. Members also receive Caring
for the Ages, a monthly newsletter with
a multitude of articles, both clinical and
management, of interest to the LTC
Medical Director. If you are not receiving
these resources, please let us know so
we can recheck mailing lists and contact
information.
Contact Us
Kindred Care Quarterly is produced
four times a year by Kindred
Healthcare. If you have story ideas,
content suggestions or any questions
about this publication, please contact
any of the following individuals:
Dr. Keith Krein
Chief Medical Officer, HSD
502.596.7342
Keith.Krein@kindredhealthcare.com
Lesley Blissett
Senior Administrative Assistant
502.596.2836
Lesley.Blissett@kindredhealthcare.com
Leigh White
Editor
502.596.6593
Leigh.White@kindredhealthcare.com
Kindred Healthcare
680 South Fourth Street
Louisville, Kentucky 40202
www.kindredhealthcare.com
Dedicated to Hope, Healing and Recovery
COPYRIGHT © 2009 Kindred Healthcare Operating, Inc. CSR 95621-01
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