A woman was treated and discharged from Fort Sanders Hospital. She refused to leave the emergency room.

The hospital called the police to force the woman to leave.

The police put her in a cruiser (for an unknown amount of time) to take her to a detention facility to be booked for trespassing.

The woman became unresponsive.

The woman is back at the hospital in critical condition.

Poor treatment of a medical patient? Did the woman have any place to go? Did she know she should not leave because she was still in need of medical care?

Blount Memorial Hospital announced on June 9 that the Board of Directors named Harold Naramore the new Chief Executive Officer.

It would appear that Dr. Naramore is a good choice for the CEO position. He has worked at the hospital for over 12 years. He was Chief Medical Officer. He is a"medical doctor with a degree from James H. Quillen College of Medicine in Johnson City, Naramore also has a master’s in business administration from The University of Tennessee, Knoxville and a law degree from UTK College of Law."

"Board-certified by the American Board of Psychiatry and Neurology and the National Board of Medical Examiners, he is an assistant professor at UTK, staff psychiatrist and general council for Frontier Health in Gray and a clinical assistant professor at Quillen."

But, then...

"The three municipal mayors within Blount County signed and sent a letter to Blount Memorial Hospital Board of Directors requesting a full review of the selection process for new Chief Executive Officer Harold Naramore."

"Prompted by concerns from numerous Blount County citizens and businesses, as well as members of legislative bodies within Blount County..."

"The two main concerns outlined in the letter questioned whether a public notice was given for a called meeting and if the hospital followed several of their own bylaws."

Who are these citizens, businesses, and/or members of legislative bodies that have concerns about the hiring of Naramore? Should there be a Freedom of Information Act request so that everyone will know who complained and why?

It all seems a little mysterious.

For over 20 years the Leapfrog Group has been doing hospital surveys to grade hospitals in a variety of areas including infections, problems with surgeries, safety problems, practices to prevent errors, and doctors, nurses and hospital staff.

You can search by city, state and a few other criteria.

Knoxville and Nashville hospitals appear to rate overall better than hospitals near/around Atlanta and Birmingham.

Not all hospitals agree with the Leapfrog Groups methodologies. In 2019, "NCH Healthcare in Naples, Florida, filed a suit to challenge its "D" rating in an effort to keep the grade from being published. The suit alleges deceptive and unfair trade practices, as well as defamation, saying the health system did not participate in the 2019 survey and, thus, Leapfrog had to rely on secondary information for more than half of its measures to compare it against hospitals that did provide those measures."

Blount Memorial Hospital, Covenant Health, East Tennessee Children’s Hospital, Sweetwater Hospital Association and The University of Tennessee Medical Center are planning to comply with the COVID-19 vaccine mandate issued by the Centers for Medicare and Medicaid Services (CMS).
...
"Clinical, non-clinical and medical staff, as well as students, volunteers, contracted employees and vendors are required to have initiated the first dose of the primary COVID-19 vaccine series or received a single dose of the one-dose vaccine by December 5, 2021, unless they qualify and are approved for a religious or medical exemption to the vaccine.

The two-dose series to be fully vaccinated must be completed by January 4, 2022."

According to the hospital leaders, about 65% of patients at Covenant Health use Medicare or Medicaid; about 61% of UTMC patients use Medicare or Medicaid; and about 60% of Children’s Hospital patients use Medicaid.

“We have supported the vaccine throughout the entire pandemic, and that has not changed. We feel the same as we have,” said Dr. James Shamiyeh, Senior Vice President and Chief Operating Officer of UTMC.
...
At Covenant Health, about 30% of employees are not fully vaccinated; at UTMC it’s about 26%, and Children’s Hospital it’s about 20%."

It's about time. Gotta hurt them in the pocketbook instead of them taking the initiative to ensure hospital patients (and fellow employees) are safe from the pandemic.

It's tough being the leader of a hospital in Tennessee. But, they required vaccines in a very large Texas hospital system months ago.

Businesses protest [state's proposed]'unnecessary government intrusion' in TN legislature's new COVID-19 bill

Tennessee hospitals are worried about wide-reaching coronavirus legislation

Tennessee's state legislature has gone Trumpian. What can be done to rein in these imbeciles? Nada in Tennessee.

Idiocracy in Tennessee!!!

In 2017, there were 41 thousand visits to the 30 treatment rooms in the emergency department at Physicians Regional (St. Mary's Hospital). Now that it has closed the other hospitals in the area have to accept possibly 41,000 more ER visits a year. That is a lot to absorb.

Tennova North Knoxville, Fort Sanders, and UT Medical Center appear to be feeling the most affects.

The shutdown has reportedly affected ambulance services as well.

AMR has been dealing with ambulance shortages, in part because ambulances are tied up with lengthy off-load delays in overcrowded hospital emergency rooms, the ambulance service told the News Sentinel last month.

In an attempt to get more ambulances on the road, Knox County is temporarily changing its contract with ambulance provider AMR (Rural/Metro). County Mayor Glenn Jacobs' office announced Monday a 90-day agreement will allow Basic Life Support ambulances to respond to all but the most severe calls. Normally, the contract requires AMR respond to calls with Advanced Life Support ambulances, which carry more equipment, but of which there are fewer.

Did you know that for a Medicare recipient to get admitted to a skilled nursing facility for rehabilitation therapy they have to be admitted to a general hospital as an inpatient for 3 days? This means that if you are getting observation services, the day(s) under observation do not count towards inpatient status in a hospital. Sitting in the ER would not be included as an inpatient day. Thus, a woman referenced in this article that spent 24 hours in the ER waiting to be admitted would have lost a full day if there had been a need to go to a skilled nursing facility for rehab. It's possible there are clauses in many private health insurance contracts with this requirement.

About five years ago I had to meet an elderly person at the UT Medical Center ER after that person had been taken there by ambulance. When I arrived the elderly person was on a hospital stretcher in the hall near the ER criminal intake area. Not a pleasant experience for this person. Luckily actually being in the ER gets you close to the services you need if it becomes unbearable or life threatening.

I worked at UT Medical Center for about five years, many moons ago. To this day I admire all they do for their patients, employees, and the community. I just hope they can keep up with demand and changes in society.

Let's hope the remaining open hospitals in the area and the ambulance services can continue to provide excellent services as expected.

Starting Jan. 1, a new federal rule requires the nation’s hospitals to post all their full-price charges on their websites. The idea is to introduce transparency into the world of hospital charges. But these newly-published price lists may end up leaving consumers even more confused than ever before.

Hospitals use a chargemaster list of prices for all services, goods, and procedures. The chargemaster price is usually the highest price a hospital would charge for services, goods, or procedures. Most people with insurance do not pay the chargemaster price. Insurance companies negotiate with hospitals to bring down the prices. If you don't have insurance or if a service, goods, or procedure is not covered, I would guess you will have to try and negotiate a lesser price or pay the high price.

Each of the hospital's standard charges sites has a disclaimer to which you have to agree with the understanding that the "information provided on these sites are estimates of the charges for a medical service or procedure. The information does not represent the actual amount you will be charged as many variables are involved in providing the amount."

Locally, UT Hospital uses the CDM code, charge description master. Tennova Turkey Creek uses a SVCCD code (don't know what that is). Fort Sanders (Covenant) uses a CPT code (current procedural terminology) as well as a CDM code.

I found it very hard if not impossible to use the price lists provided by the local hospitals to compare prices for services, goods, or procedures. It was my understanding that CPT codes were the standard for how medical providers identify services, goods, and procedures. However, using Fort Sanders Hospital downloaded file, it appears that there are over 4,000 items without a CPT code.

Besides that it is hard to navigate the price lists to compare prices, many people are covered by insurance and the prices are completely different and you are still unable to compare them.

Ft. Sanders (Covenant) has the best web site for looking up prices. UT Hospital and Tennova have you download a csv file, which can be opened in MS Excel or MS Word or similar software. Ft. Sanders also has an option to download a csv file.

I have yet to find the standard charges information when going directly to the local hospital web sites. I've had to Google hospital name standard charges to get links with access to this information.

Ft. Sanders Hospital Price Transparency

UT Hospital Price Transparency

Tennova Turkey Creek price Transparency

CMS.gov FAQs RE Price Transparency

Frequently Asked Questions Regarding Requirements for Hospitals To Make Public a List of Their Standard Charges via the Internet