TRH explains conflicting grades
Hospital gets four stars in CMS survey, ‘D’ grade in safety report from The Leapfrog Group
Published on Thursday, June 13, 2019
Taylor Regional Hospital was one of 21 hospitals in Kentucky to be given a four-star rating (out of five stars) by the Centers for Medicare and Medicaid Services (CMS) in their 2019 report.
It was also one of five hospitals in Kentucky to be given a ‘D’ grade by The Leapfrog Group in their biannual safety report for the first half of 2019.
So, what gives?
The discrepancy between the two scores comes down to methodology — the way each group calculates their scores — and how the information TRH did or did not give them factors into it.
When Taylor Regional received Leapfrog’s survey, part of it was marked as “optional.”
This part included statistics regarding hand washing, staff working together to prevent errors, tracking and reducing risk to patients, effective leadership being used to prevent errors and having enough qualified nurses.
According to a statement given by hospital spokesperson Ann Dabney, TRH chose not to submit information for the optional part of the Leapfrog survey because they already report it to several other organizations, including CMS, as well as The Joint Commission, Anthem and the Kentucky Hospital Association.
“We successfully maintain our continual compliance with multiple accreditations which review measures, including the safety items [not reported to The Leapfrog Group], and just recently completed another Joint Commission survey receiving an updated certification in Sept. 2018,” it read.
Dabney also noted that CMS makes the data hospitals submit to them public, whereas Leapfrog only makes their scores public.
TRH is classified as an “acute care hospital,” meaning they offer both inpatient and outpatient care. Other acute care hospitals nearby include Spring View Hospital in Lebanon, TJ Health in Columbia and Hardin Memorial Hospital in Elizabethtown, each with three-star ratings in the CMS report.
One question Leapfrog’s report raised has to do with Taylor Regional Hospital’s intensive care unit (ICU).
In the category that measures whether or not the hospital has “specially trained doctors” to care for ICU patients, TRH scores a five out of 100, the lowest reported score.
Dabney noted that other hospitals have received the same score and that this metric does not make any attempt to rate the quality of care patients receive in a hospital’s intensive care unit.
Instead, it measures the number of specially trained “intensivists” who work there.
Dabney referenced a study by the Society of Hospital Medicine released in May of 2018, which reported a “well-documented shortage of intensivists in the US.”
The report stated that, in rural hospital settings unable to recruit intensivists, hospitalists were often used to provide critical care instead.
Dabney went on to cite an article published in April of this year by Critical Care Medicine, which found 48% of acute care hospitals have no intensivists on staff.
“TRH is one of many rural hospitals unable to recruit intensivists,” read a statement from TRH. “However, we utilize well-trained hospitalists to take great care of our patients.”
The hospital also expressed disappointment with the grade they received from Leapfrog in a statement.
“We do not believe this [grade] adequately reflects the care that we provide to our patients,” it read. “We strive to provide the best care to our community and will continue to work diligently to demonstrate the high level of care that is synonymous with Taylor Regional Hospital.”
Higdon obtains perfect marks on evaluation
Taylor County Schools superintendent has first assessment from school board
Published on Thursday, June 13, 2019
At the end of their first school year, new superintendents give a first-year capstone presentation.
Charles Higdon Jr. gave his during a special session on June 3, which was followed by a closed meeting where members of the board sat down with Higdon and discussed his evaluation.
That meeting took four hours, according to Board of Education Chairman David Hall, and the results were kept private until the monthly board meeting on June 10.
“A year ago last month, our district hired Mr. Higdon to be superintendent of the Taylor County School District,” began Hall. “He was to be the most recent in a line decades-long of strong leaders, different men and women each facing different challenges defined by the changing minds of various board members and the changing tides of time.”
Hall said the board admired the fact Higdon came into his initial interview “not just ready to answer questions but with a vision to answer immediate needs” and “address coming challenges.”
“We were looking for someone to lead with honor and humility, collaborate with local leaders and respect all within our community as peers, be they young or old, have or have nots, students, faculty, cross-town rivals or alumni.”
He said Higdon’s plan to make himself visible in the school district and establish himself as someone anyone could approach with ideas complemented their own plan of operating transparently.
They also admired his willingness to “slow down” and allow the board to find its voice.
“Our only challenge in this review,” Hall said, “has been to strike a balance between the exemplary manner in which he has executed all seven of the standards in his required review of his first year and our efforts to satisfy the bureaucratic standard to foster the best in someone we believe to be one of a kind.
“It doesn’t do justice to great efforts to be limited to a common scale. It doesn’t speak to promises kept beyond what was asked of him to stick to a generic frame. You can’t show, in future efforts, an improvement on a perfect grade.”
Hall said the board understands the intent of the evaluation process is to examine Higdon’s leadership and address any weaknesses while maintaining his strengths. It’s meant to make the board plan for the superintendent’s continuous improvement, but they felt that wasn’t necessary.
“The seven standards for leadership evaluation are strategic, instructional, cultural, human resource, management, collaboration and influential. He has exceeded them all, and, in so doing, holds our collective esteem,” Hall said. “He has shown us other traits beyond the standards, such as a propensity for compassion, a hunger in competition, resilience in adversity and humility in success. In closing, we have given him his laurels, but know he has no desire to rest upon them.”
Hall pledged the board would “work with Mr. Higdon at the helm” to continue improving the district and themselves by improving their paths of communication, working on professional development and using each other’s “unique and collective strengths.”
“May the Lord bless our good intentions and magnify our best efforts,” Hall said.
“All the positive things we’ve said today have been about you,” board member Tommy Raikes said, “but you have given all the credit to everyone else. That is leadership, and that is what you’re doing on a daily basis. I commend you for it.”
The motion to approve Higdon’s perfect score, with exemplary in all categories, passed unanimously.
In other news:
• Taylor County is one of 20 districts in the United States to be named a National Beta Club District of Distinction. Principals from the middle, intermediate and high school were each given a commemorative plaque to hang in their respective schools honoring the achievement.
• Noah Tyler Bolin was awarded his high school diploma, which he earned through Taylor County High School’s partnership with The Healing Place.
• Randall Johnson, of Codell Construction, delivered an update on work being done to the Central Kentucky Career Center. The aviation and health labs are expected to be completed on time before the next school year begins. The industrial maintenance lab is still slated to be ready in December, though they are slightly behind schedule.
• The board voted to approve a technology plan that would have the district replace its devices every five years, setting aside 1/5 of the resources necessary each year to prevent having to make larger purchases all at once. The plan also allows for the surplus of old devices, with money from their sale going to fund new devices.
• A vote was passed to change the monthly board meeting times for the 2019-2020 school year from 5 p.m. to 6 p.m.
• The Central Kentucky Career Center will soon be looking for a welding instructor. Higdon cited the new jobs being created in Campbellsville by Manchester Tank & Equipment, as well as the popularity of welding classes at the Green County Area Technology Center, as big reasons for the new hire.
• The board voted to rename the Cardinal Career Academy, located in the upstairs area of the Central Kentucky Career Center next to the city lake, and approve its establishment as “Lakeview Academy,” an A-5 alternative school program incorporating grades seven through 12. This classification is intended to make the school eligible for additional funding it could not receive otherwise and will make it the fifth school in the Taylor County School District. No additional staff will need to be hired as a result of this change.
Supreme Court hears local case
State’s highest court rules that ‘Fields vs. Benningfield’ should have circuit court date
Published on Thursday, October 3, 2019
A Greensburg man is one step closer to having his day in court — though his list of defendants will be eight people short.
“The Kentucky Supreme Court upheld, at least in part, the Court of Appeals’ holding that government employees are protected from wrongful termination just like private employees when pursuing workers’ compensation benefits after a work injury,” said Larry Duane Ashlock, lawyer for Jerry Fields, a Greensburg man who says he was wrongfully terminated after being injured while working for the Taylor County Detention Center in 2009.
“The question before the Supreme Court, and before that the Court of Appeals, was whether or not government employers ... have immunity from civil suit regarding wrongful termination under Kentucky workers’ compensation statute.”
After the Court of Appeals found the county and its officials were not immune and ordered Fields’ case return to the Taylor County Circuit Court, the county appealed the ruling to the Kentucky Supreme Court.
In an opinion penned by Kentucky Supreme Court Justice Michelle M. Keller, the court found last Thursday that former judge-executive Eddie Rogers, former jailer Eddie “Hack” Marcum and magistrates James Jones, John Gaines, Tommy Corbin, Matt Pendleton, Ed Gorin and Richard Phillips were not relevant to Fields’ complaint, but former jailer Rick Benningfield and the Taylor County Fiscal Court were, and there was enough evidence to allow the case to return to circuit court.
Fields, of Greensburg, was hired to be a deputy jailer at the Taylor County Detention Center.
He began on Nov. 1, 2008, was promoted to sergeant in April of 2009 and then suffered a tear in his rotator cuff on June 11 of that year while attempting to restrain an inmate.
At the time, Benningfield was Taylor County Jailer.
Fields had surgery to repair the tear in August 2009 but was informed months later of a second, deeper tear. Specialists felt the chance of another surgery improving his mobility was slight, so he did not undergo additional surgery.
His doctor provided him a work release that said he was fit only for “light-duty work,” which included avoiding fights and restraint situations like the one that caused his injury.
Kevin Wilson, chief deputy jailer, told Fields there was no light-duty work available, according to court records.
Fields’ doctor had not allowed him to return to regular work, making the light-duty restrictions permanent.
During his medical leave, Fields was required to regularly update the detention center on his medical status.
Wilson testified during his deposition that Fields had visited the jail a couple of times since being injured, but he couldn’t remember speaking to him.
Benningfield’s testimony supported Wilson’s, saying Fields had visited the jail “a couple times,” and that he usually spoke with Sherry Kerr once a month since she handled medical excuses for the county judge’s office.
Fields testified that he visited the jail after every doctor’s visit. He felt, after the two or three visits he made right before his termination, he was not welcome.
According to court records, Fields recounted a conversation in which Benningfield allegedly told him he would “love to fire him” but couldn’t because he still got workers’ compensation, pointing out that he had to fill Fields’ position with part-time employees.
Fields went on to recall a conversation he had with Wilson in which he was informed of his demotion from sergeant to deputy, being told by Wilson, “I’m sitting here and you’re sitting over there. I can do this.” He also testified that the jail stopped calling to check on him when they found out he needed surgery.
Fields’ medical leave expired on March 10, 2010. Wilson testified he was contacted that day by Kerr, who let him know about the expired medical excuse and unsuccessful attempts to contact Fields about it. She asked if he had tried to contact Fields, and Wilson said it was not his job to do so and he was ready to fire him.
The jail sent a termination letter to Fields dated March 15, 2010, signed by Wilson, explaining why he was being terminated.
His doctor’s excuse expired on March 10, 2010. The Family and Medical Leave Act (FMLA) did not apply to him because he had not worked at the jail for a year before going on medical leave.
The cervical neck injury he was claiming as his current injury was not related to the shoulder injury he had when he filed his workers’ compensation claim.
“No attempt has been made to contact the Taylor County Detention Center.” And, related to that, “failure to contact employer on status of injury.”
After receiving the letter on March 20, 2010, Fields contacted Eddie Rogers, the judge-executive at the time. Rogers suggested he speak with Benningfield and the county attorney.
Fields did not follow up with either of them but instead contacted Wilson, who reiterated what was said in the letter and referred him again to the county attorney.
Fields did not speak to the county attorney and did not request a hearing to dispute his termination.
Fields received workers’ compensation for his injuries, and his claim was settled in 2011.
He then filed suit against the defendants: Rick Benningfield, individually and in his official capacity as Taylor County Jailer; Eddie “Hack” Marcum, individually and in his official capacity as Taylor County Jailer; the Taylor County Fiscal Court; Eddie Rogers, Taylor County Judge-Executive as well as James Jones, John Gaines, Tommy Corbin, Matt Pendleton, Ed Gorin and Richard Phillips, all of which were magistrates at the time, in the federal United States District Court for the Western District of Kentucky.
Fields claimed his Fourteenth Amendment right to due process had been violated, and also claimed wrongful termination and retaliation under state law.
The court granted a “summary judgment,” which means the court believed they had no more fact-related issues to discuss.
They dismissed the claim his right to due process had been violated on the grounds he had been adequately notified of the charges against him and his right to request a hearing.
They refused to rule on the wrongful termination or retaliation claims because those were related to state law, not federal.
Fields appealed, but the Court of Appeals for the Sixth Circuit affirmed the decision.
The current lawsuit being discussed was filed on April 12, 2013.
Fields’ complaint alleged he had been denied a pre-termination hearing, resulting in due process violations under state constitutional and statutory law; wrongful termination without cause, which violated KRS 71.060 and the ‘retaliation claim,’ which alleged violation of KRS 342.197 by harassing, coercing or discriminating against him for filing a workers’ compensation claim.
Because so much evidence was collected during the discovery phase of the federal lawsuit, the defendants filed a motion to have the Taylor County Circuit Court give summary judgment on April 2, 2014.
The suit was heard on June 17 of the same year, though no judgment was rendered.
During a case management conference on Sept. 15, 2015, the possibility of issuing a summary judgment was raised again.
On Nov. 15, 2015, a one-page order granted the defendants’ motion for summary judgment, saying “there are no genuine issues as to any material facts and the defendants are entitled to judgment in their favor dismissing all claims against any of them for the reasons asserted in the record.”
Fields appealed the judgment and the Court of Appeals determined all due process claims made by Fields, both at the federal and state levels, were resolved in the defendants’ favor.
Neither party sought rehearing of the due process issue.
The Court of Appeals did not address the wrongful termination claim, but neither party sought rehearing of that issue, either.
That leaves the retaliation claim.
The Court of Appeals held that KRS 342.197 implicitly waived sovereign immunity for government officials, and said the Taylor County Circuit Court’s summary judgment was inappropriate because various disputed facts existed that could establish a violation of KRS 342.197.
The defendants appealed this part of the decision.
Last Week’s Ruling
The Court of Appeals originally found, in 2015, that in the case of the Department of Corrections v. Furr (2000), the Kentucky Supreme Court had ruled that the Commonwealth waives sovereign immunity for claims brought under the Kentucky Civil Rights Act (KCRA).
The KCRA makes it unlawful for an employer to discriminate on the basis of “race, color, religion, national origin, sex, age, disability or status as a smoker.” The court also found that “the state” and “any of its political subdivisions or agencies” can be considered employers under the KCRA.
Because the state is specified as an employer, it is prohibited from discriminating against its employees under the KCRA, which waived sovereign immunity “by overwhelming implication.”
The court also argued that immunity “frustrates the act’s purpose and intent, deprives many of its citizens of protection and renders meaningless its pledge to safeguard all individuals from discrimination.”
The Court of Appeals determined Taylor County is an employer, making the county subject to the standards of KRS Chapter 342, which includes KRS 342.197, when dealing with Fields, who was an employee.
The Court of Appeals then said that, under KRS 342.197, any employee who is “harassed, coerced, discharged or discriminated against in any manner whatsoever” for filing a workers’ compensation claim “shall have a civil cause of action in Circuit Court to ... recover the actual damages sustained by him, together with the costs of the lawsuit including a reasonable fee for his attorney of record.”
There is no exception made for government employers.
The Court of Appeals concluded that government employees have the ability under KRS 342.197 to seek recourse if they are terminated for filing a workers’ compensation claim.
“Any contrary conclusion would render the protections of KRS 342.197 afforded to government employees in Kentucky to be meaningless.”
The Court of Appeals went on to list seven facts it felt could have supported the retaliation case had it been tried in front of a jury.
The Kentucky Supreme Court, in its Sept. 26, 2019, ruling, agreed with the Court of Appeals — in part.
“...these facts, if proven, could lead a jury to believe that Fields’ pursuit of workers’ compensation benefits was a ‘substantial and motivating factor’ leading to his termination,” wrote Justice Keller, agreeing with the Court of Appeals before listing additional facts the Court of Appeals overlooked which could support Fields’ claim.
“A jury presented with these facts could reasonably find in favor of Fields,” wrote Justice Keller.
“Summary judgment was therefore inappropriate.”
Fields’ allegations did not suggest wrongdoing on the part of Eddie Rogers or any of the magistrates, though.
When asked during his deposition what they had to do with his complaints, Fields said, “I could say they had nothing to do with my termination.”
There were also no allegations of wrongdoing against Marcum.
“Because it is undisputed that these individuals had no involvement in the termination of Fields, summary judgment was appropriate [for] these individuals.”
The Supreme Court also ruled Rick Benningfield was shielded from the lawsuit as an individual but not as a county official since Fields’ allegations involve him in his role as county jailer.
With the Supreme Court’s ruling, the case returns to Taylor County Circuit Court.
“There was a question of whether or not there was enough evidence to take the case to trial, and on that they ruled in favor of my client,” said Ashlock. “They found that there were numerous pieces of evidence from the deposition testimony that, if a jury were allowed to hear it, they could find my client was wrongfully terminated by the former jailer Benningfield and the Taylor County Fiscal Court.”
Ashlock said Fields is looking forward to finally presenting his case before a jury.
“We have fought this case a long way,” said Ashlock, “and sometimes you have to fight all the way to the Supreme Court to get justice.”
Arden Winter Roberston Huff, attorney representing Benningfield and the county, did not return requests for comment by press time.