|Convenient Care at Lady of the Sea AFTER HOURS Clinic!|
The South Lafourche community now has a convenient location during evenings and weekends for medical care of minor illnesses, injuries and infections. Open 7 days a week, Monday through Friday from 5pm to 9pm and Saturday and Sunday from 9am to 3pm, the After Hours Clinic is located at 186 West 134th Street, directly across from the Emergency Room. The walk-in clinic means no appointments are necessary.
Click here to view the After Hours page
We are recognized in the May 2014 newsletter from the Louisiana Emergency Response Network as a success story for Stroke Tele-Medicine. Through early identification and treatment, one of our patients received excellent care and made a successful recovery through life-saving techniques provided by Lady of the Sea in partnership with Ochsner Medical Center's tele-medicine tool. To read the entire article, please click here.
|Commercial - Surgery Team at LOSGH|
You can feel comfortable coming to Lady of the Sea knowing that you are receiving the very best in medical care. View this TV Commercial about our excellence in surgery at Lady of the Sea General Hospital.
Want to see all our TV commercials? Click here!
|LOSGH Receives Studer Award|
Lady of the Sea has earned the "Firestarter" Award, also known as the Healthcare Organization of the Month Award, for May 2012. Quint Studer, founder of the Studer Group, is shown in this video presenting us with this prestigious award. The award distinguishes LOSGH among other hospitals by highlighting our improvements to quality of care.
See the video here
|Lady of the Sea Listed in LA Top Hospitals|
Louisiana Life Magazine has listed Lady of the Sea General Hospital as a top hospital in the state, among others. Patients queried by Medicare about their quality of service from hospitals are the source of evaluations that can be found on medicare.gov. The ranking in this article from the magazine is the work of two years of research by the magazine using Medicare's evaluations. At least 50 percent of the patients queried had to give the hospital a top overall ranking of 9 or 10 in order to qualify for the magazine's elite listing. Lady of the Sea is proud of its employees, who have all contributed to the consistent high scoring. "Louisiana's Top Hospitals - The Patients Speak" can be viewed on Louisiana Life's website: MyNewOrleans.com
|LOS Medical Clinics convert to Electronic Health Records!|
Lady of the Sea Medical Clinics have converted to Electronic Health Records!
Patients will be able to: Exchange messages with our practice, review and pay billing statements, request appointments, research health topics, review Personal Health Information, complete and update medical forms, and update your profile and contact information. There is also a link on our main website, www.losgh.org, on the main navigation bar with other links titled "Clinic Portal" or click here to access it now.
Ask your provider for more information!
Web address and personal PIN will be available upon office visit check-in.
|Wrapped Up in Appreciation|
Mr. Rex Matherne and his wife, Mrs. Anna Matherne recently donated a beautiful hand-made quilt to our staff in appreciation of the care Mr. Matherne received during a recent ER visit. "We wanted to show our appreciation for all that the staff did for Rex, for all ya'll help getting him back well. We want people to see the quilt and know how good the care is at our hospital," said Mrs. Matherne. Our staff was so grateful to be recognized with such a heartfelt gift. The quilt has a medical theme in each panel, including one that depicts our Physicians and one that depicts our Nurses. The quilt will be displayed in our lobby for everyone to see and enjoy the beautiful work of art. Shown (L-R) Karen Collins, RN, CEO; Chantelle Bouffanie, CNA; Brittney Ledet, RN, BSN; Mr. Rex Matherne; Kalie Gisclair, RN, BSN; Mrs. Anna Matherne; Miss Ashlyn Shicksnider, Granddaughter.
On Thursday, October 16, Lady of the Sea General Hospital, in conjunction with Lafourche Ambulance District (LAD) #1 and the Hospital Designated Regional Coordinator from Health and Human Services (HHS) conducted an Ebola Virus Disease (EVD) drill to test our competency and readiness to face a possible EVD case in our community. CLICK HERE to learn more about our Ebola Drill.
|LOSGH Receives ISO-9001-2008 Quality System Certification and 5-star CMS Status|
Lady of the Sea General Hospital has received ISO 9001:2008 certification by DNV, a leading accreditor of U.S. hospitals that integrates ISO 9001 quality compliance with Medicare conditions of Participation. Lady of the Sea General Hospital is the first critical access hospital in Louisiana to receive this certification. In April, Lady of the Sea General Hospital was notified that it had also received the newly developed "5-Star" rating using HCAHPS results by the Centers for Medicare and Medicaid Services (CMS), which is a patient experience rating system based on surveys indicating patient's perspective of the care they receive in hospitals. Hospitals differ on the quality of care and services they provide to patients. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is the first national, standardized, publicly reported survey of patients' perspectives of hospital care, and has been in place since 2008. In 2015, CMS began using a "star" system to make it easier for patients to recognize better quality care by facilities who participate in the HCAHPS system. To calculate the HCAHPS star ratings, the survey information from one hospital is compared to that from others. More starts indicate better quality care than fewer stars. "Lady of the Sea is proud to be the only 5-Star hospital in Lafourche and Terrebonne parishes. In the state of Louisiana, there were 17 facilities to earn the 5-Star rating," said Karen Collins, CEO. "Our staff is committed to providing personalized, quality care, and their efforts are reflected in this patient focused accomplishment." ISO 9001 is a quality management system recognized by business around the world, including hospitals and healthcare providers, as the benchmark for continual quality improvement. It was created by the International Organization for Standardization (ISO). The ISO 9001:2008 standards place significant emphasis on proper documentation of all processes within a hospital to ensure that the staff is consistently delivering care in the safest and most effective way. While other certifications mandate specific yet static criteria for participation, ISO 9001:2008, focuses on continuous improvement of services and processes, which has a positive impact on safety and quality. DNV was authorized by CMS in 2008 as the only accreditation and certification program for hospitals that integrates the ISO quality management system with the core requirements for hospitals set forth by the U.S. government. Lady of the Sea General Hospital received their required hospital accreditation from DNV in January, 2011. The administration then chose to pursue ISO 9001:2008 certification, which is a more rigorous yearly quality assurance process than accreditation alone. To receive the certification, the hospital underwent an intense on-site evaluation each year for the next three years, showing progress and demonstrating quality in a number of areas including but not limited to inpatient care, outpatient care, administering of medications, food service, operating and administrative procedures, medical equipment and supplies, and infection control. To maintain this certification, each year the hospital will undergo a similar review by DNV to demonstrate continued compliance. "Hard work and dedication by our employees using their critical thinking skills in addition to their compassion and caring attitudes when it comes to patient care is what sets us apart and drives our high patient satisfaction scores," said Lloyd Guidry, COO at Lady of the Sea. "In addition to our patients being satisfied, we also focused on demonstrating quality and efficiency in all areas of our facility, which has enabled us to receive both of these designations at the same time. I'm very proud to be a member of this team at Lady of the Sea."
|Lady of the Sea's Lloyd Guidry, Jr. in National Magazine!|
Our Pharmacy Director and Chief Operating Officer, Lloyd Guidry, Jr., PharmD, RPh. is the main contributor to the cover story appearing in the June 2015 edition of Pharmacy Purchasing and Products, a national magazine targeting the Pharmacy industry.
The article reads:
Q&A with Lloyd J. Guidry, Jr, PharmD, RPh, director of pharmacy and chief operations officer, Lady of the Sea General Hospital, Cut Off, Louisiana
Pharmacy Purchasing & Products: In your experience, what are the biggest challenges to ensuring 340B compliance?
Lloyd J. Guidry, Jr: Remaining abreast of changes to the program is key to continually ensuring the integrity of the covered entity's 340B practices. Moreover, this must be accomplished without overloading staff with excessive responsibilities or imposing additional costs upon the covered entity.
To effectively manage the complex dynamics of the 340B program, and address issues as they arise, consider forming a multidisciplinary team of staff directly involved in 340B-related activities. Given that covered entities can gain significant financial savings by exercising the full capacity of 340B, this team should enlist staff from the highest echelons of the hospital. Thus, a comprehensive team should include the CEO, CFO, director of pharmacy, compliance officer, director of revenue cycle, and clinical IT representatives.
These individuals must be well versed in the tenets of the 340B program. Fortunately, there are numerous resources available, including the Health Resources and Services Administration (HRSA), the Office of Pharmacy Affairs (OPA), the 340B Prime Vendor Program managed by Apexus, and the Safety Net Hospitals for Pharmaceutical Access (SNHPA). 340B University, a product of the Apexus 340B Prime Vendor Program, offers free guides and a sample policy and procedures manual, in addition to 340B compliance self-assessments and sample self-audits. SNHPA is a non-profit advocate for providers of the 340B drug program, and offers 340B resources to members as well as non-members.
PP&P: What are the operational priorities for establishing an effective 340B program?
Guidry: After a management team is developed, staff education detailing 340B program tenets and establishing formal, written policies and procedures (P&Ps) for 340B compliance become top priorities. Because covered entities must have inventory controls in place to ensure that 340B drugs are not dispensed to ineligible patients, decide whether the entity will establish a separate 340B drug inventory, utilize a split-billing software program, or identify another way to ensure compliance. In addition, the covered entity should establish and maintain a provider panel that indicates eligible providers. The director of pharmacy, in collaboration with human resources, can determine provider eligibility, according to the organization's definition, and institute a process to ensure the provider panel is current and accurate. Thereafter, perform periodic self-audits of the program to ensure continuous staff adherence to the P&Ps. Engaging the assistance of an outside auditor to periodically assess the program's compliance and integrity may be particularly useful.
PP&P: What is the best approach to developing 340B P&Ps? Guidry: A covered entity's formal 340B P&Ps should include a broad overview of 340B program rules and requirements, as well as 340B eligibility definitions and requirements, both for the covered entity and its patients. In addition, be sure P&Ps include rules governing the orphan drug exclusion (for critical access hospitals, free-standing cancer hospitals, sole community hospitals, and rural referral centers).
Equally important is ensuring accurate billing. To comply with the duplicate discount prohibition, the covered entity must specify whether 340B drugs will be used for Medicaid patients (ie, carve-in), or if drugs for Medicaid patients will be purchased through other mechanisms (ie, carve-out).1,2 P&Ps also must describe an entity's compliance structure, which should encompass 340B medication procurement, inventory management, internal and external audits, the use of contract pharmacies (if applicable), registration and recertification activities, and process flow diagrams.
Certainly, the pharmacy director should maintain primary ownership of these P&Ps; however, the drafting process should involve input and approval from the multidisciplinary team, as well as a committee appointed by the entity's governing body.
PP&P: Who should receive 340B training and how should training be presented?
Guidry: Given the complexities and importance of the program, any staff members whose responsibilities are even tangentially related to 340B activities should receive basic training. More detailed training should be required for all pharmacy personnel and members of the multidisciplinary team, as well as any other staff identified by the director of pharmacy; these may include registration or revenue cycle staff, if the entity works with contract pharmacies. 340B training should begin with a basic overview of the program, emphasizing the overall benefit of the program to the covered entity and to the community it serves. Incorporate an annual competency assessment into training materials for those staff that handle 340B drugs (see Pharmacy Department 340B Proficiencies and Competencies CHECKLIST).
PP&P: Can you describe the process for conducting an internal 340B audit?
Guidry: First, it is important to establish the scope of the audit. Internal auditing should include a date-range sample of patient transactions; medications charged (per 11-digit NDC) including quantity; patient location, date, and time of service; provider ID; medications administered (per 11-digit NDC, if possible); and payer information.
Second, make it clear that the audit is to be taken seriously. It is wise to establish an audit process that mirrors the methods of an actual HRSA audit. For example, make sure the director of pharmacy (or the designated 340B liaison) quickly and clearly can present proper 340B documentation in patient medical records. Involving clinical IT and compliance office representatives may be required. It is best to perform audits quarterly, but certainly not less than twice a year.
Several vital issues should be considered during an internal audit: -Patient status at time of service. Was the patient an outpatient?
-Patient location at time of service. Is the location listed as a reimbursable cost center on the covered entity's most recent Medicare cost report, and is this report reviewed at least annually?
-Provider eligibility. Is the provider panel reviewed for accuracy at appropriate intervals?
-Medication acquisition. How, and from where, was the medication obtained for use?
-NDC tracking. What is the billed 11-digit NDC number, and does it match what was ordered for inventory replenishment?
-Exclusions. Is the medication affected by the orphan drug exclusion?
-CMS status. Is the payer Medicaid, and does the entity carve-in or carve-out?
-Documentation. Does the medical record contain clear documentation of an eligible medication order and its subsequent administration or dispensing, including a valid reason or diagnosis for use?
-Cost savings use. Does the entity have written guidelines for the use of 340B savings? Have these guidelines been approved at a Board of Commissioners' appointed-committee level?
In addition to ensuring peace of mind, performing internal audits protects the integrity of the program and maintains a state of audit preparedness, should the entity be selected for an actual audit. These audits also inspire confidence in all involved with the 340B program so that they ably can answer an auditor's questions.
PP&P: What preparation is required for a 340B audit?
Guidry: Our approach (see SIDEBAR for a HRSA 340B Audit Experience) included contracting with a vendor for 340B auditing preparation and compliance services. Many service providers are available; it is best to speak with colleagues at similar facilities who have used such services and completed an audit before selecting a vendor for your facility.
The services provided by our vendor included a mock audit performed remotely by vendor representatives well versed in the tenets of 340B, as well as guidance on updating our P&P manual. After the mock audit was complete, we were given recommendations to assist in preparing for the actual audit.
In addition, our pharmacy director and clinical IT director perform mock audits at least quarterly to ensure their own proficiency in navigating through the different types of medical records in our facility. Practicing the audit process made for a smoother experience during the actual compliance audit.
It is indeed important to ensure that all documentation and reports related to 340B activities and compliance are complete. While overall 340B compliance requires more than just data, it is vital that the following elements be easily accessible during an audit: -Evidence of internal and external audits, including outcomes/recommendations -Committee-approved 340B P&P manuals -Process flow charts -Current provider panels -The most recent Medicare cost report -Copies of contract pharmacy contracts -Records indicating proper 340B staff training and competency assessment -Evidence that 340B drugs are replenished with the same 11-digit NDC codes as the ones used -An up-to-date record for the entity, its child sites, and its contract pharmacies on the HRSA.gov Web site, demonstrating accurate information and compliance with Medicaid carve-in/carve-out and the Orphan Drug Exclusion
PP&P: What resource commitments are necessary to ensure ongoing 340B compliance?
Guidry: To ensure perpetual, successful 340B compliance, staff must understand that the task is a collective responsibility. The commitment and involvement of the organization's CEO, CFO, and compliance officer, as well as the pharmacy director, pharmacy technicians, and ancillary staff, are imperative. Dedication to compliance must include appropriate education for all involved and an understanding that the program requires strict adherence in order to provide continued benefit to the community and the hospital.
Ultimately, the organization should commit to investing the potentially significant financial savings reaped through the 340B program in maintaining, improving, or expanding access to pharmaceuticals and other patient care services that benefit low-income, uninsured, and underinsured populations.
1. US Department of Health and Human Services Health Resources and Services Administration. 340B Drug Pricing Program. Medicaid Exclusion/Duplicate Discount Prohibition.http://www.hrsa.gov/opa/programrequirements/medicaidexclusion/. Accessed March 25, 2015.
2. US Department of Health and Human Services Health Resources and Services Administration. 340B Drug Pricing Program. Program Integrity: Audit Results.http://www.hrsa.gov/opa/programintegrity/auditresults/. Accessed March 25, 2015.
________________________________________ Lloyd J. Guidry, Jr, PharmD, RPh, is the director of pharmacy and chief operations officer at Lady of the Sea General Hospital in Cut Off, Louisiana. He received a BS in pharmacy from the University of Louisiana at Monroe and a doctor of pharmacy degree from the University of Florida. In addition to clinical pharmacy and administrative duties, Lloyd is working to expand the 340B benefit within his community by establishing hospital-owned retail pharmacy locations that provide 340B pricing to augment the limited number of partner pharmacies in this rural area.
A HRSA 340B Audit Experience
In November 2014, our hospital, Lady of the Sea General Hospital in Cut Off, Louisiana, received a letter from the Office of Pharmacy Affairs indicating that we had been selected for an audit. The letter stated that a program integrity analyst from HRSA's Office of Federal Assistance Management would contact us by phone to coordinate the audit. In January 2015, we had an introductory telephone conference with an auditor, who later sent a data request. We had approximately 2 weeks to compile and return the requested materials. The audit occurred in early February 2015, a month following the initial telephone conference, and was completed over 3.5 days.
Having recently been audited for 340B compliance, we learned a great deal about how such audits are performed and what is expected of the covered entity.
Accompanying the notification of our impending audit was a list of items to be submitted to the auditor prior to the actual audit, which included: -A list of all 340B orders or prescriptions issued (including all child sites and contract pharmacies) for a designated 6-month period -Our written 340B P&Ps -Complete names and addresses of all entities associated with the organization -A list of pharmacy settings within the hospital where 340B drugs are ordered, administered, and dispensed -Documentation of our entity's 340B eligibility -Our most recently filed Medicare cost report -A list of providers eligible to write 340B prescriptions -The most current 340B pharmaceutical inventory listing, inventory count, and reconciliation report -A list identifying all accounts used for the purchase of both 340B and non-340B drugs, and a description of the drug types ordered -A list identifying all child sites -A list of all contract pharmacy names and locations -Copies of contract-pharmacy contracts -Reports indicating oversight or monitoring of the contract pharmacy by the covered entity -Our Medicaid provider enrollment verification letter (NPI) or Medicaid number -Our organizational chart and a oneto two-page biography of the entity -Any software used for the purpose of 340B drug procurement and utilization
Certain accommodations were requested for the 340B auditor, including an enclosed, lockable work space/office; access to the Internet; a telephone and photocopier; and a facility parking space for the duration of the audit. Audit Phase When onsite, the auditor initially asked for a demonstration of our 340B processes and toured our central pharmacy, one of our medical clinics, and one of our contract pharmacies, as well as our dialysis clinic and outpatient rehabilitation unit.
From the list of previously submitted 340B orders, the auditor then selected 28 outpatient transactions for review (including examples of employee prescriptions, ER visits, OR outpatients, and observation patients). Moreover, the auditor chose an additional 28 transactions that involved contract pharmacies. Finally, the auditor selected to review five high-cost items from various areas of the hospital.
The auditor spent the next 3 days examining the 61 chosen transactions, in each case reviewing the medication order, the patient's eligibility to receive the medication and the provider's eligibility to prescribe it, the location at the time of service, the medication administered, and the payer type. For transactions involving a contract pharmacy, the auditor examined medical record details to ensure the provider encounter related both to the patient's diagnosis and the medication being dispensed. If the provider was a referral, documentation of the referral in the medical record was required.
Hot Button Questions Covered in the Audit
The auditor required identification of the payer for all transactions; evidence of the integrity of the ordering process all the way through administration, which established that 340B P&Ps are followed as written; as well as evidence that the patient remained eligible at the time of medication administration. Additional queries from the auditor included: -Is the covered entity's information on the HRSA Web site complete-including the entity, its child sites, and contract pharmacies-and is it accurate and up to date? -Are prescriptions written for patients and employees documented in the medical record as originating from a provider encounter that resulted in a diagnosis related to the medication ordered? ? For example, if an employee or patient receives a prescription from a provider as a non-established patient, during an informal meeting (eg, in the hall of the facility, or from an ER provider without a documented visit), the prescription is not eligible to be filled through the 340B program ? If a medication, such as lidocaine 1%, is used to numb a patient for suturing, the medical record must show documentation of an order for that medication, even if it is considered standard practice -Is a patient who presented through the ED but was later transferred to an inpatient area, considered an inpatient or an observation patient? ? Observation patients are considered outpatients, and, therefore are eligible for 340B medications, even if the setting is an inpatient area. Proof must be documented in the medical record, including the date, time, patient type, and location of the patient at the time of medication administration -If a name brand drug was ordered, but the drug administration was documented with the generic name, is there proof that it was the same drug? -If the drug was ordered retrospectively, was the same 11-digit NDC replaced? -If drugs are ordered prospectively, are they segregated from the rest of the pharmacy stock? If so, how? (See Online-Only 340B Medication Receiving and Segregation Process) -What is the process for ordering medications for the entity's child sites (eg, rural health clinics)? -The auditor also inquired about our Medicare cost report, specifically with regard to Worksheet A and the cost centers indicated on the reimbursable section.
Prior to the audit, the certified onsite auditor made it clear that any findings uncovered during the audit would not be shared with us, as onsite findings are considered preliminary and must be reviewed by HRSA's Office of Pharmacy Affairs. We were notified that it could take 9 to 12 months before we received a report outlining any findings, at which time we would have the opportunity to respond to the report. In addition, any findings indicating 340B program non-compliance would necessitate corrective action by the facility and may generate follow-up by HRSA prior to completion of the audit.
However, less than 3 months after this communication, the HRSA Office of Pharmacy Affairs completed its review and issued a final report to our covered entity, constituting notice of 340B audit findings; there were no unexpected findings. If an entity disagrees with the findings, it has a 30-day period during which it can submit written notice of disagreement. Our report did offer opportunities for improvement, which do not identify specific violations of the 340B program requirements and do not require corrective action.
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|Parlor Trick That Boosts Brainpower|
Next time you forget where you parked, here's a little idea that could get you back behind the wheel pronto: Pinch your right nostril shut. Sounds strange, but research shows that pinching the right one shut and breathing through the left one boosts spatial memory -- that part of your brain that helps with memory and navigation.
Pick a Side
It's a right brain/left brain thing. In general, you use the left side of your brain to balance your checkbook, carry on conversations, and solve problems that require linear reasoning. The right side? It helps you paint like Picasso and recognize faces, and it controls spatial abilities. And the right side is also in charge of the left side of your body. But here's the twist: The left side of your body controls the right side of your brain, and vice versa. So when you breathe through the left nostril, it gives the right side of your brain a boost! It's neat cocktail-party trivia.
|Fats That Might Depress You|
Shift your fatty acid balance in favor of a brighter mood. Modern diets are high in omega-6 fatty acids -- found in meat, eggs, refined grains, and corn oil -- and low in omega-3 fatty acids. New research suggests this imbalance could be a risk factor for depression. Add more mood-boosting omega-3-rich foods, such as flaxseeds, fish, and nuts, to your diet. Omega-6s and omega-3s are forms of polyunsaturated fatty acids. Researchers have long suspected that deficiency in omega-3 fatty acids contributes to depression. Now, a new study reveals that the balance between omega-3s and omega-6s may influence depression risk. In the study, brain cell membranes of depressed rats had elevated levels of arachidonic acid, a type of omega-6, in certain areas. Nondepressed rats had lower levels. The amount of omega-3s in the brains of both depressed and nondepressed rats, however, did not differ significantly. Omega-6s are found in abundance in red meat, poultry, refined grains, and certain fats such as corn oil and margarine.
|Get Fit Faster with This One Easy Rule|
The deceptively simple path to a fit bod begins with the easiest activity in the world: walking.
Every get-fit plan should start with a basic 30-minute daily walk for 30 days. It will prime your body for the muscle-toning and stamina-building exercises you need in order to go from couch potato to hot tamale. Cheat or skip this simple step and you run the risk of injuring yourself and falling off the fitness wagon.
First Things First
According to RealAge expert Mehmet Oz, MD, an out-of-shape muscle is deficient in two things: tiny powerhouse factories (called mitochondria) that generate juice for your workouts, and contractile proteins that give the muscle strength. And walking for 30 minutes a day -- or for 10 minutes three times a day -- for a month replenishes mitochondria and contractile proteins, so your body will be ready and able to build on your fitness routine.
Take the Next Step
When you're ready to expand your exercise program, follow Dr. Oz's guidelines for sculpting a lean, healthy body: