Memorial Day Post

5/29/2016

Once again, for those new to this blog site, at present there are 17 posts on the blog and each has its own set of comments. To read the comments you have to hit the word "Comments" at the beginning or end of the post. Somewhat confusing is that when you bring up the comments for a specific post it eliminates the other posts from the screen. To bring the other posts back up simply go back to the top of the page and click on Blog. Finally, to understand the development of the blog it is best to read it from the bottom post (Dr. Paul Kearney Case) up. One point of note here, to read the earliest posts you have to click on the word "<<Previous" at the very bottom of the posts available.

* Note: To see PDF Documents cited in this post simply click on the underlined segment

Having served 4 years in the military and two of those in a war zone, I felt it might be appropriate on this Memorial Day to further discuss the current war being perpetrated by the university administration against one of its tenured faculty members. I recently received a copy of the latest letter sent from General Council Thro to Dr. Kearney's attorney. This letter is disturbing in many ways but most importantly is that it reflects a University official whose bias and hatred of Dr. Kearney have driven him to not only distort the truth but also seemingly redefine university regulations. He clearly has taken this threat of 'take the deal or we will destroy your career' to heart. A copy of this letter can be found here: Document 1.

It is a long letter but let's spend a little time with it. To begin with, General Council Thro states: “When the Board of Trustees’ University Health Care Committee permanently revoked Dr. Kearney’s clinical privileges at the beginning of the academic year, the University of Kentucky had sufficient grounds to revoke his tenure.” General Council Thro is clearly not familiar with the University's Governing regulations (GR;X KRS 164.230) defining the procedural requirements for this process, nor the basic Administrative Regulations (AR 2:1) regarding tenure.

General Council Thro then states: “The University Health Care Committee chose to reaffirm Dr. Kearney status as a tenured professor but without clinical privileges. In taking this step the University Health Care Committee implicitly expressed an expectation of Dr Kearney developing expertise as a researcher and thus making positive contributions to the University.” To begin with, I believe that General Council Thro is referring to the UK Board of Trustees Health Care Committee not the University Health Care Committee. Furthermore, I am not sure what General Council Thro is reading, but the UK BoT Health Care Committee put no explicit or implicit conditions on his return to campus (see Document 12). Almost immediately General Counsel Thro, “speaking for the President”, wrote an August 28, 2015 directive blocking Dr. Kearney from any instructional activities with resident trainees or medical students (see Document 13). In fact, the committee allegedly convened to develop these restrictions was composed of the very same small group of individuals who promulgated the so-called peer review against Dr. Kearney.

General Council Thro then goes on to erroneously state that Dr. Kearney had “the 2015-2016 academic year to transition to his new role.”  For the first two months of the academic year, he was banned from the entire UK campus and forbidden to speak with colleagues, residents, students, and staff. Where and from whom did the authority/order to ban Dr. Kearney from campus come from? Did CMO Boulanger have that authority? This would appear to be a clear violation of Dr. Kearney’s constitutional rights guaranteed in the First, Fourth, and Fourteenth amendments. After reinstatement, it took another 8 weeks to get a serviceable office with a functioning computer and telephone. That is hardly the entire academic year. Each and every step taken against Dr. Kearney by General Council Thro since August 24, 2015 has been in direct contravention to the “Final Action” of the Health Care Committee of the Board of Trustees (see Document 12 again).

Moving on, General Council Thro states in paragraph 3: “Dr. Kearney is providing expert testimony in a medical malpractice case without obtaining the required approvals.” I am not sure what legal case General Council Thro is referring to but Dr. Kearney had been providing expert testimony in a number of cases prior to this disciplinary process. He has a legal and ethical obligation to see these through to completion. The fees associated with these cases have been surrendered to KMSF as required in the Practice Plan agreement. What General Council Thro fails to mention is that for the last thirteen months (beginning in March 2015), the Department of Surgery/UKCOM has denied reimbursement to Dr. Kearney for legitimate business/academic expenses. Consequently these expenses have all come out of his pocket

The next few paragraphs General Council Thro goes on to elaborate the restrictions they have imposed on Dr. Kearney (where he can go, what he can’t do, the impossible things he has to do, his salary reduction to $43,500/yr., and all of the negatives he can conger up) and of course his bad boy behavior. General Council Thro states that the latter are: “examples of Dr. Kearney’s neglect of duty and questionable competence.”  All evidence to the contrary, beyond this small vendetta group, Dr. Kearney has never been accused of neglect of duty or incompetence. In fact, the disciplinary process acknowledged his clinical excellence, outstanding surgical skills, and teaching record.

General Council Thro further states: “Dr. Kearney engaged in pervasive abusive and harassing behavior directed at patients, medical students, residents, nurses, and other staff members. In addition to being unethical and contrary to the professional standards, Dr. Kearney’s behavior and attitude contributed to an offensive and unacceptable culture within the Department of Surgery that represents and educational shortcoming requiring immediate correction.” It is clear that General Council Thro, along with the small group of individuals who promulgated the so-called peer review must believe that if you repeat something enough it becomes true. It is clear that these allegations are now approaching the level of slander. So lets look a little closer at the real facts behind General Council Thro’s fictional tale?

1.      One patient complaint in 27 years of distinguished service. During the fair hearing, two resident physician eyewitnesses, under oath stated that Dr. Kearney never made the statements the patient alleged. The University then refused to provide legal defense for Dr. Kearney after the patient filed an Outrageous Tort Claim. Records show that the University has provided legal defense for other faculty involved in identical claims. General Council Thro also fails to mention that the patient’s lawsuit against Dr. Kearney has been dismissed with prejudice (see Document 7) further eroding the credibility of this claim. In 27 years, there are no other patient complaints in Dr. Kearney’s personnel file.

2.      In 27 years of University Service, Dr. Kearney has one anonymous student complaint from a first-year anatomy lecture in which Dr. Kearney received an ovation at the completion of the lecture. A review of Dr. Kearney personnel file documents a record of outstanding teaching with evaluation scores well above the Department and UKCOM faculty means. Moreover, he has 29 teaching awards in 27 years of Academic practice. There are no other student complaints in Dr. Kearney’s personnel file.

3.      In 27 years of distinguished service to the University of Kentucky, Dr. Kearney has no resident complaints in his confidential personnel file. Instead, he has the most teaching awards of any active faculty in the Department of Surgery. This list of awards includes the highest teaching award given to faculty member in the Department of Surgery. Even though Dr. Kearney was banned from campus and forbidden to speak with residents and students, the 2015 surgical resident graduating class bestowed a career teaching award for Dr. Kearney speaking to his mentoring, surgical teaching skills, leadership, and professionalism. One of those graduating residents was the Department Chairman’s daughter!

4.      There are no faculty complaints in Dr. Kearney’s Personnel file.

5.      Dr. Kearney has twenty-six consecutive outstanding performance evaluations and was promoted on time from Assistant Professor to Associate Professor then Full Professor with Tenure. In his confidential personnel file there is no mention of unprofessional behavior. Contrary to General Council Thro’s unsubstantiated allegations, all of his evaluations document his excellence as a tenured faculty member and physician. Dr. Kearney accumulated more teaching awards than any other Department of Surgery Faculty Member including the highest teaching award. He has more teaching awards than the vast majority of faculty in the College of Medicine. There is a two million dollar Endowed Chair in his name and he has an honorary Doctorate of Science from his undergraduate Alma Mater. With his leadership, the ACS verified level I trauma center has achieved national recognition for teaching, research, and clinical care. He has trained countless students and residents many of whom remain at UK, in the community, or the region. Some have gone on to lead other academic programs in the country. The pattern he has established here at UK is not that of unprofessional behavior but rather that of excellence in every facet of academic surgery.

Finally, contrary to what General Council Thro would wish you to believe, Dr. Kearney has not refused to comply with the University’s request. He has made repeated efforts to develop a plan that is suited to his greatest strengths. Simply put, General Council Thro, “speaking for the President”, has intentionally created an untenable position for Dr. Kearney. Furthermore, Dr. Kearney has submitted yet another plan to the Dean in compliance with General Council Thro’s ultimatum. Lastly, perhaps if General Council Thro had either monitored this blog or conversed with CoM administration, he could have saved his secretary some typing because he would have been aware that Dean de Beer restricted Dr. Kearney’s access to Grand Rounds months ago. The bottom line being that General Council Thro has lost all perspective when it comes to this Dr. Kearney matter and for the good of the university should totally recuse himself from the case.

Before I close this, I must add that what I find very interesting about all of this is that General Council Thro reports to the President of the University and has stated multiple times that he is "speaking for the President". However, the discovery request received from the University through Mr. Beauman as part of the litigation in the Kearney WhistleBlower lawsuit (see Document 2: Interrogatory No. 8) categorically denies the involvement of President Capilouto in any aspect of this. Because the discovery request is a legal document, I can only interpret this to mean that this whole thing is a personal vendetta instituted against Dr. Kearney without the knowledge of the president and in the absence of approval from the University President. Whatever the case, I personally view it to be a sad statement for a public university when an administrator, whether it be a President, a General Council, an EVPHA, a Dean, a Department Chair etc. utilizes his/her capacity at said university to vindictively destroy the career of a tenured faculty member.

Of course there still remains the great mystery of WHY???? Conspiracy theorists might interpret this, along with the open records war and the KMSF battle as further confirmation that they have something they are hiding. As you ponder all of this on Memorial Day, keep in your memory all those that have died for our American rights to a fair trial and justice.

40 Comments

Deputy Dawg

5/30/2016 03:25:03 am

Isn't this the same Thro that some earlier commenter mentioned prefers to use the title of professor, as opposed to his true title of adjunct instructor, on his academic documents? If so, that may help to explain his disregard for promotion and tenure regulations as well as his propensity to manipulate the truth.

Doo-Rag

5/30/2016 05:26:52 am

Equating the Kearney Kerfuffle to death in the line of military service is a bit over dramatic don't you think?

spoon snake

5/30/2016 05:30:08 am

Also, the patient's lawsuit was dismissed because the plaintiff (patient) didn't appear in court, not because the case was tried and found to be without merit of that the facts of the case were established by trial in favor or Kearney. I think you need to be clear about that otherwise it just looks as though you are spinning the facts to serve your pro kearney agenda...

Dan Noonan

5/30/2016 07:44:28 am

Thank you Deputy, Doo and Spoon for your comments. Yes this is the same Mr. Thro Deputy and your point would appear to be a valid one.

Although the comment isn't relevant to the issues of the blog, I never equated the Kearney tragedy to death in the line of military duty Mr/Mrs Doo, which hopefully you have never had to personally witness.

Finally, you are absolutely correct councilor, the lawsuit was dismissed because the plaintiff didn't appear in court. Having said that, one can only assume the plaintiff did not show up because he knew there was no merit to his case. I would suggest that when two resident physician eyewitnesses, under oath state that Dr. Kearney never made the statements the patient alleges he made, one can only assume this case never had any merit. So no, we are not spinning the facts, they are there for all to see and judge.

Bernd Das brot

5/30/2016 03:15:59 pm

care to identify these residents or post their depositions? and in any case don't you think that bad language and insults are acceptable OR banter when super surgeon Kearney is saving a few lives. The case being dismissed is a fact. The underlying reasons are your own speculations, not facts. Just like all of your other silly theories.

Sam

5/31/2016 02:36:08 am

I am not a physician nor part of this university, but personally, as a patient I don't care what type of language is being used when someone is saving my life. I will take a crude talking highly skilled surgeon over a sweet talking inept surgeon any day. I have experienced the latter and paid dearly for it. I have to believe that a trauma ward may at times require a strong personality to orchestrate what needs to be done. Lives often hang in the balance.

Spoon Snake

5/30/2016 08:18:18 am

At least if you were active duty military you can get your healthcare from the VA so you don't have to deal with UKHealthcare...Although presumably you enjoy taking your business to "The Competition".

Can you point me to the relevant laws or statutes that guarantee Kearney's right to practice medicine at UK?

Also, since you seem to have access to a lot of inside info could you post Kearney's "plan" for his academic activities that he has apparently "repeatedly" submitted? It would be interesting to see how reasonable or unreasonable this plan is.

5/30/2016 03:08:39 pm

Thanks for your comment Spoon. I am retired and on the UK Carve Out Program for my health insurance. I live 30+ miles from Lexington, so yes, my primary care physician is not located at UK. Although not a relevant question for the blog, I am registered with the VA and could use their facilities should the need arise.

I believe you have asked this question previously, but I know of no statutes that guarantee Dr. Kearney's right to practice medicine at UK, other than his accreditation and license, both of which UK has tried to take away but couldn't. What is perhaps germane here are the tactics that are being used to drive a tenured faculty member out of this public institution. Taking a tenured faculty member who was hired as a physician and teacher and who has performed superlatively at these functions for 27 years and telling him he now will not be allowed to do what he was hired to do, is simply unethical and wrong. This especially in an area like trauma surgery that is in desperate need of help as their work force dwindles. To make matters even more absurd they require him to submit a basic research program to justify his $43,500 full professor salary, knowing that this is a total impossibility and therefore developing a totally bogus pathway for taking away his tenure. If even you as an administrator can't see the injustice in this, then you deserve your title.

Finally, you probably have better access than I to Dr. Kearney's submitted plans, so why don't you simply tell us? If you don't, then simply give him a call, email him or ask the Dean for a copy. As discussed earlier, unfortunately I doubt that you will be able to get it through an open records request.

Bernd Das Brot

5/30/2016 03:59:54 pm

I'm not an administrator, just someone who is sick and tired of you, kearney, UK, UKhealthcare and everything associated with this never ending saga. Couldn't you just settle this with a duel? Or a pie eating contest?

Also, if Kearney was really getting to the bottom of some wrongdoings why not sit tight, keep digging, collect evidence, wage some psychological warfare. Calling everyone out was exactly the wrong thing to do if the long term goal was to really cause some damage. Thats what I would really like to see.

Anyway, its good to see how many different people are posting to your blog!

jurgen haabermaaster

5/30/2016 04:20:19 pm

Bravo Bernd Das Brot. Finally someone has the balls to say what most of us here have been thinking for a long time!

Bill

5/31/2016 02:17:18 am

Well that makes one of you Jurgen and Bernd, because you are surely the same administrator. Unfortunately for you there are hundreds of faculty (did you forget about the faculty electoral votes to the University Senate?), and hundreds of physicians (did you also forget about the electoral votes to the University HealthCare College's Council?), and hundreds of students (did you not attend the student presentation of the 2015 class that presented the Dr. Kearney teaching award for mentoring, surgical skills, leadership and professionalism?) and did you not read the hundreds of letters written to President Capilouto by public citizens expressing their support for Dr. Kearney? The reason I doubt your claim of not being an administrator is the observation that you have already forgotten everything they taught you in anatomy class. It does not take a set of balls to make the accusations you folks are making, just rudimentary typing skills along with very little conscience and compassion. Are you sure this is not Jurgen Ohlsen and Bernd Wegner?

Dennis

5/31/2016 06:18:36 am

Bill- I think you are operating under the misconception that UK is a democracy and the "administrators" can be controlled by the weight of public opinion. Do you actually work there?

Dan- I think "Bernd" does have a point there- if the goal was to expose "mismanagement" at UKHealthcare/KMSF forcing a situation where they had to get rid of Kearney probably wasn't the most effective approach.

I personally don't have a lot of sympathy for Kearney. I think the outcome here is entirely predictable. He must have thought that because he has tenure and was so highly regarded by all of you that would make him immune from the consequences of making trouble.

I agree that there are people at UK who need to suffer the consequences for their mismanagement and other misdeeds. I just don't think the Kearney approach was the way to go. I think that will become clearer to you as the process slowly moves towards its inevitable conclusion.

5/31/2016 01:17:21 pm

Thanks for your blog comment Dennis. I think I see where you are coming from, but I am not sure I agree with this strategy of sitting back and letting it happen simply because you and a few others feel the conclusions to be inevitable and that it is a useless waste of our time to try to change them. I will say I am heartened by your apparent agreement that it was the attempts to expose financial mismanagement by the hospital administration that was the cause of this Dr. Kearney scenario. I may be wasting my time in this blog and Dr. Kearney may be wasting his career attempting to question the administration about possible financial mismanagement, but when I look in the mirror in the morning, and I suspect the same is true for Dr. Kearney, we like what we see. Similar to my statement to Bernd, if you view this cause and this blog as a big waste of time and the conclusions to be predictable, please don’t let it be a waste of your time. Simply do not visit us here on the blog. Our feelings will not be hurt.

5/31/2016 04:27:02 am

I see the blog has been busy in my absence. Thanks everyone for your comments. I like to hear both sides of the debate. I am sorry if this attempt to defend the rights of a university faculty member who is clearly being abused and harassed by the authoritative body at the university makes you sick and tired Bernd. For the tired I would recommend some sleep and for the sick, simply do not read or participate in the blog. Take these once a day and see us next year if you are not feeling better. Everybody else play nice, try to be constructive and have a beautiful day. I am off to once again enjoy a sunny day of golf.

5/31/2016 02:11:28 pm

Whats the point of having a blog just so everyone can agree with you about how corrupt Karpf and co are and how heroic and terribly wronged Kearney is. Or maybe thats what you want? I am just as interested as you are in the outcome.

Also, not sure why you keep bringing up this issue of having a clear conscience all the time. Nobody has died yet...oh hang on I am sure you will tell me that people have died because kearney hasn't been allowed to deploy his superlative surgery skills...

5/31/2016 02:50:18 pm

Thanks again for the comment Dennis. I nor anyone else that I can remember said anything about it being a necessity that people commenting on this blog agree with what I say. In fact, if you would simply look up to my comment just above the statement you just made you will see where I say, "I like to hear both sides of the debate". You are sounding very much like the administration in that you tend to twist the truth in some attempt to belittle anyone you disagree with. For example, what's with this: "not sure why you keep bringing up this issue of having a clear conscience all the time". I can't remember ever making that statement, let alone "all the time". Like I mentioned above, if you are so sure this is all a waste of time, why even waste your time expressing an opinion. Simply let the inevitable happen and then maybe stop by the blog, if it is still up and running, and say, "see I told you so." I can almost guarantee you that I will once again thank you for your comment.

Kearntastic Kearney Konquerer

5/31/2016 02:24:24 pm

Paul Kearney is gentleman, scholar and one of the finest human beings on the planet. He repaired my scrotum after an unfortunate lawnmower accident in 1978, On the other hand, everyone else in the upper echelons of UK Healthcare is a crooked scumbag, particularly Karpf and DeBeer. I am pretty sure Karpf cheats on his taxes and I saw DeBeer kicking a puppy once. Go Kearney!

5/31/2016 02:56:56 pm

Thanks for the comment Kearntastic. What would life be without a little sarcastic humor to bring us back to earth. Thanks for your opinions.

5/31/2016 05:22:16 pm

Deleted your comment simply because we are looking for constructive comments. If you wish to do a belittling and insulting campaign for your administration pals, simply start up your own blog site. I am certain KMSF would fund it. Please do not use this site to fund your bonuses. Thank you.

5/31/2016 05:36:32 pm

Sorry folks for the change in the settings. There appears to be a concerted effort by folks working on their administrator bonuses who only wish to insult Dr. Kearney, myself and anyone that may wish to constructively comment on the important matters being discussed on this site. If you wish to post a comment or present a constructive opinion feel free to do so. Anyone else who is simply out to insult or draw attention away from the critical issues being discussed in this blog site, simply know that your comments are not welcomed and will not show up on this site.

Someone's button got pushed.

5/31/2016 06:54:36 pm

Keep going Noonan. Your work is important. UKHealthcare, KMFS, and Karpf are all crooks and I'd love to unload everything I know but fear the retribution. This is a small town. This would all be out in the open years ago if the H-L wasn't in bed with UK.

Rosie

6/1/2016 03:44:14 am

Dan, you should take this as a compliment. Your blog posts are obviously hitting an administration nerve by this reaction. They are like bullies on a playground, their first reaction when caught in a lie is to punch you in the face. It is all smoke and mirrors for them. You have to expect that the louder they claim innocence and the more they try to discredit your blog site, the closer you are getting to their guilt. Innocent people at their level of authority would simply pay no attention to this stuff.

Wayne

6/1/2016 04:25:35 am

I agree, whoever this is must really be nervous about something happening at the upper echelons here in the hospital. Keep on blogging.

6/1/2016 04:33:44 am

Thanks Someone, Rosie and Wayne for your comments. I thank you for your support and tend to agree, someone is nervous over in the hospital. I am off to enjoy the day but will be back later so everyone please keep commenting and I will approve when I get home.

6/3/2016 04:12:26 am

So any word on whether they are going to or have released the results of the Press-Ganey Physician/Faculty engagement survey? For that matter, any word on whether Swish is going and if so when? I couldn't be too soon for me.

6/3/2016 04:23:17 am

Thanks for the comment Bill. I have not heard anything other than what The Mole posted earlier. I suspect they are doing all they can to keep this quiet. Meanwhile morale continues downstream. But more importantly, you should be excited to see the progress they are making on that new research building. The word on the street is that they are planning to develop robots to work in this new building. Where is Will Smith when you need him. Take care Bill and have a great day.

6/3/2016 03:58:43 pm

Well blog readers, if you haven't seen or read it already, you might want to check this Herald Leader story out: http://www.kentucky.com/news/local/education/article81581847.html

It is entitled: Amid secrecy, UK pays $5 million to fix billing issues at Hazard Clinic.

Highlights include:

- UK refuses to release a presentation about the problems that was provided to trustees

- Payments include $4 million to federal government, $1 million to Washington, D.C. lawyer

- University denies newspaper’s requests for documents about deal, including an audit

So it looks like Professor/Instructor Thro has had his hands full. We appear not to be the only ones out there questioning the financial practices of the hospital administration. We also appear not to be the only ones being denied an audit of these financial practices. Finally, we also appear not to be the only ones being refused access to open records from this public institution and hospital. Hmmm, Professor/Instructor Thro and the EVPHA may find it a bit more difficult putting together a sanctioning committee to take away the "writing privileges" of this Herald Leader reporter. So just add this to the ever increasing list of reasons for asking: Why and what are they hiding?

6/3/2016 04:30:48 pm

I saw this. What a joke. Thro is refusing access to an open meeting presentation to the BoT predicated upon "attorney-client privilege". Should have read 'crooked attorney-client privilege'.

6/4/2016 12:19:02 pm

Well just to be fair, here is how the spin doctor at KMSF tried to put out the flames before they burned down the house. It is an email sent out by Dr. Marc Randall, President of KMSF and University of Kentucky College of Medicine professor and the Markey Foundation Endowed Chair in Radiation Medicine (remember KMSF is that company they are claiming is not part of the university). I guess this later position must be his part-time job working for that other company, the University of Kentucky. You will notice how Dr. Randall avoids the subject of their refusal of a public audit as well as their denying open records requests.

Subject: Message from KMSF President Dr. Marc Randall

Dear UK Physician Colleagues,

I was honored by the recent vote of confidence by the KMSF Board of Directors that elected me to a three-year term as president. Our physician organization has evolved rapidly over the last several years, as we continue to work to meet our missions to support the University of Kentucky, its medical center, and its physicians during a time of tremendous change in health care generally.

The members of the KMSF board and all its committees are our peers who take seriously their fiduciary responsibility to our organization. Every faculty member is represented on the KMSF board, and you should feel free to contact members of the board to discuss issues or concerns. Along these lines, we have taken and are taking steps to increase transparency of operations and communication within and among our physicians. You will be hearing more about these efforts in the coming weeks and months. For example, in the coming weeks, we will be rolling out a new, more accessible and user-friendly website.

As part of that commitment to increased and timely communication, I wanted to let you know as soon as possible about a story that we expect to run soon in the Lexington Herald-Leader. It is likely that KMSF will be part of the article.

The focus of the story is on the recent dissolution of UK HealthCare’s partnership with Appalachian Heart Care, an outstanding physician practice headquartered in Hazard. As many of you know, about three years ago, UK HealthCare transitioned the practice to a provider-based clinic associated with our system as part of our commitment to providing more advanced specialty care to underserved populations. It is a core mission for us and this practice is well-regarded in Eastern Kentucky for the outstanding heart care its doctors provide.

KMSF, as has been our practice in other affiliations and partnerships, leased for UK HealthCare’s use the clinic space in Hazard, Harlan and Hyden. UK HealthCare and KMSF also purchased, at fair market value, office equipment – including medical machinery and supplies – for about $440,000. Our role in this transition was consistent with our charitable purpose of supporting the University in its missions.

With the dissolution of that partnership, the university is in the process of selling the equipment back to the physicians at fair market value. The leases and our faculty agreements have all been terminated upon mutual agreement.

The story, we believe, will largely focus on two issues:

--First, discussions of this partnership conducted by the Board of Trustees as well as audits and records that detail various aspects of it. In both cases, the university strongly believes that these discussions and the records of these discussions involve matters of attorney-client privilege and can be private. The Herald-Leader strongly disagrees with that perspective.

--Second, the issues around repayments that UK HealthCare made to the Centers for Medicare and Medicaid Services (CMS). An internal audit uncovered issues with documentation for some procedures conducted at the clinic. All the procedures occurred. Patient care was outstanding and never compromised. But there were documentation issues uncovered by UKHC’s corporate compliance office and KMSF Compliance.

The simple fact is that the merger of a small, but excellent, community practice and a large academic medical center was never smooth and there were issues with integrating systems that resulted in the documentation challenges.

Ultimately, assisted by the review of outside counsel, UK HealthCare made the decision to make repayments for all the visits and procedures during the payment period in which there were documentation issues. In all, more than $4 million has been repaid to CMS.

The process worked as it should. Our compliance offices found a problem during internal, routine audits. More review was conducted, which verified the initial assessment of significant issues with documentation. The issues were fixed and reported to the federal government, as required by regulation.

Despite our best efforts and desire to continue the partnership, our colleagues in Hazard decided that they wanted to return to their previous practice model. We respect their wish

Ken

6/4/2016 02:09:41 pm

Interesting blog. It really looks like a David versus Goliath situation. UK is a powerful force in the state and it somewhat looks like they view themselves untouchable and maybe even above the law. Money and ambition can be very strong motivators, and couple those with arrogance and a sense of invincibility you you can easily end up with corruption. Under normal circumstances I would generally declare it is your responsibility to provide the proof that there is something illegal going on here, but after reading some of the history in the blog I can see where they have done everything they can, even defying the state's Attorney General, to prevent you from doing that. Being a state institution and hospital, I believe in this case it is their responsibility to prove their innocence. I therefore agree that a public audit as well as release of the public records requested is a necessity on their part. Good luck in your work here.

PermaTemp

6/5/2016 09:26:59 am

I don't know you or any of the individuals who so regularly post here, but I am grateful you have taken the time from your retirement to perform what I consider a public service. It seems to me your thinking is logical and critical and your arguments are well-supported.

It also seems to me that many of the negative comments posted here are irrational and downright childish. The reiterative commands to "put up or shut up" are absurd. Lack of transparency at UK HealthCare deprives us all of the information required to "put up." That's the entire point of this exercise.

The insults lobbed at you are directly informative of the character of those making such worthless and infantile remarks. The pettiness of these individuals is on full display. The thoroughly absurd characterization of Dr. Kearney and anyone else who challenges the administration as "bullying the university" borders on insanity. How can a monolithic institution that holds itself above the law be bullied? What utter nonsense.

I commend you for your commitment to exposing the truth behind this sad saga. I also commend you for your calm demeanor in the face of some needlessly obnoxious comments. Everyone in the community should be concerned about the corrosive effect this matter is having on the medical staff at UK HealthCare. They may as well burn their very expensive buildings to the ground. The net effect will be the same.

Rufus

6/5/2016 10:33:18 am

To a layman, this seems a lot of obfuscation to escape the real question raised by the multimillion-dollar payments to Medicaid, Medicare and the hired-gun lawyer. The question is, of course, who in Hazard (or Lexington) was over-billing Medicare and Medicaid by millions and why are they being protected? How long has this been going on and who's gotten rich off of it? A couple years ago, King's Daughters' Medical Center in Ashland got caught overbilling Medicare by $40 million, but its CEO at the time resigned just before it all hit the fan and bailed with a million-dollar golden parachute. Is that really what's going on here? Or what?

The Mole

6/5/2016 10:53:06 am

I think this is more of a case of incompetence than dishonesty. I suspect that the lawyer was brought in because the Hazard physicians may have had a case to sue UK for botching up their billing.

The Kings Daughter's debacle was for unnecessary/needed procedures (primarily stents). There was another big case like this at St Joseph's in London KY. This is definitely not what was happening with the ARH group- in fact UK had substantial oversight for the ARH cardiology clinical practice in place to make sure the actual services were needed and appropriate.

So you can spin this as being further evidence for Karpf/UKHealthcare/KMSF misconduct but in all likelihood this has nothing to do with the relationship between UK and KMSF and the transparency/adherence to bylaws issues that you are all so keen on around here.

6/5/2016 11:33:05 am

Thanks Ken, Perma Temp and Rufus for your comments and support. Although some may feel that nothing presented so far supports the contention that there has been mismanagement of funds by the hospital and College of Medicine administrations, some of us would beg to differ. The Hazard revelation is simply the latest as far as we are concerned. Just to reiterate, some of the others include:

The claims and evidence presented by Dan Ross, an internal UK auditor, that there has been mismanagement of KMSF funds. This, in part, led to his firing for insubordination.

Then there is the sworn statement by the former head of KMSF, Darrell Griffith, in which he listed some of the extraneous financial activities of KMSF and he stated, "As the former Executive Director of the Kentucky Medical Services Foundation, it is my opinion that KMSF exceeded its scope. KMSF business activities were outside the purview ofthe UK Board of Trustees by design and, by design, outside the Commonwealth of Kentucky Model Procurement Laws." Full affidavit can be found here: https://pageonekentucky.com/2016/02/23/juicy-affidavit-hits-in-uk-kmsf-case/

Of course then there is the Dr. Kearney case wherein Dr. Kearney challenged an aspect of the financial management practices of KMSF, and shortly after the General Council of the university, acting on behalf of the University President, has done and continues to do everything in his power to destroy Dr. Kearney's career.

Finally, there is the outright refusal by the General Council, again by definition acting on behalf of the President of the University, refusing to obey the directive of the state's Attorney General to release open records, as well as blocking any public audit of the financial activities in KMSF, an organization he is claiming is not part of the university but as the University General Council has been actively litigating for.

The bottom line being, there is more than just smoke here, there are actual flames. It is unfortunate that this University chooses to cover it up rather than admit to it, pay the price and move on. Personally, I think what really needs to happen is for the University President to realize that his job here is more than simply handing out diplomas.

6/5/2016 11:44:50 am

Thanks The Mole for your comment and information. Your perspectives sound very informed and they are definitely welcomed. As I note above though, this Hazard thing, whether it be incompetence or something more, is simply one more suggestion that the administration governing KMSF activities is either totally incompetent or something more.

6/5/2016 01:05:53 pm

To go a little further, I know that the providers involved in the UKHC ARH partnership entered into it with a lot of hope that the arrangement would improve access to and quality of healthcare available to people in an undeserved part of The State. Now of course some people (possibly with the initials MK) may have had the idea that this would be a way to generate referrals for high value procedures at UK.

But, since this is the place for conspiracy theories you do all realize that Joe Craft comes from Hazard and personally gave substantial funds for a $47M tower at ARH in Hazard. And given Mr Coal, I mean Craft's, value to UK (particularly UK Athletics) and position of power and influence you don't seriously think that there wasn't a good faith effort to make this arrangement work for the benefit of everyone.

What Mark Randall said in his email is basically true. UKHC/KMSF screwed up the billing and records. Due to the incompetence of UK and UK's lawyers (a topic that you all enjoy piling onto around here) an outside legal expert was consulted to evaluate the legal liability towards both the ARH group and Medicaid/Medicare. My understanding is that the outside counsel make it clear what documentation would be needed to substantiate everything. UKHC/KMSF could not produce that so the decision was made to forego the funds.

The terms of the separation with ARH would be interesting. Obviously in addition to getting their stuff back these people were being paid (a lot).

Now, it may be that all this is relevant to the Kearney Case, not because UKHC/KMSF have anything to hide, but rather because they are so incompetent that they have no confidence their records and accounts will stand scrutiny and this is why they are so resistant to opening the books.

6/5/2016 01:54:43 pm

Thanks once again The Mole for this information. You are obviously well informed in this area and I thank you for sharing your insights. I am not sure that it really matters whether they are attempting to block access to records because of incompetency issues, legal issues or personal issues. The fact that they are willing to defy the state's Attorney General to prevent this from happening strongly suggests it needs to happen. The original concern that motivated all of this had nothing to do with this Hazard hazard. The records requested had to do with the information pertaining to the Practice Plan Committee and information on the University of Kentucky Healthcare Compensation Planning Committee meeting minutes. It just seems that the farther we travel down this road the more accidents we run into.

Norman

6/5/2016 02:31:36 pm

Actually, they aren't defying the Attorney General...yet. In regards to the Hazard issue, UK is defying the Lexington Herald Leader...and they will likely file a complaint with the AG and we will have to see what the AG has to say...

Frankly, I can't blame UK. The Herald Leader like most local newspapers has an axe to grind with the major employers in their region as if they find something bad, it's good publicity for the paper.

6/5/2016 04:04:00 pm

All that you will find from the healthcare compensation and practice plan committee records (if they exist) is that some people are getting paid an eye watering amount and that there is no relationship between what people do, how hard they work, how good they are at their job and what they get paid. The lack of oversight was so that Karpf, Moliterno and DeBeer could just pay people whatever they wanted without having to justify it to anyone or even show it to anyone. This is exactly the same as what goes on with the non clinical faculty except that when they want to pay people more they give them administrative assignments or just appoint them in clinical departments so that the disparities are less obvious.

Does this involve breaking any actual federal or state laws? I doubt it. Is it fair or in the best interests of the university. Unquestionably not.

Inside Man

6/8/2016 04:55:03 pm

Speaking directly to the purchase of the Hazard ARH Cardiology Practice. 1. UK already has a substantial presence there. 2. The referrals always came to UK. So why buy the practice? Follow the money. 3. Here is the stunner. Prior to purchase, the Hazard Cardiology books were reviewed in 2012. The advice of the consultant was not to purchase the practice due to some billing issues. UK went ahead with the purchase in 2013 despite the warning. President Capilouto was aware of the billing issue PRIOR TO THE PURCHASE! 4. A billing and a coding audit was done by UKHealthcare (that includes KMSF) and the results showed over-billing based on documentation provided. THEY BURIED THE AUDIT. MK then flies to Hazard in his KMSF leased plane to compliment the Hazard Cardiologists on their work. 5. It was not until an ORR for the audit was made, that UK ponied up the $$$ and paid a Washington lawyer 1 million to get them out of trouble. What Douglas, Birdwhistle, and Randall have stated is spin BS. Stay tuned.

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